Department of Pediatrics and Medicine, Johns Hopkins University School of Medicine, Baltimore MD, USA.
J Clin Sleep Med. 2009 Aug 15;5(4):317-23.
A high proportion of children with Down syndrome (DS) have the obstructive sleep apnea syndrome (OSAS). Although adults with DS have many predisposing factors for OSAS, this population has not been well studied. We hypothesized that OSAS is common in adults with DS, and that the severity of OSAS is worse in DS adults who are more obese.
Cohort study.
Sleep laboratory.
16 adults with DS underwent evaluation for sleep disordered breathing.
Polysomnographic results were compared to a retrospective sample of adult patients referred for clinically suspected OSAS.
Polysomnograms were abnormal in 94% of DS subjects. The median apnea hypopnea index (AHI) was 37/h (range 0-118). The median arterial oxygen saturation nadir was 75% (23% to 95%), and the median peak end-tidal CO2 was 58 (47-66) mm Hg. There was a significant correlation between body mass index and AHI (r = 0.53, p < 0.05). Sixty-three percent had an Epworth score > 10. The AHI and saturation nadir were significantly worse in DS than non-DS patients.
Adults with DS frequently have OSAS, with obstructive apnea, hypoxemia, hypoventilation, and sleep fragmentation. The severity of OSAS correlated with obesity. We speculate that the complications of untreated OSAS (cardiovascular disease, increased mortality, and neurobehavioral morbidities including daytime sleepiness and impaired cognitive function) commonly overlap with the manifestations of DS and therefore may not elicit a prompt investigation in these patients. We speculate that OSAS is an important, but potentially treatable, cause of morbidity in adults with DS.
唐氏综合征（DS）患儿中有很大一部分患有阻塞性睡眠呼吸暂停综合征（OSAS）。尽管 DS 成人有许多发生 OSAS 的易感因素，但该人群尚未得到充分研究。我们假设 OSAS 在 DS 成人中很常见，并且肥胖程度更高的 DS 成人 OSAS 严重程度更差。
队列研究。
睡眠实验室。
16 名患有 DS 的成年人接受了睡眠呼吸障碍评估。
将多导睡眠图结果与因临床疑似 OSAS 而转介的成人患者的回顾性样本进行比较。
94%的 DS 受试者多导睡眠图异常。中位呼吸暂停低通气指数（AHI）为 37/h（范围 0-118）。中位动脉血氧饱和度最低为 75%（23%-95%），中位呼气末二氧化碳峰值为 58（47-66）mmHg。体重指数与 AHI 呈显著相关性（r=0.53，p<0.05）。63%的人 Epworth 评分>10。DS 患者的 AHI 和饱和度最低均明显差于非 DS 患者。
患有 DS 的成年人经常患有 OSAS，表现为阻塞性呼吸暂停、低氧血症、低通气和睡眠片段化。OSAS 的严重程度与肥胖相关。我们推测，未经治疗的 OSAS 的并发症（心血管疾病、死亡率增加以及包括日间嗜睡和认知功能受损在内的神经行为学疾病）通常与 DS 的表现重叠，因此这些患者可能不会引起及时的调查。我们推测，OSAS 是 DS 成人发病和致残的一个重要但潜在可治疗的原因。
