PT  - JOURNAL ARTICLE
AU  - Jasneek Chawla
AU  - Caitlin Forwood
AU  - Helen Heussler
TI  - CPAP to treat obstructive sleep apnoea (OSA) in children with Down syndrome (DS)
AID  - 10.1183/13993003.congress-2016.PA3066
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA3066
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA3066.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA3066.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: Children with Down Syndrome (DS) are at risk of obstructive sleep apnoea (OSA), with a prevalence of 45-79% (de Miguel-Diez et al. Sleep 2003;26(8):1006-9). Treatment protocols using continuous positive airway pressure (CPAP) for OSA in DS are not dissimilar to the general population.AIM: To evaluate the experience at our institution using CPAP to treat OSA in children with DSMethods: A retrospective review of clinical data for children with DS in whom CPAP therapy was started between 2000-2012 was undertaken.Results: 156 patients with DS had polysomnography (PSG) during this period. 25(16%) children with DS were commenced on CPAP. The mean age at initiation was 8.4yrs (0-17yr). PSG information was available for 16/25 patients(64%) and the mean obstructive apnoea hypopnoea index (OAHI) was 23/hr(2.5-51.2/hr). Titration of CPAP failed in only 3 patients, 2 of who were later re-trialled successfully. Amongst those continuing treatment at home, sustained usage was “poor” (<4hr/day) in 11 children(46%) and was discontinued in 5. 3 children had “moderate” usage(4-6hrs/night) but continued on therapy due to reported clinical improvement. Of the 10 patients with “good” usage(>6hr/day), 7 transitioned to adult services, 2 improved and discontinued therapy and 1 required escalation to bi-level.Conclusions: CPAP therapy was recommended to treat OSA in a significant proportion of children with DS at our institution over a 12yr period. Only just over 50% of these patients sustained therapy at acceptable levels. This study highlights that CPAP therapy is challenging in this population. Further studies are required to determine if specific interventions or management strategies can improve outcomes.