1. Home page
  2. Contents
  3. Obstructive Sleep Apnea Syndrome (OSAS)
  1. Home page
  2. Contents
  3. Obstructive Sleep Apnea Syndrome (OSAS)
Medical and paramedical


Obstructive Sleep Apnea Syndrome (OSAS)

Obstructive sleep apnea syndrome (OSAS) is the most frequent type of sleep-disordered breathing. OSAS is more prevalent and severe in patients with trisomy 21 than in the general population, both in children and in adults, among whom it affects more than 3 out of 4 people.


It has early onset and is diagnosed by the age of 5 years in 50% of cases. It is especially prevalent in infants aged less than 6 months. If untreated, OSAS is a major cause of morbidity, heart and cerebrovascular, metabolic, and neurocognitive problems, and alters quality of life. As a result, it is essential to diagnose it as early as possible.


In the video and accompanying technical sheet, Dr. Hervé Walti, a pediatrician at the Jérôme Lejeune Institute, explains OSAS in children and adults with trisomy 21.  He describes the risk factors, talks about the conditions and methods for diagnosis, discusses morbidity, and outlines current treatment and screening options.

    • Akkari M, Yildiz S, Marianowski R, Monteyrol PJ, Chalumeau F, Fayoux P, Leboulanger N, Franco P, Couloigner V, Mondain M. Role of the ENT specialist in the diagnosis of pediatric obstructive sleep apnea-hypopnea syndrome (POSAHS). Part 3: sleep recordings. Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Nov;137(5):405-410. doi: 10.1016/j.anorl.2020.02.001. Epub 2020 Feb 24. PMID: 32107171.
    • Akkina SR, Ma CC, Kirkham EM, Horn DL, Chen ML, Parikh SR. Does drug induced sleep endoscopy-directed surgery improve polysomnography measures in children with Down Syndrome and obstructive sleep apnea? Acta Otolaryngol. 2018 Nov;138(11):1009-1013. doi: 10.1080/00016489.2018.1504169. PMID: 30776267; PMCID: PMC6813773.
    • Alexander M, Petri H, Ding Y, Wandel C, Khwaja O, Foskett N. Morbidity and medication in a large population of individuals with Down syndrome compared to the general population. Dev Med Child Neurol. 2016 Mar;58(3):246-54. doi: 10.1111/dmcn.12868. Epub 2015 Aug 18. PMID: 26282180.
    • Alexiev F, Brill AK, Ott SR, Duss S, Schmidt M, Bassetti CL. Sleep-disordered breathing and stroke: chicken or egg? J Thorac Dis. 2018 Dec;10(Suppl 34):S4244-S4252. doi: 10.21037/jtd.2018.12.66. PMID: 30687540; PMCID: PMC6321898.
    • Alonso-Álvarez ML, Terán-Santos J, Ordax Carbajo E, Cordero-Guevara JA, Navazo-Egüia AI, Kheirandish-Gozal L, Gozal D. Reliability of home respiratory polygraphy for the diagnosis of sleep apnea in children. Chest. 2015 Apr;147(4):1020-1028. doi: 10.1378/chest.14-1959. PMID: 25539419; PMCID: PMC4388115.
    • Amaddeo A, Khirani S, Frapin A, Teng T, Griffon L, Fauroux B. High-flow nasal cannula for children not compliant with continuous positive airway pressure. Sleep Med. 2019 Nov;63:24-28. doi: 10.1016/j.sleep.2019.05.012. Epub 2019 Jun 6. PMID: 31604152.
    • Amaddeo A, Khirani S, Griffon L, Teng T, Lanzeray A, Fauroux B. Non-invasive Ventilation and CPAP Failure in Children and Indications for Invasive Ventilation. Front Pediatr. 2020 Oct 26;8:544921. doi: 10.3389/fped.2020.544921. PMID: 33194886; PMCID: PMC7649204.
    • Andreou G, Galanopoulou C, Gourgoulianis K, Karapetsas A, Molyvdas P. Cognitive status in Down syndrome individuals with sleep disordered breathing deficits (SDB). Brain Cogn. 2002 Oct;50(1):145-9.
    • Baker AB, Farhood Z, Brandstetter KA, Teufel RJ 2nd, LaRosa A, White DR. Tonsillectomy in Children with Down Syndrome: A National Cohort of Inpatients. Otolaryngol Head Neck Surg. 2017 Sep;157(3):499-503. doi: 10.1177/0194599817711377. Epub 2017 Aug 1. PMID: 28762292.
    • Bertapelli F, Pitetti K, Agiovlasitis S, Guerra-Junior G. Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review. Res Dev Disabil. 2016 Oct;57:181-92. doi: 10.1016/j.ridd.2016.06.018. Epub 2016 Jul 19. PMID: 27448331.
    • Blanc F, Kennel T, Merklen F, Blanchet C, Mondain M, Akkari M. Contribution of drug-induced sleep endoscopy to the management of pediatric obstructive sleep apnea/hypopnea syndrome. Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Nov;136(6):447-454. doi: 10.1016/j.anorl.2019.09.001. Epub 2019 Sep 16. PMID: 31537488.
    • Blanc F, Kennel T, Merklen F, Blanchet C, Mondain M, Akkari M. Contribution of drug-induced sleep endoscopy to the management of pediatric obstructive sleep apnea/hypopnea syndrome. Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Nov;136(6):447-454. doi: 10.1016/j.anorl.2019.09.001. Epub 2019 Sep 16. PMID: 31537488.
    • Breslin J, Spanò G, Bootzin R, Anand P, Nadel L, Edgin J. Obstructive sleep apnea syndrome and cognition in Down syndrome. Dev Med Child Neurol. 2014 Jul;56(7):657-64.
    • Brockmann PE, Damiani F, Nuñez F, Moya A, Pincheira E, Paul MA, Lizama M. Sleep-disordered breathing in children with Down syndrome: Usefulness of home polysomnography. Int J Pediatr Otorhinolaryngol. 2016 Apr;83:47-50. doi: 10.1016/j.ijporl.2016.01.030. Epub 2016 Feb 1. PMID: 26968052.
    • Brockmann PE, Perez JL, Moya A. Feasibility of unattended home polysomnography in children with sleep-disordered breathing. Int J Pediatr Otorhinolaryngol. 2013 Dec;77(12):1960-4. doi: 10.1016/j.ijporl.2013.09.011. Epub 2013 Sep 23. PMID: 24120158.
    • Bush D, Galambos C, Dunbar Ivy D. Pulmonary hypertension in children with Down syndrome. Pediatr Pulmonol. 2021 Mar;56(3):621-629. doi: 10.1002/ppul.24687. Epub 2020 Feb 12. PMID: 32049444.
    • Bush D, Galambos C, Ivy DD, Abman SH, Wolter-Warmerdam K, Hickey F. Clinical Characteristics and Risk Factors for Developing Pulmonary Hypertension in Children with Down Syndrome. J Pediatr. 2018 Nov;202:212-219.e2. doi: 10.1016/j.jpeds.2018.06.031. Epub 2018 Jul 17. PMID: 30025669.
