Department of Pediatrics, University of Louisville and Norton Children Medical Group, 9880 Angies Way Suite 300, Louisville, KY, 40241, USA.
Bioinformatics & Biostatistics, University of Louisville, Louisville, KY, USA.
Sleep Breath. 2024 Mar;28(1):251-260. doi: 10.1007/s11325-023-02900-6. Epub 2023 Aug 10.
Children with Down Syndrome (DS) have a high prevalence of obstructive sleep apnea (OSA). We aimed to assess OSA prevalence in a single center cohort of children with DS, identify associated risk factors of obstructive respiratory events, and examine the influence of different sleep stages and body positions on respiratory events distribution.
Single center retrospective study that included children with DS who underwent overnight polysomnogram (PSG). OSA severity was categorized by obstructive apnea-hypopnea index (OAHI) as mild (1.5-4.9 events/h), moderate (5-9.9 events/h), and severe (≥ 10 events/h). A logistic regression analysis was used to examine the association between OSA-related risk factors in normal and abnormal OAHI category and in REM and Non-REM predominant AHI groups.
PSG data were available for 192 children with a median age of 5 years (IQR 7). OSA prevalence was 82.3% (27.1% mild, 19.8% moderate, and 35.4% severe). A logistic regression model identified BMI and being an African American as significant predictors for OAHI severity. In children with OSA, the median OAHI was 7.6 and obstructive respiratory events were more common in REM sleep and in the supine position. The median REM OAHI was 20 events/h (IQR: 24.4), whereas the median Non-REM OAHI was 5.2 events/h (IQR: 12.6 p < 0.0001). Similarly, supine OAHI was 11.6 (IQR: 19.3) and off supine OAHI was 6.6 (IQR: 11.6, p = 0.0004). Age was a significant predictor (p = 0.012) for Non-REM predominant OSA which was present in 15.2% of children with OSA.
Children with DS have a high prevalence of OSA. Higher BMI and being an African American were significant associated risk factors for higher OAHI. Obstructive respiratory events in children with DS occur predominantly in REM sleep and in the supine position. Non-REM predominant distribution of respiratory events was noted in older children with DS.
唐氏综合征（DS）患儿阻塞性睡眠呼吸暂停（OSA）的患病率较高。本研究旨在评估单中心 DS 患儿队列的 OSA 患病率，确定阻塞性呼吸事件的相关危险因素，并检查不同睡眠阶段和体位对呼吸事件分布的影响。
本研究为单中心回顾性研究，纳入接受过夜多导睡眠图（PSG）检查的 DS 患儿。根据阻塞性呼吸暂停低通气指数（OAHI）将 OSA 严重程度分为轻度（1.5-4.9 次/小时）、中度（5-9.9 次/小时）和重度（≥10 次/小时）。采用逻辑回归分析，评估正常和异常 OAHI 分类以及 REM 和非 REM 为主的 AHI 组中与 OSA 相关的危险因素之间的相关性。
192 例患儿的 PSG 数据可用，中位年龄为 5 岁（IQR 7）。OSA 患病率为 82.3%（27.1%轻度、19.8%中度和 35.4%重度）。逻辑回归模型确定 BMI 和非裔美国人身份是 OAHI 严重程度的显著预测因素。在 OSA 患儿中，中位 OAHI 为 7.6， REM 睡眠和仰卧位时阻塞性呼吸事件更为常见。中位 REM OAHI 为 20 次/小时（IQR：24.4），而非 REM OAHI 为 5.2 次/小时（IQR：12.6，p<0.0001）。同样，仰卧位 OAHI 为 11.6（IQR：19.3），非仰卧位 OAHI 为 6.6（IQR：11.6，p=0.0004）。年龄是 REM 为主的 OSA 的显著预测因素（p=0.012），15.2%的 OSA 患儿存在这种情况。
DS 患儿 OSA 患病率较高。较高的 BMI 和非裔美国人身份是 OAHI 较高的显著相关危险因素。DS 患儿的阻塞性呼吸事件主要发生在 REM 睡眠和仰卧位。在年龄较大的 DS 患儿中，出现以非 REM 为主的呼吸事件分布。
