0767 Outcomes Of Various Interventions For Sleep Disordered Breathing In Infants With Down Syndrome. (27th April 2018)

• Record Type: Journal Article
• Authors: Jalou, H; Bandyopadhyay, A; Chauhan, D; Slaven, J E; Harmon, H M; Matt, B H; Daftary, A S
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A285
• Page End: A285
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.766
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Children with Down Syndrome (DS) have a higher rate of sleep disordered breathing: (SDB). Polysomnography (PSG) is the gold standard test to monitor SDB. First-line treatment for SDB in the pediatric population remains adenotonsillectomy, but studies have shown varied results for reduction in Apnea Hypopnea Index (AHI) in patients with DS. The aim of this study was to describe and compare the treatment outcomes of SDB in DS infants. Methods: A retrospective chart review was performed on DS patients who were admitted and underwent PSG from 2005–2015 at Riley Hospital in the first year of life, followed by intervention (surgery or oxygen) and a second PSG to assess the intervention results. Patients were excluded if they were diagnosed with cyanotic congenital heart disease, congestive heart failure, hypoxic-ischemic encephalopathy, neonatal seizures or myelomeningocele. Data were collected on demographics, comorbidities and PSG parameters including (AHI), hypoxia (cumulative sleep time <90% saturation of, and hypoventilation (end-tidal carbon dioxide (ETCO2) > 45 mmHg for). Both PSGs were performed in room air. Results: Of the 206 DS infants screened, 41 patients (Male=26, 63.4%) were eligible. Interventions were supplemental oxygen (n=21) and surgical interventions (n=20), such as tonsillectomy, adenoidectomy, and tracheostomy. Median age at first PSG was 49 days (range: 0 - 340). Regression analyses did not show any significant effect of birth gestational age, birth weight, oromotor dysfunction, or duration between PSGs on the change in AHI, hypoxia, or hypoventilation with time. Statistically significant reduction in the apnea hypopnea index (AHI) occurred in both in the oxygen (95% CI: (-27.12, -1.13); p=0.049) and surgical (95% CI: (-19.25, -7.07); p=0.002) therapy groups over time. We saw no statistical difference in AHI (P=0.931) or hypoxia (p=0.861) between the two groups. Conclusion: A significant decrease in AHI occurred in both the surgical intervention and oxygen therapy groups. No significant difference between the two groups was seen. Larger randomized controlled studies are needed to determine the effect of interventions on AHI, hypoxia, and hypoventilation in infants with DS and SDB. Support (If Any):