Obstructive sleep apnea in patients with Down syndrome: current perspectives

Ryne Simpson,1 Anthony A Oyekan,2 Zarmina Ehsan,1,2 David G Ingram1,2 1Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO, USA; 2School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA Abstract: For individuals with Down syndrome (DS), obstructive sle...

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Autores principales:	Simpson R, Oyekan AA, Ehsan Z, Ingram DG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Sleep-disordered breathing pediatric adenotonsillectomy polysomnography positive airway pressure drug-induced sleep endoscopy Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/0f46343bcb6d4267a43605c1f08b9081
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spelling	oai:doaj.org-article:0f46343bcb6d4267a43605c1f08b90812021-12-02T01:43:47ZObstructive sleep apnea in patients with Down syndrome: current perspectives1179-1608https://doaj.org/article/0f46343bcb6d4267a43605c1f08b90812018-09-01T00:00:00Zhttps://www.dovepress.com/obstructive-sleep-apnea-in-patients-with-down-syndrome-current-perspec-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Ryne Simpson,1 Anthony A Oyekan,2 Zarmina Ehsan,1,2 David G Ingram1,2 1Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO, USA; 2School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA Abstract: For individuals with Down syndrome (DS), obstructive sleep apnea (OSA) is a complex disorder with significant clinical consequences. OSA is seen frequently in DS, and when present, it tends to be more severe. This increased prevalence is likely related to common anatomic abnormalities and a greater risk of additional comorbidities such as hypotonia and obesity. Because signs and symptoms do not often correlate with disease, all children and adults with DS should receive routine screening for OSA. Similar to the general population, polysomnography remains the gold standard for diagnosis. Because individuals with DS may be more susceptible to cardiovascular and neurocognitive sequelae, early diagnosis and treatment of OSA is becoming increasingly important. Treatment options generally involve upper airway surgery (primarily adenotonsillectomy) and continuous positive airway pressure (CPAP); however, various adjunctive therapies including intranasal steroids, palatal expansion, and oropharyngeal exercises are also available. Residual disease status post adenotonsillectomy is common, and further evaluation (eg, drug-induced sleep endoscopy [DISE]) is often needed. More advanced and directed airway surgery can be performed if additional sites of obstruction are observed. Novel therapies including hypoglossal nerve stimulation are emerging as effective treatments for refractory OSA. Due to the diversity among individuals with DS, personalized treatment plans should be developed. Within this arena, opportunities for research remain abundant and should include areas involving patient risk factors, alternative diagnostic methods, and outcome analysis. Keywords: sleep-disordered breathing, pediatric, adenotonsillectomy, polysomnography, positive airway pressure, drug-induced sleep endoscopySimpson ROyekan AAEhsan ZIngram DGDove Medical PressarticleSleep-disordered breathingpediatricadenotonsillectomypolysomnographypositive airway pressuredrug-induced sleep endoscopyPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 10, Pp 287-293 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sleep-disordered breathing pediatric adenotonsillectomy polysomnography positive airway pressure drug-induced sleep endoscopy Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Sleep-disordered breathing pediatric adenotonsillectomy polysomnography positive airway pressure drug-induced sleep endoscopy Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Simpson R Oyekan AA Ehsan Z Ingram DG Obstructive sleep apnea in patients with Down syndrome: current perspectives
description	Ryne Simpson,1 Anthony A Oyekan,2 Zarmina Ehsan,1,2 David G Ingram1,2 1Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO, USA; 2School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA Abstract: For individuals with Down syndrome (DS), obstructive sleep apnea (OSA) is a complex disorder with significant clinical consequences. OSA is seen frequently in DS, and when present, it tends to be more severe. This increased prevalence is likely related to common anatomic abnormalities and a greater risk of additional comorbidities such as hypotonia and obesity. Because signs and symptoms do not often correlate with disease, all children and adults with DS should receive routine screening for OSA. Similar to the general population, polysomnography remains the gold standard for diagnosis. Because individuals with DS may be more susceptible to cardiovascular and neurocognitive sequelae, early diagnosis and treatment of OSA is becoming increasingly important. Treatment options generally involve upper airway surgery (primarily adenotonsillectomy) and continuous positive airway pressure (CPAP); however, various adjunctive therapies including intranasal steroids, palatal expansion, and oropharyngeal exercises are also available. Residual disease status post adenotonsillectomy is common, and further evaluation (eg, drug-induced sleep endoscopy [DISE]) is often needed. More advanced and directed airway surgery can be performed if additional sites of obstruction are observed. Novel therapies including hypoglossal nerve stimulation are emerging as effective treatments for refractory OSA. Due to the diversity among individuals with DS, personalized treatment plans should be developed. Within this arena, opportunities for research remain abundant and should include areas involving patient risk factors, alternative diagnostic methods, and outcome analysis. Keywords: sleep-disordered breathing, pediatric, adenotonsillectomy, polysomnography, positive airway pressure, drug-induced sleep endoscopy
format	article
author	Simpson R Oyekan AA Ehsan Z Ingram DG
author_facet	Simpson R Oyekan AA Ehsan Z Ingram DG
author_sort	Simpson R
title	Obstructive sleep apnea in patients with Down syndrome: current perspectives
title_short	Obstructive sleep apnea in patients with Down syndrome: current perspectives
title_full	Obstructive sleep apnea in patients with Down syndrome: current perspectives
title_fullStr	Obstructive sleep apnea in patients with Down syndrome: current perspectives
title_full_unstemmed	Obstructive sleep apnea in patients with Down syndrome: current perspectives
title_sort	obstructive sleep apnea in patients with down syndrome: current perspectives
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/0f46343bcb6d4267a43605c1f08b9081
work_keys_str_mv	AT simpsonr obstructivesleepapneainpatientswithdownsyndromecurrentperspectives AT oyekanaa obstructivesleepapneainpatientswithdownsyndromecurrentperspectives AT ehsanz obstructivesleepapneainpatientswithdownsyndromecurrentperspectives AT ingramdg obstructivesleepapneainpatientswithdownsyndromecurrentperspectives
_version_	1718402881448574976

Obstructive sleep apnea in patients with Down syndrome: current perspectives

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