    • Caloway CL, Diercks GR, Keamy D, de Guzman V, Soose R, Raol N, Shott SR, Ishman SL, Hartnick CJ. Update on hypoglossal nerve stimulation in children with down syndrome and obstructive sleep apnea. Laryngoscope. 2020 Apr;130(4):E263-E267. doi: 10.1002/lary.28138. Epub 2019 Jun 20. PMID: 31219619.
    • Camacho M, Chang ET, Song SA, Abdullatif J, Zaghi S, Pirelli P, Certal V, Guilleminault C. Rapid maxillary expansion for pediatric obstructive sleep apnea: A systematic review and meta-analysis. Laryngoscope. 2017 Jul;127(7):1712-1719. doi: 10.1002/lary.26352. Epub 2016 Oct 31. PMID: 27796040
    • Capone GT, Aidikoff JM, Taylor K, Rykiel N. Adolescents and young adults with Down syndrome presenting to a medical clinic with depression: co-morbid obstructive sleep apnea. Am J Med Genet A. 2013 Sep;161A(9):2188-96. doi: 10.1002/ajmg.a.36052. Epub 2013 Aug 2. PMID: 23913657.
    • Capone GT, Chicoine B, Bulova P, Stephens M, Hart S, Crissman B, Videlefsky A, Myers K, Roizen N, Esbensen A, Peterson M, Santoro S, Woodward J, Martin B, Smith D; Down Syndrome Medical Interest Group DSMIG-USA Adult Health Care Workgroup. Co-occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Am J Med Genet A. 2018 Jan;176(1):116-133. doi: 10.1002/ajmg.a.38512. Epub 2017 Nov 12. PMID: 29130597.
    • Carvalho AA, Amorim FF, Santana LA, de Almeida KJQ, Santana ANC, Neves FAR. STOP-Bang questionnaire should be used in all adults with Down Syndrome to screen for moderate to severe obstructive sleep apnea. PLoS One. 2020 May 8;15(5):e0232596. doi: 10.1371/journal.pone.0232596. PMID: 32384092; PMCID: PMC7209101.
    • Chamseddin BH, Johnson RF, Mitchell RB. Obstructive Sleep Apnea in Children with Down Syndrome: Demographic, Clinical, and Polysomnographic Features. Otolaryngol Head Neck Surg. 2019 Jan;160(1):150-157. doi: 10.1177/0194599818797308. Epub 2018 Aug 28. PMID: 30149781.
    • Chang CH, Chen SJ, Liu CY. Pediatric sleep apnea and depressive disorders risk: A population-based 15-year retrospective cohort study. PLoS One. 2017 Jul 14;12(7):e0181430. doi: 10.1371/journal.pone.0181430. PMID: 28708880; PMCID: PMC5510869.
    • Chen CC, Spanò G, Edgin JO. The impact of sleep disruption on executive function in Down syndrome. Res Dev Disabil. 2013 Jun;34(6):2033-9. doi: 10.1016/j.ridd.2013.03.009. Epub 2013 Apr 11. PMID: 23584183.
    • Chen J, He S. Drug-induced sleep endoscopy-directed adenotonsillectomy in pediatric obstructive sleep apnea with small tonsils. PLoS One. 2019 Feb 22;14(2):e0212317. doi: 10.1371/journal.pone.0212317. PMID: 30794596; PMCID: PMC6386441.
    • Choi EK, Jung E, Van Riper M, Lee YJ. Sleep problems in Korean children with Down syndrome and parental quality of life. J Intellect Disabil Res. 2019 Nov;63(11):1346-1358. doi: 10.1111/jir.12675. Epub 2019 Jul 28. PMID: 31353681.
    • Cho JH, Choi EK, Moon IK, Jung JH, Han KD, Choi YJ, Park J, Lee E, Lee SR, Cha MJ, Lim WH, Oh S. Chromosomal abnormalities and atrial fibrillation and ischemic stroke incidence: a nationwide population-based study. Sci Rep. 2020 Sep 28;10(1):15872. doi: 10.1038/s41598-020-72678-0. PMID: 32985552; PMCID: PMC7522243.
    • Chuang LC, Lian YC, Hervy-Auboiron M, Guilleminault C, Huang YS. Passive myofunctional therapy applied on children with obstructive sleep apnea: A 6-month follow-up. J Formos Med Assoc. 2017 Jul;116(7):536-541. doi: 10.1016/j.jfma.2016.08.002. Epub 2016 Oct 3. PMID: 27712960.
    • Chung J, Donelan K, Macklin EA, Schwartz A, Elsharkawi I, Torres A, Hsieh YG, Parker H, Lorenz S, Patsiogiannis V, Santoro SL, Wylie M, Clarke L, Estey G, Baker S, Bauer PE, Bull M, Chicoine B, Cullen S, Frey-Vogel A, Gallagher M, Hasan R, Lamb A, Majewski L, Mast J, Riddell T, Sepucha K, Skavlem M, Skotko BG. A randomized controlled trial of an online health tool about Down syndrome. Genet Med. 2021 Jan;23(1):163-173. doi: 10.1038/s41436-020-00952-7. Epub 2020 Sep 3. Erratum in: Genet Med. 2020 Nov 9;: PMID: 32879436.
    • Churchill SS, Kieckhefer GM, Bjornson KF, Herting JR. Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome. Sleep. 2015 Jan 1;38(1):61-71. doi: 10.5665/sleep.4326. PMID: 25325444; PMCID: PMC4262957.
    • Churchill SS, Kieckhefer GM, Landis CA, Ward TM. Sleep measurement and monitoring in children with Down syndrome: a review of the literature, 1960-2010. Sleep Med Rev. 2012 Oct;16(5):477-88. doi: 10.1016/j.smrv.2011.10.003. Epub 2012 Mar 10. PMID: 22410159; PMCID: PMC3408773.
    • Cornacchia M, Sethness J, Alapat P, Lin YH, Peacock C. The Prevalence of OSA Among an Adult Population With Down Syndrome Referred to a Medical Clinic. Am J Intellect Dev Disabil. 2019 Jan;124(1):4-10. doi: 10.1352/1944-7558-124.1.4. PMID: 30715921.
    • Corsi MM, Dogliotti G, Pedroni F, Galliera E, Malavazos AE, Villa R, Chiappelli M, Licastro F. Adipocytokines in Down’s syndrome, an atheroma-free model: Role of adiponectin. Arch Gerontol Geriatr. 2009 Jan-Feb;48(1):106-9. doi: 10.1016/j.archger.2007.10.011. Epub 2008 Jan 18. PMID: 18207581.
    • de Moura CP, Andrade D, Cunha LM, Tavares MJ, Cunha MJ, Vaz P, Barros H, Pueschel SM, Clemente MP. Down syndrome: otolaryngological effects of rapid maxillary expansion. J Laryngol Otol. 2008 Dec;122(12):1318-24. doi: 10.1017/S002221510800279X. Epub 2008 Jun 25. PMID: 18577269.
    • de Moura CP, Vales F, Andrade D, Cunha LM, Barros H, Pueschel SM, Clemente MP. Rapid maxillary expansion and nasal patency in children with Down syndrome. Rhinology. 2005 Jun;43(2):138-42. PMID: 16008071.
    • Diercks GR, Keamy D, Kinane TB, Skotko B, Schwartz A, Grealish E, Dobrowski J, Soose R, Hartnick CJ. Hypoglossal Nerve Stimulator Implantation in an Adolescent With Down Syndrome and Sleep Apnea. Pediatrics. 2016 May;137(5):e20153663. doi: 10.1542/peds.2015-3663. PMID: 27244805.
