Early detection and treatment of obstructive sleep apnoea in infants with Down syndrome: a prospective, non-randomised, controlled, interventional study.

BACKGROUND

Infants with Down syndrome (DS) are at high risk of obstructive sleep apnoea (OSA) which is associated with neurocognitive dysfunction and behaviour problems. The aim of our study was to evaluate the effect of early OSA treatment in infants with DS on neurocognitive development and behaviour.

METHODS

In this prospective, interventional, non-randomised study, 40 infants with DS underwent polysomnography (PSG) every 6 months in room air between 6 and 36 months of age () and were compared to a control group of 40 infants with DS receiving standard of care and a single, systematic PSG in room air at 36 months of age (). When present, OSA was treated. The primary endpoint was the total score of the Griffiths Scales of Child Development, Third Edition (Griffiths III) and its subscores at 36 months. Secondary endpoints included a battery of neurocognitive and behaviour questionnaires, and PSG outcomes.

FINDINGS

On the Griffiths III, the total score was significantly higher in the compared to the (difference: 4.1; 95%CI: 1.3; 7.6; p = 0.009). Results in Griffiths III subscores and secondary endpoints were in support of better neurocognitive outcomes in the compared with the At 36 months, median (Q1; Q3) apnoea-hypopnea index was higher in the (4.0 [1.5; 9.0] events/hour) compared to the (1.0 [1.0; 3.0] events/hour, p = 0.006). Moderate and severe OSA were more frequent in the as compared to the (18.9% versus 3.7% for moderate OSA and 27.0% versus 7.4% for severe OSA).

INTERPRETATION

Early diagnosis and treatment of OSA in infants with DS may contribute to a significantly better neurocognitive outcome and behaviour at the age of 36 months.

FUNDING

The study was funded by the Jérôme Lejeune Foundation.