Kim Rebecca, Teng Arthur, Soma Marlene
School of Clinical Medicine, Women's Health Paediatrics and Child Health, University of New South Wales, Sydney, NSW, Australia.
Department of Sleep Medicine, Sydney Children's Hospital, Sydney, NSW, Australia.
Ann Otol Rhinol Laryngol. 2025 May;134(5):332-340. doi: 10.1177/00034894241309213. Epub 2025 Jan 3.
The prevalence of obstructive sleep apnea (OSA) is known to be higher in children with Down syndrome (DS) than the general pediatric population, with lower rates of surgical cure. This study aims to determine the prevalence and predictors of OSA and evaluate the outcomes of surgical intervention for OSA in a cohort of Australian children with DS.
A retrospective chart review was conducted on 156 patients with DS from 0 to 18 years who had undergone overnight, attended polysomnography (PSG) at Sydney Children's Hospital from January 2010 to July 2023. Logistic regression was used to assess associations between OSA and age, gender, body mass index (BMI), and tonsillar size. The outcomes of surgery were determined by comparing the pre-operative and post-operative PSG results.
The prevalence of OSA at first PSG was 65.8%, defined by an obstructive apnea-hypopnea index (OAHI) ≥1 event/hour. Elevated BMI in children above 2 years was associated with the presence of OSA (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.02-1.71). Male gender was a predictor for an OAHI >5 events/hour (OR = 4.01, 95% CI = 1.09-14.78). Among 35 patients who underwent adenotonsillectomy and had a valid pre-operative and post-operative PSG, median OAHI was reduced from 12.6 to 3.8 events/hour ( = .002). In 13 patients who had secondary upper airway surgery, median OAHI was reduced from 8.5 to 2.6 events/hour ( = .075).
Children with DS and OSA who undergo surgical intervention may experience improvements to their PSG parameters.
已知唐氏综合征（DS）患儿阻塞性睡眠呼吸暂停（OSA）的患病率高于普通儿科人群，手术治愈率较低。本研究旨在确定澳大利亚DS患儿队列中OSA的患病率和预测因素，并评估OSA手术干预的结果。
对2010年1月至2023年7月在悉尼儿童医院接受过夜多导睡眠图（PSG）检查的156例0至18岁DS患者进行回顾性病历审查。采用逻辑回归分析评估OSA与年龄、性别、体重指数（BMI）和扁桃体大小之间的关联。通过比较术前和术后PSG结果来确定手术效果。
首次PSG检查时OSA的患病率为65.8%，定义为阻塞性呼吸暂停低通气指数（OAHI）≥1次/小时。2岁以上儿童BMI升高与OSA的存在相关（优势比[OR]=1.32；95%置信区间[CI]=1.02-1.71）。男性是OAHI>5次/小时的预测因素（OR=4.01，95%CI=1.09-14.78）。在35例行腺样体扁桃体切除术且术前和术后PSG有效的患者中，OAHI中位数从12.6降至3.8次/小时（P=.002）。在13例行二次上气道手术的患者中，OAHI中位数从8.5降至2.6次/小时（P=.075）。
接受手术干预的DS合并OSA患儿的PSG参数可能会有所改善。