    • Diercks GR, Wentland C, Keamy D, Kinane TB, Skotko B, de Guzman V, Grealish E, Dobrowski J, Soose R, Hartnick CJ. Hypoglossal Nerve Stimulation in Adolescents With Down Syndrome and Obstructive Sleep Apnea. JAMA Otolaryngol Head Neck Surg. 2018 Jan 1;144(1):37-42. doi: 10.1001/jamaoto.2017.1871. PMID: 29098288; PMCID: PMC5833588.
    • Donnelly LF, Shott SR, LaRose CR, Chini BA, Amin RS. Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol. 2004 Jul;183(1):175-81. doi: 10.2214/ajr.183.1.1830175. PMID: 15208134.
    • Dudoignon B, Amaddeo A, Frapin A, Thierry B, de Sanctis L, Arroyo JO, Khirani S, Fauroux B. Obstructive sleep apnea in Down syndrome: Benefits of surgery and noninvasive respiratory support. Am J Med Genet A. 2017 Aug;173(8):2074-2080. doi: 10.1002/ajmg.a.38283. Epub 2017 May 24. PMID: 28544488.
    • Edgin JO, Tooley U, Demara B, Nyhuis C, Anand P, Spanò G. Sleep Disturbance and Expressive Language Development in Preschool-Age Children With Down Syndrome. Child Dev. 2015 Nov-Dec;86(6):1984-98. doi: 10.1111/cdev.12443. Epub 2015 Oct 5. PMID: 26435268; PMCID: PMC4626407.
    • Elsharkawi I, Gozal D, Macklin EA, Voelz L, Weintraub G, Skotko BG. Urinary biomarkers and obstructive sleep apnea in patients with Down syndrome. Sleep Med. 2017 Jun;34:84-89. doi: 10.1016/j.sleep.2017.02.005. Epub 2017 Mar 7. PMID: 28522103; PMCID: PMC5439300.
    • Esbensen AJ, Hoffman EK, Stansberry E, Shaffer R. Convergent validity of actigraphy with polysomnography and parent reports when measuring sleep in children with Down syndrome. J Intellect Disabil Res. 2018 Apr;62(4):281-291. doi: 10.1111/jir.12464. Epub 2018 Jan 5. PMID: 29314419; PMCID: PMC5847446.
    • Fan Z, Ahn M, Roth HL, Li L, Vaughn BV. Sleep Apnea and Hypoventilation in Patients with Down Syndrome: Analysis of 144 Polysomnogram Studies. Children (Basel). 2017 Jun 30;4(7):55. doi: 10.3390/children4070055. PMID: 28665356; PMCID: PMC5532547.
    • Ferber R, Millman R, Coppola M, Fleetham J, Murray CF, Iber C, McCall WV, Nino-Murcia G, Pressman M, Sanders M. Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep. 1994 Jun;17(4):378-92. doi: 10.1093/sleep/17.4.378. Erratum in: Sleep. 2018 Sep 1;41(9): PMID: 7973323.
    • Fleck RJ, Shott SR, Mahmoud M, Ishman SL, Amin RS, Donnelly LF. Magnetic resonance imaging of obstructive sleep apnea in children. Pediatr Radiol. 2018 Aug;48(9):1223-1233. doi: 10.1007/s00247-018-4180-2. Epub 2018 Aug 4. PMID: 30078047.
    • Fluger KR, Zhou A, Al-Jewair T. Low-Quality Evidence Supports the Use of Mandibular Advancement Appliances in Managing Obstructive Sleep Apnea in Children. J Evid Based Dent Pract. 2020 Mar;20(1):101411. doi: 10.1016/j.jebdp.2020.101411. Epub 2020 Feb 20. PMID: 32381414.
    • Framnes SN, Arble DM. The Bidirectional Relationship Between Obstructive Sleep Apnea and Metabolic Disease. Front Endocrinol (Lausanne). 2018 Aug 6;9:440. doi: 10.3389/fendo.2018.00440. PMID: 30127766; PMCID: PMC6087747.
    • Fray S, Biello A, Kwan J, Kram YA, Lu K, Camacho M. Tracheostomy for paediatric obstructive sleep apnoea: A systematic review. J Laryngol Otol. 2018 Aug;132(8):680-684. doi: 10.1017/S0022215118001160. Epub 2018 Aug 3. PMID: 30073941.
    • Fricke BL, Donnelly LF, Shott SR, Kalra M, Poe SA, Chini BA, Amin RS. Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls. Pediatr Radiol. 2006 Jun;36(6):518-23. doi: 10.1007/s00247-006-0149-7. Epub 2006 Apr 5. PMID: 16596369.
    • Friedman NR, Ruiz AG, Gao D, Ingram DG. Accuracy of Parental Perception of Nighttime Breathing in Children with Down Syndrome. Otolaryngol Head Neck Surg. 2018 Feb;158(2):364-367. doi: 10.1177/0194599817726286. Epub 2017 Sep 5. PMID: 28871845.
    • Fructuoso M, Rachdi L, Philippe E, Denis RG, Magnan C, Le Stunff H, Janel N, Dierssen M. Increased levels of inflammatory plasma markers and obesity risk in a mouse model of Down syndrome. Free Radic Biol Med. 2018 Jan;114:122-130. doi: 10.1016/j.freeradbiomed.2017.09.021. Epub 2017 Sep 25. Erratum in: Free Radic Biol Med. 2018 Mar 7;: PMID: 28958596.
    • Gandy KC, Castillo HA, Ouellette L, Castillo J, Lupo PJ, Jacola LM, Rabin KR, Raghubar KP, Gramatges MM. The relationship between chronic health conditions and cognitive deficits in children, adolescents, and young adults with down syndrome: A systematic review. PLoS One. 2020 Sep 11;15(9):e0239040. doi: 10.1371/journal.pone.0239040. PMID: 32915911; PMCID: PMC7485757.
    • Giménez S, Videla L, Romero S, Benejam B, Clos S, Fernández S, Martínez M, Carmona-Iragui M, Antonijoan RM, Mayos M, Fortuna A, Peñacoba P, Plaza V, Osorio RS, Sharma RA, Bardés I, Rebillat AS, Lleó A, Blesa R, Videla S, Fortea J. Prevalence of Sleep Disorders in Adults With Down Syndrome: A Comparative Study of Self-Reported, Actigraphic, and Polysomnographic Findings. J Clin Sleep Med. 2018 Oct 15;14(10):1725-1733. doi: 10.5664/jcsm.7382. PMID: 30353801; PMCID: PMC6175810.
    • Goffinski A, Stanley MA, Shepherd N, Duvall N, Jenkinson SB, Davis C, Bull MJ, Roper RJ. Obstructive sleep apnea in young infants with Down syndrome evaluated in a Down syndrome specialty clinic. Am J Med Genet A. 2015 Feb;167A(2):324-30. doi: 10.1002/ajmg.a.36903. Epub 2015 Jan 13. PMID: 25604659; PMCID: PMC4638183.
