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Open AccessArticle

Sleep Apnea and Hypoventilation in Patients with Down Syndrome: Analysis of 144 Polysomnogram Studies

Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Department of Mathematics and Statistics, University of Nevada, Reno, NV 89503, USA
Biostatistics and Computational Biology, National Institute of Environmental Sciences, Research Triangle Park, NC 27709, USA
Author to whom correspondence should be addressed.
Academic Editor: Sari A. Acra
Children 2017, 4(7), 55;
Received: 16 May 2017 / Revised: 20 June 2017 / Accepted: 27 June 2017 / Published: 30 June 2017
(This article belongs to the Section Child Neurology)
PDF [589 KB, uploaded 5 July 2017]


Patients with Down syndrome (DS) are at risk for both obstructive sleep apnea (OSA) and central sleep apnea (CSA); however, it is unclear how these components evolve as patients age and whether patients are also at risk for hypoventilation. A retrospective review of 144 diagnostic polysomnograms (PSG) in a tertiary care facility over 10 years was conducted. Descriptive data and exploratory correlation analyses were performed. Sleep disordered breathing was common (seen in 78% of patients) with an average apnea-hypopnea index (AHI) = 10. The relative amount of obstructive apnea was positively correlated with age and body mass index (BMI). The relative amount of central sleep apnea was associated with younger age in the very youngest group (0–3 years). Hypoventilation was common occurring in more than 22% of patients and there was a positive correlation between the maximum CO2 and BMI. Sleep disordered breathing, including hypoventilation, was common in patients with DS. The obstructive component increased significantly with age and BMI, while the central component occurred most in the very young age group. Due to the high risk of hypoventilation, which has not been previously highlighted, it may be helpful to consider therapies to target both apnea and hypoventilation in this population. View Full-Text
Keywords: Down syndrome; hypoventilation; sleep apnea and sleep disordered breathing Down syndrome; hypoventilation; sleep apnea and sleep disordered breathing

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Fan, Z.; Ahn, M.; Roth, H.L.; Li, L.; Vaughn, B.V. Sleep Apnea and Hypoventilation in Patients with Down Syndrome: Analysis of 144 Polysomnogram Studies. Children 2017, 4, 55.

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