Obstructive Sleep Apnoea (OSA) in Children and Adults with DS

Down syndrome is a genetic problem which starts at birth. One of the consequences of having Down Syndrome is obstructive sleep apnoea. An article from https://www.dsrf.org/blog/dsrf_blog offers several insights regarding these two disorders.

• Obstructive Sleep Apnoea (OSA) is defined by sleep abnormalities that consist of complete and partial upper airway obstruction during sleep, a reduction in the amount of air entering the lungs with an abnormally high level of carbon dioxide in the blood, and oxygen loss.

• Children and adults with Down syndrome (DS) are more susceptible to obstructive sleep apnoea because their upper airway tissues tend to be larger and more crowded. Their flattened mid-face, narrowed nasopharyngeal area, low tone of the muscles of the upper airway, enlarged adenoids and/or tonsils puts them at high risk for OSA.

• Some symptoms that you could observe if you suspect that someone has sleep apnoea are: snoring, witnessed gasping or choking, frequent night-time awakenings, restless sleep or sleep with head in unusual positions, night sweats, excessive daytime sleepiness, irritability and/or hyper-activity, and dry mouth issues.

• Parents may not notice symptoms or they may be in doubt about them. The research literature reports poor correlation between parent reports of symptoms and the results of sleep apnoea testing in people with DS.

• OSA can also cause detrimental effects to our bodily functions by decreasing the amount of oxygen available to our vital organs and increasing carbon dioxide in the blood. Damage to the brain can occur, and the low blood oxygenation can cause an increase in the blood pressure in the lungs as the body tries to get more oxygen. This is called pulmonary hypertension and can cause the right side of the heart to become enlarged as well as other cardiac complications.

• The best way to diagnose sleep apnoea is a sleep study. Sleep is monitored using different parameters such as heart rate, ECG, blood pressure, oxygen levels, airway obstructions, periodic limb movements and brain waves.

• For adults, a sleep study monitor can be provided in the community so that it can be worn in the comfort of their home. It will measure heart rate, oxygen levels, airway obstructions, chest expansion and abnormal breathing patterns. A recommendation for this sleep study can be made to a Respiratory Therapist by a family physician.

• Continuous positive airway pressure (CPAP) is usually the treatment of choice and is tolerated by children and adults with DS very well. It involves wearing a nasal mask which is attached to a CPAP machine during sleep. The CPAP machine outputs air through the mask at a desired pressure to keep the airway open and prevent snoring from occurring.

• Surgery is another form of treatment and is often done for children. Soft airway tissues such as the adenoid, tonsils and/or soft palate may be surgically removed to open the airway.

• Dentists and orthodontists can also evaluate options for oral appliances to see if upper airways can be opened through jaw positioning devices.

Read more here:

https://www.dsrf.org/blog/dsrf_blog/obstructive-sleep-apnoea--osa--in-children-and-adults-with-down-syndrome-911

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