    • Goodwin JL, Enright PL, Kaemingk KL, Rosen GM, Morgan WJ, Fregosi RF, Quan SF. Feasibility of using unattended polysomnography in children for research–report of the Tucson Children’s Assessment of Sleep Apnea study (TuCASA). Sleep. 2001 Dec 15;24(8):937-44. doi: 10.1093/sleep/24.8.937. PMID: 11766164.
    • Gozal D, Tan HL, Kheirandish-Gozal L. Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision. J Clin Med. 2020 Mar 24;9(3):888. doi: 10.3390/jcm9030888. PMID: 32213932; PMCID: PMC7141493.
    • Grantham-Hill S, Evans HJ, Tuffrey C, Sanders E, Elphick HE, Gringras P, Kingshott RN, Martin J, Reynolds J, Joyce A, Hill CM, Spruyt K. Psychometric Properties and Predictive Value of a Screening Questionnaire for Obstructive Sleep Apnea in Young Children With Down Syndrome. Front Psychiatry. 2020 Apr 28;11:285. doi: 10.3389/fpsyt.2020.00285. PMID: 32425820; PMCID: PMC7212346.
    • Gulotta G, Iannella G, Vicini C, Polimeni A, Greco A, de Vincentiis M, Visconti IC, Meccariello G, Cammaroto G, De Vito A, Gobbi R, Bellini C, Firinu E, Pace A, Colizza A, Pelucchi S, Magliulo G. Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art. Int J Environ Res Public Health. 2019 Sep 4;16(18):3235. doi: 10.3390/ijerph16183235. PMID: 31487798; PMCID: PMC6765844.
    • Hamill CS, Tracy MM, Staggs VS, Manimtim WM, Neff LL, Jensen DR. Tracheostomy in the pediatric trisomy 21 population. Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110540. doi: 10.1016/j.ijporl.2020.110540. Epub 2020 Dec 1. PMID: 33290923.
    • Hawkins S, Huston S, Campbell K, Halbower A. High-Flow, Heated, Humidified Air Via Nasal Cannula Treats CPAP-Intolerant Children With Obstructive Sleep Apnea. J Clin Sleep Med. 2017 Aug 15;13(8):981-989. doi: 10.5664/jcsm.6700. PMID: 28728621; PMCID: PMC5529135.
    • Herzig LD10.4172/2572-0775.1000102, Walker OW, TeKolste K, Bjornson K, Christensen A, et al. (2016) Pediatrician Use of Down Syndrome Health Supervision Guidelines. Clin Pediatr 1: 102. doi:
    • Hill CM, Elphick HE, Farquhar M, Gringras P, Pickering RM, Kingshott RN, Martin J, Reynolds J, Joyce A, Gavlak JC, Evans HJ. Home oximetry to screen for obstructive sleep apnoea in Down syndrome. Arch Dis Child. 2018 Oct;103(10):962-967. doi: 10.1136/archdischild-2017-314409. Epub 2018 May 14. PMID: 29760010.
    • Hill EA, Fairley DM, Williams LJ, Spanò G, Cooper SA, Riha RL. Prospective Trial of CPAP in Community-Dwelling Adults with Down Syndrome and Obstructive Sleep Apnea Syndrome. Brain Sci. 2020 Nov 12;10(11):844. doi: 10.3390/brainsci10110844. PMID: 33198148; PMCID: PMC7696635.
    • Horne RSC, Roy B, Walter LM, Biggs SN, Tamanyan K, Weichard A, Nixon GM, Davey MJ, Ditchfield M, Harper RM, Kumar R. Regional brain tissue changes and associations with disease severity in children with sleep-disordered breathing. Sleep. 2018 Feb 1;41(2):zsx203. doi: 10.1093/sleep/zsx203. PMID: 29267958.
    • Howard JJM, Sarber KM, Yu W, Smith DF, Tikhtman RO, Simakajornboon N, Ishman SL. Outcomes in children with down syndrome and mild obstructive sleep apnea treated non-surgically. Laryngoscope. 2020 Jul;130(7):1828-1835. doi: 10.1002/lary.28325. Epub 2019 Oct 11. PMID: 31603543.
    • Hsu B, Emperumal CP, Grbach VX, Padilla M, Enciso R. Effects of respiratory muscle therapy on obstructive sleep apnea: a systematic review and meta-analysis. J Clin Sleep Med. 2020 May 15;16(5):785-801. doi: 10.5664/jcsm.8318. Epub 2020 Feb 6. PMID: 32026802.
    • Huang YS, Hsu SC, Guilleminault C, Chuang LC. Myofunctional Therapy: Role in Pediatric OSA. Sleep Med Clin. 2019 Mar;14(1):135-142. doi: 10.1016/j.jsmc.2018.10.004. Epub 2018 Nov 30. PMID: 30709528.
    • Hughes BH, Brinton JT, Ingram DG, Halbower AC. The Impact of Altitude on Sleep-Disordered Breathing in Children Dwelling at High Altitude: A Crossover Study. Sleep. 2017 Sep 1;40(9):zsx120. doi: 10.1093/sleep/zsx120. PMID: 28934528; PMCID: PMC5806567.
    • Hurvitz MS, Lesser DJ, Dever G, Celso J, Bhattacharjee R. Findings of routine nocturnal polysomnography in children with Down syndrome: a retrospective cohort study. Sleep Med. 2020 Dec;76:58-64. doi: 10.1016/j.sleep.2020.10.003. Epub 2020 Oct 8. PMID: 33120129.
    • Hyzer JM, Milczuk HA, Macarthur CJ, King EF, Quintanilla-Dieck L, Lam DJ. Drug-Induced Sleep Endoscopy Findings in Children With Obstructive Sleep Apnea With vs Without Obesity or Down Syndrome. JAMA Otolaryngol Head Neck Surg. 2020 Dec 3:e204548. doi: 10.1001/jamaoto.2020.4548. Epub ahead of print. PMID: 33270102; PMCID: PMC7716249
    • Idris G, Galland B, Robertson CJ, Gray A, Farella M. Mandibular advancement appliances for sleep-disordered breathing in children: A randomized crossover clinical trial. J Dent. 2018 Apr;71:9-17. doi: 10.1016/j.jdent.2018.01.006. Epub 2018 Jan 31. PMID: 29357293.
    • Ingram DG, Ruiz AG, Gao D, Friedman NR. Success of Tonsillectomy for Obstructive Sleep Apnea in Children With Down Syndrome. J Clin Sleep Med. 2017 Aug 15;13(8):975-980. doi: 10.5664/jcsm.6698. PMID: 28728615; PMCID: PMC5529134.
    • Ingram DG, Singh AV, Ehsan Z, Birnbaum BF. Obstructive Sleep Apnea and Pulmonary Hypertension in Children. Paediatr Respir Rev. 2017 Jun;23:33-39. doi: 10.1016/j.prrv.2017.01.001. Epub 2017 Jan 11. PMID: 28185814.
    • Ioan I, Whitney D, Sevin F, Sanlaville D, Fréminville B, Schweitzer C, Akkari M, Coutier L, Putois B, Thieux M, Franco P. Pulse transit time as a diagnostic test for OSA in children with Down syndrome. J Clin Sleep Med. 2021 Jun 24. doi: 10.5664/jcsm.9510. Epub ahead of print. PMID: 34170228.
