A comprehensive evaluation of obstructive sleep apnoea (OSA) may allow for the development of more efficient management of Down syndrome (DS). We aimed to evaluate the effect of a multidisciplinary approach to DS with OSA. A total of 48 DS children aged 4–12 years were prospectively investigated with nasal endoscopy, orthodontic examination, and overnight polygraphy (PG); the Italian Child Sleep Habits Questionnaire (CSHQ-IT) was filled out by the mothers. The total CSHQ-IT score was 63 (96% of children reporting sleep problems). The major ear, nose, and throat characteristics were enlarged palatine tonsils (62%), adenoid tonsils (85%), and chronic rhinosinusitis (85%). DS children showed orthognathic profile in 68% of cases, class I relationship in 63%, and cross-bite in 51%. PG revealed OSA in 67% of cases (37% mild, 63% moderate–severe). The oxygen desaturation index (ODI) was higher in the group with OSA (5.2) than with non-OSA (1.3; p < 0.001). The ODI was higher (p = 0.001) and SpO2 lower (p = 0.03) in children with moderate–severe OSA than with mild OSA. The apnoea–hypopnea index (AHI) and percentage time with SpO2 < 90% were higher in DS children with grade III than with grade I or II adenoids (5 vs. 1, p = 0.04, and 1.2 vs. 0.1, p = 0.01, respectively). No significant correlations were found between PG and the total CSHQ-IT score or orthodontic data. However, children showing associated cross-bite, grade III adenoids and size 3 or 4 palatine tonsils showed higher AHI and ODI than those without (p = 0.01 and p = 0.04, respectively). A coordinated multidisciplinary approach with overnight PG is a valuable tool when developing diagnostic protocols for OSA in DS.

Obstructive Sleep Apnoea in Children with Down Syndrome: A Multidisciplinary Approach / Borrelli, Melissa; Corcione, Adele; Rongo, Roberto; Cantone, Elena; Scala, Iris; Bruzzese, Dario; Martina, Stefano; Strisciuglio, Pietro; Michelotti, Ambrosina; Santamaria, Francesca. - In: JOURNAL OF PERSONALIZED MEDICINE. - ISSN 2075-4426. - 13:1(2023), pp. 71-84. [10.3390/jpm13010071]

Obstructive Sleep Apnoea in Children with Down Syndrome: A Multidisciplinary Approach

Borrelli, Melissa
Primo
;
Corcione, Adele;Rongo, Roberto;Cantone, Elena;Scala, Iris;Bruzzese, Dario;Martina, Stefano;Strisciuglio, Pietro;Michelotti, Ambrosina;Santamaria, Francesca
Ultimo
Supervision
2023

Abstract

A comprehensive evaluation of obstructive sleep apnoea (OSA) may allow for the development of more efficient management of Down syndrome (DS). We aimed to evaluate the effect of a multidisciplinary approach to DS with OSA. A total of 48 DS children aged 4–12 years were prospectively investigated with nasal endoscopy, orthodontic examination, and overnight polygraphy (PG); the Italian Child Sleep Habits Questionnaire (CSHQ-IT) was filled out by the mothers. The total CSHQ-IT score was 63 (96% of children reporting sleep problems). The major ear, nose, and throat characteristics were enlarged palatine tonsils (62%), adenoid tonsils (85%), and chronic rhinosinusitis (85%). DS children showed orthognathic profile in 68% of cases, class I relationship in 63%, and cross-bite in 51%. PG revealed OSA in 67% of cases (37% mild, 63% moderate–severe). The oxygen desaturation index (ODI) was higher in the group with OSA (5.2) than with non-OSA (1.3; p < 0.001). The ODI was higher (p = 0.001) and SpO2 lower (p = 0.03) in children with moderate–severe OSA than with mild OSA. The apnoea–hypopnea index (AHI) and percentage time with SpO2 < 90% were higher in DS children with grade III than with grade I or II adenoids (5 vs. 1, p = 0.04, and 1.2 vs. 0.1, p = 0.01, respectively). No significant correlations were found between PG and the total CSHQ-IT score or orthodontic data. However, children showing associated cross-bite, grade III adenoids and size 3 or 4 palatine tonsils showed higher AHI and ODI than those without (p = 0.01 and p = 0.04, respectively). A coordinated multidisciplinary approach with overnight PG is a valuable tool when developing diagnostic protocols for OSA in DS.
2023
Obstructive Sleep Apnoea in Children with Down Syndrome: A Multidisciplinary Approach / Borrelli, Melissa; Corcione, Adele; Rongo, Roberto; Cantone, Elena; Scala, Iris; Bruzzese, Dario; Martina, Stefano; Strisciuglio, Pietro; Michelotti, Ambrosina; Santamaria, Francesca. - In: JOURNAL OF PERSONALIZED MEDICINE. - ISSN 2075-4426. - 13:1(2023), pp. 71-84. [10.3390/jpm13010071]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/915684
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