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Severe OSA More Prevalent In Adults With Down Syndrome Than Previously Thought Westchester, Ill -- August 17, 2009 -- A study published in the August 15 issue of the Journal of Clinical Sleep Medicine shows that adults with Down syndrome frequently suffer from severe obstructive sleep apnoea (OSA) -- more than previously thought. However, the complications of untreated OSA such as cardiovascular disease, daytime sleepiness, and impaired cognitive functioning overlap with the manifestations of Down syndrome; therefore, OSA may not be detected. Results indicate that 94% of individuals with Down syndrome had OSA; 88% had at least moderate OSA with an apnoea-hyperpnoea index (AHI) of more than 15 breathing pauses per hour of sleep; and 69% had severe OSA with an AHI of more than 30. Twelve of the 16 individuals with Down syndrome were obese, and there was a significant correlation between body mass index (BMI) and AHI. Total sleep time in patients with Down syndrome (307 minutes) was more than an hour less than in controls (380 minutes). Despite the severity of OSA in the study group, medical evaluation had been sought in only 1 case. According to senior author Carole Marcus, University of Pennsylvania and the Children’s Hospital of Philadelphia Sleep Center, Philadelphia, Pennsylvania, it is well known that children with Down syndrome are at risk for OSA, with a prevalence of 30% to 55%, and adults with Down syndrome have even more predisposing factors for OSA than children, as they still have the craniofacial anomalies and are more likely to be obese or hypothyroid. “Patients with Down syndrome have a great deal of risk factors for OSA (based on their narrow midface, large tongue, floppy muscle tone, tendency towards being overweight, and thyroid disease),” said Marcus. “However, the fact that almost all of the subjects studied had OSA was a much higher prevalence than we expected. It was surprising how severe the illness was, and how the OSA was unsuspected by their caregivers.” The authors suggested that obesity, a common and potentially treatable problem in Down syndrome, appears to play an important role in the pathophysiology of OSA in this population. SOURCE: American Academy of Sleep Medicine E-mail this page to a friend or colleague! To print, use this version