    • Isaiah A, Kiss E, Olomu P, Koral K, Mitchell RB. Characterization of upper airway obstruction using cine MRI in children with residual obstructive sleep apnea after adenotonsillectomy. Sleep Med. 2018 Oct;50:79-86. doi: 10.1016/j.sleep.2017.10.006. Epub 2017 Nov 2. PMID: 30015255.
    • Jonas DE, Amick HR, Feltner C, Weber RP, Arvanitis M, Stine A, Lux L, Harris RP. Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017 Jan 24;317(4):415-433. doi: 10.1001/jama.2016.19635. Erratum in: JAMA. 2017 Mar 28;317(12 ):1278. PMID: 28118460.
    • Joyce A, Elphick H, Farquhar M, Gringras P, Evans H, Bucks RS, Kreppner J, Kingshott R, Martin J, Reynolds J, Rush C, Gavlak J, Hill CM. Obstructive Sleep Apnoea Contributes to Executive Function Impairment in Young Children with Down Syndrome. Behav Sleep Med. 2020 Sep-Oct;18(5):611-621. doi: 10.1080/15402002.2019.1641501. Epub 2019 Jul 16. PMID: 31311334.
    • Ju YS, Zangrilli MA, Finn MB, Fagan AM, Holtzman DM. Obstructive sleep apnea treatment, slow wave activity, and amyloid-β. Ann Neurol. 2019 Feb;85(2):291-295. doi: 10.1002/ana.25408. Epub 2019 Jan 17. PMID: 30597615; PMCID: PMC6396979.
    • Kang EK, Xanthopoulos MS, Kim JY, Arevalo C, Shults J, Beck SE, Marcus CL, Tapia IE. Adherence to Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea in Children With Developmental Disabilities. J Clin Sleep Med. 2019 Jun 15;15(6):915-921. doi: 10.5664/jcsm.7850. PMID: 31138379; PMCID: PMC6557645.
    • Kang KT, Koltai PJ, Lee CH, Lin MT, Hsu WC. Lingual Tonsillectomy for Treatment of Pediatric Obstructive Sleep Apnea: A Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2017 Jun 1;143(6):561-568. doi: 10.1001/jamaoto.2016.4274. PMID: 28208178; PMCID: PMC5824231.
    • Karlik JB, Raol N, Gilbertson L. Hypoglossal Nerve Stimulator Placement for Pediatric Trisomy 21 Patients with Refractory Obstructive Sleep Apnea: A Case Series. Children (Basel). 2020 Jul 24;7(8):81. doi: 10.3390/children7080081. PMID: 32722055; PMCID: PMC7464795.
    • Kheirandish-Gozal L, Sahib AK, Macey PM, Philby MF, Gozal D, Kumar R. Regional brain tissue integrity in pediatric obstructive sleep apnea. Neurosci Lett. 2018 Aug 24;682:118-123. doi: 10.1016/j.neulet.2018.06.002. Epub 2018 Jun 5. PMID: 29883682; PMCID: PMC6102065.
    • Kirk V, Baughn J, D’Andrea L, Friedman N, Galion A, Garetz S, Hassan F, Wrede J, Harrod CG, Malhotra RK. American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children. J Clin Sleep Med. 2017 Oct 15;13(10):1199-1203. doi: 10.5664/jcsm.6772. PMID: 28877820; PMCID: PMC5612636.
    • Knollman PD, Heubi CH, Wiley S, Smith DF, Shott SR, Ishman SL, Meinzen-Derr J. Demographic and Clinical Characteristics Associated With Adherence to Guideline-Based Polysomnography in Children With Down Syndrome. Otolaryngol Head Neck Surg. 2021 Apr;164(4):877-883. doi: 10.1177/0194599820954837. Epub 2020 Sep 15. PMID: 32928046.
    • Koren D, Gozal D, Philby MF, Bhattacharjee R, Kheirandish-Gozal L. Impact of obstructive sleep apnoea on insulin resistance in nonobese and obese children. Eur Respir J. 2016 Apr;47(4):1152-61. doi: 10.1183/13993003.01430-2015. Epub 2016 Feb 4. PMID: 26846822.
    • Lal C, White DR, Joseph JE, van Bakergem K, LaRosa A. Sleep-disordered breathing in Down syndrome. Chest. 2015 Feb;147(2):570-579. doi: 10.1378/chest.14-0266. PMID: 25644910.
    • Lee CF, Lee CH, Hsueh WY, Lin MT, Kang KT. Prevalence of Obstructive Sleep Apnea in Children With Down Syndrome: A Meta-Analysis. J Clin Sleep Med. 2018 May 15;14(5):867-875. doi: 10.5664/jcsm.7126. PMID: 29734982; PMCID: PMC5940439.
    • Lee NC, Hsu WC, Chang LM, Chen YC, Huang PT, Chien CC, Chien YH, Chen CL, Hwu WL, Lee PL. REM sleep and sleep apnea are associated with language function in Down syndrome children: An analysis of a community sample. J Formos Med Assoc. 2020 Jan;119(1 Pt 3):516-523. doi: 10.1016/j.jfma.2019.07.015. Epub 2019 Aug 1. PMID: 31378642.
    • Liguori C, Mercuri NB, Nuccetelli M, Izzi F, Cordella A, Bernardini S, Placidi F. Obstructive sleep apnea may induce orexinergic system and cerebral β-amyloid metabolism dysregulation: is it a further proof for Alzheimer’s disease risk? Sleep Med. 2019 Apr;56:171-176. doi: 10.1016/j.sleep.2019.01.003. Epub 2019 Jan 11. PMID: 30799255.
    • Liu SY, Riley RW, Yu MS. Surgical Algorithm for Obstructive Sleep Apnea: An Update. Clin Exp Otorhinolaryngol. 2020 Aug;13(3):215-224. doi: 10.21053/ceo.2020.01053. Epub 2020 Jul 1. PMID: 32631040; PMCID: PMC7435437.
    • Lucey BP. It’s complicated: The relationship between sleep and Alzheimer’s disease in humans. Neurobiol Dis. 2020 Oct;144:105031. doi: 10.1016/j.nbd.2020.105031. Epub 2020 Jul 29. PMID: 32738506; PMCID: PMC7484285.
    • Machado-Júnior AJ, Signorelli LG, Zancanella E, Crespo AN. Randomized controlled study of a mandibular advancement appliance for the treatment of obstructive sleep apnea in children: A pilot study. Med Oral Patol Oral Cir Bucal. 2016 Jul 1;21(4):e403-7. doi: 10.4317/medoral.21072. PMID: 26946208; PMCID: PMC4920451.
    • Magge SN, O’Neill KL, Shults J, Stallings VA, Stettler N. Leptin levels among prepubertal children with Down syndrome compared with their siblings. J Pediatr. 2008 Mar;152(3):321-6. doi: 10.1016/j.jpeds.2007.08.008. Epub 2007 Oct 24. PMID: 18280834; PMCID: PMC2267910.
    • Magge SN, Zemel BS, Pipan ME, Gidding SS, Kelly A. Cardiometabolic Risk and Body Composition in Youth With Down Syndrome. Pediatrics. 2019 Aug;144(2):e20190137. doi: 10.1542/peds.2019-0137. Epub 2019 Jul 17. PMID: 31315916; PMCID: PMC6855833.
    • Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, Schechter MS, Ward SD, Sheldon SH, Shiffman RN, Lehmann C, Spruyt K; American Academy of Pediatrics. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012 Sep;130(3):e714-55. doi: 10.1542/peds.2012-1672. Epub 2012 Aug 27. PMID: 22926176.
    • Marcus CL, Moore RH, Rosen CL, Giordani B, Garetz SL, Taylor HG, Mitchell RB, Amin R, Katz ES, Arens R, Paruthi S, Muzumdar H, Gozal D, Thomas NH, Ware J, Beebe D, Snyder K, Elden L, Sprecher RC, Willging P, Jones D, Bent JP, Hoban T, Chervin RD, Ellenberg SS, Redline S; Childhood Adenotonsillectomy Trial (CHAT). A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013 Jun 20;368(25):2366-76. doi: 10.1056/NEJMoa1215881. Epub 2013 May 21. PMID: 23692173; PMCID: PMC3756808.
    • Marcus CL, Radcliffe J, Konstantinopoulou S, Beck SE, Cornaglia MA, Traylor J, DiFeo N, Karamessinis LR, Gallagher PR, Meltzer LJ. Effects of positive airway pressure therapy on neurobehavioral outcomes in children with obstructive sleep apnea. Am J Respir Crit Care Med. 2012 May 1;185(9):998-1003. doi: 10.1164/rccm.201112-2167OC. Epub 2012 Feb 9. PMID: 22323303; PMCID: PMC3359938.
    • Marcus CL, Traylor J, Biggs SN, Roberts RS, Nixon GM, Narang I, Bhattacharjee R, Davey MJ, Horne RS, Cheshire M, Gibbons KJ, Dix J, Asztalos E, Doyle LW, Opie GF, D’ilario J, Costantini L, Bradford R, Schmidt B. Feasibility of comprehensive, unattended ambulatory polysomnography in school-aged children. J Clin Sleep Med. 2014 Aug 15;10(8):913-8. doi: 10.5664/jcsm.3970. PMID: 25126039; PMCID: PMC4106947.
    • Maris M, Verhulst S, Saldien V, Van de Heyning P, Wojciechowski M, Boudewyns A. Drug-induced sedation endoscopy in surgically naive children with Down syndrome and obstructive sleep apnea. Sleep Med. 2016 Aug;24:63-70. doi: 10.1016/j.sleep.2016.06.018. Epub 2016 Aug 22. PMID: 27810188.
    • Maris M, Verhulst S, Wojciechowski M, Van de Heyning P, Boudewyns A. Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome. Sleep. 2016 Mar 1;39(3):699-704. doi: 10.5665/sleep.5554. PMID: 26612391; PMCID: PMC4763351.
    • Mehra R, Foldvary-Schaefer N. The USPSTF and screening for obstructive sleep apnea: Dispelling misconceptions. Cleve Clin J Med. 2017 Jun;84(6):429-431. doi: 10.3949/ccjm.84a.17023. PMID: 28628426.
    • Mehta S, Wang D, Kuo CL, Mu J, Vich ML, Allareddy V, Tadinada A, Yadav S. Long-term effects of mini-screw-assisted rapid palatal expansion on airway. Angle Orthod. 2020 Dec 14. doi: 10.2319/062520-586.1. Epub ahead of print. PMID: 33315060.
    • Must A, Parisi SM. Sedentary behavior and sleep: paradoxical effects in association with childhood obesity. Int J Obes (Lond). 2009 Apr;33 Suppl 1(Suppl 1):S82-6. doi: 10.1038/ijo.2009.23. PMID: 19363515; PMCID: PMC3586418.
    • Muzumdar H, Arens R. Physiological effects of obstructive sleep apnea syndrome in childhood. Respir Physiol Neurobiol. 2013 Sep 15;188(3):370-82. doi: 10.1016/j.resp.2013.05.006. Epub 2013 May 23. PMID: 23707879; PMCID: PMC3778149.
  • Nation J, Brigger M. The Efficacy of Adenotonsillectomy for Obstructive Sleep Apnea in Children with Down Syndrome: A Systematic Review. Otolaryngol Head Neck Surg. 2017 Sep;157(3):401-408. doi: 10.1177/0194599817703921. Epub 2017 May 9. PMID: 28485249.
  • Nehme J, LaBerge R, Pothos M, Barrowman N, Hoey L, Monsour A, Kukko M, Katz SL. Predicting the presence of sleep-disordered breathing in children with Down syndrome. Sleep Med. 2017 Aug;36:104-108. doi: 10.1016/j.sleep.2017.03.032. Epub 2017 May 31. PMID: 28735906.
  • Nerfeldt P, Sundelin A. Obstructive sleep apnea in children with down syndrome – Prevalence and evaluation of surgical treatment. Int J Pediatr Otorhinolaryngol. 2020 Jun;133:109968. doi: 10.1016/j.ijporl.2020.109968. Epub 2020 Feb 26. PMID: 32126418.
  • Nisbet LC, Phillips NN, Hoban TF, O’Brien LM. Characterization of a sleep architectural phenotype in children with Down syndrome. Sleep Breath. 2015 Sep;19(3):1065-71. doi: 10.1007/s11325-014-1094-6. Epub 2014 Dec 12. PMID: 25500979.
  • O’Driscoll DM, Horne RS, Davey MJ, Hope SA, Anderson V, Trinder J, Walker AM, Nixon GM. Cardiac and sympathetic activation are reduced in children with Down syndrome and sleep disordered breathing. Sleep. 2012 Sep 1;35(9):1269-75. doi: 10.5665/sleep.2084. PMID: 22942505; PMCID: PMC3413804.
  • Oxelgren UW, Myrelid Å, Annerén G, Ekstam B, Göransson C, Holmbom A, Isaksson A, Åberg M, Gustafsson J, Fernell E. Prevalence of autism and attention-deficit-hyperactivity disorder in Down syndrome: a population-based study. Dev Med Child Neurol. 2017 Mar;59(3):276-283. doi: 10.1111/dmcn.13217. Epub 2016 Aug 9. PMID: 27503703.
  • Pabary R, Goubau C, Russo K, Laverty A, Abel F, Samuels M. Screening for sleep-disordered breathing with Pediatric Sleep Questionnaire in children with underlying conditions. J Sleep Res. 2019 Oct;28(5):e12826. doi: 10.1111/jsr.12826. Epub 2019 Mar 7. PMID: 30848047
  • Parola M, Vajro P. Nocturnal hypoxia in obese-related obstructive sleep apnea as a putative trigger of oxidative stress in pediatric NAFLD progression. J Hepatol. 2016 Sep;65(3):470-2. doi: 10.1016/j.jhep.2016.05.042. Epub 2016 Aug 5. PMID: 27501737.
  • Patel TA, Nguyen SA, White DR. Down Syndrome as an indicator for pediatric otolaryngologic procedures. Int J Pediatr Otorhinolaryngol. 2018 Sep;112:182-187. doi: 10.1016/j.ijporl.2018.07.007. Epub 2018 Jul 9. PMID: 30055730; PMCID: PMC6080252.
  • Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2019;15(2):301–334
  • Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013 May 1;177(9):1006-14. doi: 10.1093/aje/kws342. Epub 2013 Apr 14. PMID: 23589584; PMCID: PMC3639722.
  • Pirelli P, Saponara M, Guilleminault C. Rapid maxillary expansion (RME) for pediatric obstructive sleep apnea: a 12-year follow-up. Sleep Med. 2015 Aug;16(8):933-5. doi: 10.1016/j.sleep.2015.04.012. Epub 2015 May 19. PMID: 26141004.
  • Posada AM, Isaza N, Panqueva P, Rondon-Sepulveda MA, Hidalgo P. High Incidence of Sleep-Related Breathing Disorders in Children with Down Syndrome Referred to a High-Altitude Sleep Laboratory. High Alt Med Biol. 2019 Sep;20(3):231-235. doi: 10.1089/ham.2017.0149. Epub 2019 Jun 28. PMID: 31259618.
  • Praud JP. Long-Term Non-invasive Ventilation in Children: Current Use, Indications, and Contraindications. Front Pediatr. 2020 Nov 5;8:584334. doi: 10.3389/fped.2020.584334. PMID: 33224908; PMCID: PMC7674588.
  • Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. J Clin Sleep Med. 2015 Jul 15;11(7):773-827. doi: 10.5664/jcsm.4858. PMID: 26094920; PMCID: PMC4481062.
  • Rana M, August J, Levi J, Parsi G, Motro M, DeBassio W. Alternative Approaches to Adenotonsillectomy and Continuous Positive Airway Pressure (CPAP) for the Management of Pediatric Obstructive Sleep Apnea (OSA): A Review. Sleep Disord. 2020 Jul 4;2020:7987208. doi: 10.1155/2020/7987208. PMID: 32695520; PMCID: PMC7355373.
  • Rotenberg BW, Murariu D, Pang KP. Trends in CPAP adherence over twenty years of data collection: a flattened curve. J Otolaryngol Head Neck Surg. 2016 Aug 19;45(1):43. doi: 10.1186/s40463-016-0156-0. PMID: 27542595; PMCID: PMC4992257.
  • Rotenberg BW, Vicini C, Pang EB, Pang KP. Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature. J Otolaryngol Head Neck Surg. 2016 Apr 6;45:23. doi: 10.1186/s40463-016-0136-4. PMID: 27048606; PMCID: PMC4822285.
  • Sanders E, Hill CM, Evans HJ, Tuffrey C. The Development of a Screening Questionnaire for Obstructive Sleep Apnea in Children with Down Syndrome. Front Psychiatry. 2015 Oct 20;6:147. doi: 10.3389/fpsyt.2015.00147. PMID: 26539127; PMCID: PMC4611960.
  • Santoro SL, Bartman T, Cua CL, Lemle S, Skotko BG. Use of Electronic Health Record Integration for Down Syndrome Guidelines. Pediatrics. 2018 Sep;142(3):e20174119. doi: 10.1542/peds.2017-4119. PMID: 30154119.
  • Santoro SL, Martin LJ, Pleatman SI, Hopkin RJ. Stakeholder Buy-In and Physician Education Improve Adherence to Guidelines for Down Syndrome. J Pediatr. 2016 Apr;171:262-8.e1-2. doi: 10.1016/j.jpeds.2015.12.026. Epub 2016 Jan 29. PMID: 26831529.
  • Senthilvel E, Krishna J. Body position and obstructive sleep apnea in children with Down syndrome. J Clin Sleep Med. 2011 Apr 15;7(2):158-62. PMID: 21509330; PMCID: PMC3077343.
  • Shott SR, Donnelly LF. Cine magnetic resonance imaging: evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome. Laryngoscope. 2004 Oct;114(10):1724-9. doi: 10.1097/00005537-200410000-00009. PMID: 15454761.
  • Simpson R, Oyekan AA, Ehsan Z, Ingram DG. Obstructive sleep apnea in patients with Down syndrome: current perspectives. Nat Sci Sleep. 2018 Sep 13;10:287-293. doi: 10.2147/NSS.S154723. PMID: 30254502; PMCID: PMC6143127.
  • Skotko BG, Davidson EJ, Weintraub GS. Contributions of a specialty clinic for children and adolescents with Down syndrome. Am J Med Genet A. 2013 Mar;161A(3):430-7. doi: 10.1002/ajmg.a.35795. Epub 2013 Feb 7. PMID: 23401090.
  • Skotko BG, Macklin EA, Muselli M, Voelz L, McDonough ME, Davidson E, Allareddy V, Jayaratne YS, Bruun R, Ching N, Weintraub G, Gozal D, Rosen D. A predictive model for obstructive sleep apnea and Down syndrome. Am J Med Genet A. 2017 Apr;173(4):889-896. doi: 10.1002/ajmg.a.38137. Epub 2017 Jan 26. PMID: 28124477.
  • Slaats MALJ, Loterman D, van Holsbeke C, Vos W, Van Hoorenbeeck K, de Backer J, de Backer W, Wojciechowski M, Boudewyns A, Verhulst S. The Role of Functional Respiratory Imaging in Treatment Selection of Children With Obstructive Sleep Apnea and Down Syndrome. J Clin Sleep Med. 2018 Apr 15;14(4):651-659. doi: 10.5664/jcsm.7064. PMID: 29609707; PMCID: PMC5886443
  • Sobey CG, Judkins CP, Sundararajan V, Phan TG, Drummond GR, Srikanth VK. Risk of Major Cardiovascular Events in People with Down Syndrome. PLoS One. 2015 Sep 30;10(9):e0137093. doi: 10.1371/journal.pone.0137093. PMID: 26421620; PMCID: PMC4589343.
  • Stenerson ME, Yu PK, Kinane TB, Skotko BG, Hartnick CJ. Long-term stability of hypoglossal nerve stimulation for the treatment of obstructive sleep apnea in children with Down syndrome. Int J Pediatr Otorhinolaryngol. 2021 Aug 5;149:110868. doi: 10.1016/j.ijporl.2021.110868. Epub ahead of print. PMID: 34371294.
  • Storto CJ, Garcez AS, Suzuki H, Cusmanich KG, Elkenawy I, Moon W, Suzuki SS. Assessment of respiratory muscle strength and airflow before and afterled to a significant long-term increase in nasopharyngeal volumemicroimplant-assisted rapid palatal expansion. Angle Orthod. 2019 Sep;89(5):713-720. doi: 10.2319/070518-504.1. Epub 2019 Mar 21. PMID: 30896250.
  • Sudarsan SS, Paramasivan VK, Arumugam SV, Murali S, Kameswaran M. Comparison of treatment modalities in syndromic children with obstructive sleep apnea–a randomized cohort study. Int J Pediatr Otorhinolaryngol. 2014 Sep;78(9):1526-33. doi: 10.1016/j.ijporl.2014.06.027. Epub 2014 Jul 7. PMID: 25064627.
  • Sundaram SS, Halbower A, Pan Z, Robbins K, Capocelli KE, Klawitter J, Shearn CT, Sokol RJ. Nocturnal hypoxia-induced oxidative stress promotes progression of pediatric non-alcoholic fatty liver disease. J Hepatol. 2016 Sep;65(3):560-9. doi: 10.1016/j.jhep.2016.04.010. Epub 2016 Aug 5. PMID: 27501738; PMCID: PMC4992457.
  • Tahrani AA, Ali A. Obstructive Sleep Apnoea and Type 2 Diabetes. Eur Endocrinol. 2014 Feb;10(1):43-50. doi: 10.17925/EE.2014.10.01.43. Epub 2014 Feb 28. PMID: 29872463; PMCID: PMC5983096.
  • Tan HL, Kheirandish-Gozal L, Gozal D. Pediatric Home Sleep Apnea Testing: Slowly Getting There! Chest. 2015 Dec;148(6):1382-1395. doi: 10.1378/chest.15-1365. PMID: 26270608; PMCID: PMC4665733.
  • Taylor HG, Bowen SR, Beebe DW, Hodges E, Amin R, Arens R, Chervin RD, Garetz SL, Katz ES, Moore RH, Morales KH, Muzumdar H, Paruthi S, Rosen CL, Sadhwani A, Thomas NH, Ware J, Marcus CL, Ellenberg SS, Redline S, Giordani B. Cognitive Effects of Adenotonsillectomy for Obstructive Sleep Apnea. Pediatrics. 2016 Aug;138(2):e20154458. doi: 10.1542/peds.2015-4458. PMID: 27464674; PMCID: PMC4960728.
  • Templier L, Rossi C, Miguez M, Pérez JC, Curto A, Albaladejo A, Vich ML. Combined Surgical and Orthodontic Treatments in Children with OSA: A Systematic Review. J Clin Med. 2020 Jul 26;9(8):2387. doi: 10.3390/jcm9082387. PMID: 32722638; PMCID: PMC7463535.
  • Trois MS, Capone GT, Lutz JA, Melendres MC, Schwartz AR, Collop NA, Marcus CL. Obstructive sleep apnea in adults with Down syndrome. J Clin Sleep Med. 2009 Aug 15;5(4):317-23. PMID: 19968008; PMCID: PMC2725249.
  • Trosman I, Trosman SJ. Cognitive and Behavioral Consequences of Sleep Disordered Breathing in Children. Med Sci (Basel). 2017 Dec 1;5(4):30. doi: 10.3390/medsci5040030. PMID: 29194375; PMCID: PMC5753659.
  • Trucco F, Chatwin M, Semple T, Rosenthal M, Bush A, Tan HL. Sleep disordered breathing and ventilatory support in children with Down syndrome. Pediatr Pulmonol. 2018 Oct;53(10):1414-1421. doi: 10.1002/ppul.24122. Epub 2018 Jul 10. PMID: 29992744.
  • Ulualp S. Outcomes of Tongue Base Reduction and Lingual Tonsillectomy for Residual Pediatric Obstructive Sleep Apnea after Adenotonsillectomy. Int Arch Otorhinolaryngol. 2019 Oct;23(4):e415-e421. doi: 10.1055/s-0039-1685156. Epub 2019 May 28. PMID: 31649761; PMCID: PMC6805200.
  • US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, García FA, Herzstein J, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Phillips WR, Phipps MG, Pignone MP, Silverstein M, Tseng CW. Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2017 Jan 24;317(4):407-414. doi: 10.1001/jama.2016.20325. PMID: 28118461.
  • Valentini D, Alisi A, di Camillo C, Sartorelli MR, Crudele A, Bartuli A, Nobili V, Villani A. Nonalcoholic Fatty Liver Disease in Italian Children with Down Syndrome: Prevalence and Correlation with Obesity-Related Features. J Pediatr. 2017 Oct;189:92-97.e1. doi: 10.1016/j.jpeds.2017.05.077. Epub 2017 Jun 26. PMID: 28662945.
  • Verhulst S. Long Term Continuous Positive Airway Pressure and Non-invasive Ventilation in Obstructive Sleep Apnea in Children With Obesity and Down Syndrome. Front Pediatr. 2020 Aug 28;8:534. doi: 10.3389/fped.2020.00534. PMID: 32984228; PMCID: PMC7484653.
  • Von Lukowicz M, Herzog N, Ruthardt S, Quante M, Iven G, Poets CF. Effect of a 1-week intense myofunctional training on obstructive sleep apnoea in children with Down syndrome. Arch Dis Child. 2019 Mar;104(3):275-279. doi: 10.1136/archdischild-2018-315064. Epub 2018 Aug 2. PMID: 30072363.
  • Wang X, Bi Y, Zhang Q, Pan F. Obstructive sleep apnoea and the risk of type 2 diabetes: a meta-analysis of prospective cohort studies. Respirology. 2013 Jan;18(1):140-6. doi: 10.1111/j.1440-1843.2012.02267.x. PMID: 22988888.
  • Watson SE, Li Z, Tu W, Jalou H, Brubaker JL, Gupta S, Huber JN, Carroll A, Hannon TS. Obstructive sleep apnoea in obese adolescents and cardiometabolic risk markers. Pediatr Obes. 2014 Dec;9(6):471-7. doi: 10.1111/j.2047-6310.2013.00198.x. Epub 2013 Sep 17. PMID: 24106092; PMCID: PMC3956725.
  • Wu J, Gu M, Chen S, Chen W, Ni K, Xu H, Li X. Factors related to pediatric obstructive sleep apnea-hypopnea syndrome in children with attention deficit hyperactivity disorder in different age groups. Medicine (Baltimore). 2017 Oct;96(42):e8281. doi: 10.1097/MD.0000000000008281. PMID: 29049225; PMCID: PMC5662391.
  • Yahia S, El-Farahaty RM, El-Hawary AK, El-Hussiny MA, Abdel-Maseih H, El-Dahtory F, El-Gilany AH. Leptin, insulin and thyroid hormones in a cohort of Egyptian obese Down syndrome children: a comparative study. BMC Endocr Disord. 2012 Oct 15;12:22. doi: 10.1186/1472-6823-12-22. PMID: 23067442; PMCID: PMC3528445.
  • Yanyan M, Min Y, Xuemei G. Mandibular advancement appliances for the treatment of obstructive sleep apnea in children: a systematic review and meta-analysis. Sleep Med. 2019 Aug;60:145-151. doi: 10.1016/j.sleep.2018.12.022. Epub 2019 Jan 29. PMID: 31182328.
  • Yumusakhuylu AC, Binnetoglu A, Demir B, Baglam T, Sari M. Is it safe to perform adenotonsillectomy in children with Down syndrome? Eur Arch Otorhinolaryngol. 2016 Sep;273(9):2819-23. doi: 10.1007/s00405-016-4012-7. Epub 2016 Mar 28. PMID: 27020270.
  • Yu W, Sarber KM, Howard JJM, Huang G, Hossain MM, Heubi CH, Lu X, Simakajornboon N. Children with Down syndrome and mild OSA: treatment with medication versus observation. J Clin Sleep Med. 2020 Jun 15;16(6):899-906. doi: 10.5664/jcsm.8358. PMID: 32043964.
  • 202002-dsp-pathway-document-vs.-3.1.pdf (hullccg.nhs.uk)

Similar contents

See all content

Sign Up

Sign up to receive our newsletter and stay informed of new content!

        Institut Jérôme Lejeune
        37 rue des Volontaires
        75015 PARIS

        Institut Jérôme Lejeune
        37 rue des Volontaires 75015 PARIS

        Follow the Jérôme Lejeune Institute’s
        news on our social media accounts

        Follow the Jérôme Lejeune Institute’s news on our social media accounts

         Votre inscription a bien été prise en compte