Down syndrome, a genetic disorder, afflicts more than 350,000 individuals in the United States, according to the National Down Syndrome Society. For many of these individuals, especially children, the medical complications involve a life time of treatment and care from specialists in all areas of medicine. One such condition, sleeping disorders, are an essential part of daily living that prevent many Down syndrome patients from obtaining adequate sleep and, therefore, an inability to function on a daily basis. Of the sleeping disorders found in Down syndrome children, Obstructive Sleep Apnea, OSA, is most prevalent but can be alleviated with a select few medical treatment options.
Obstructive Sleep Apnea, OSA, encompasses a variety of symptoms in children. For most Down syndrome children, the condition involves the cessation of respiration, for up to 20 seconds, with respiratory activity continuing without further complication. Most commonly, OSA in the Down syndrome child is the direct result of the malformation of the facial structure including the narrow passageway of the nasal and throat area. In addition, Down syndrome children often suffer from OSA, in part, due to the enlarged tonsils and adenoids.
When suffering from Obstructive Sleep Apnea, Down syndrome children will exhibit a variety of symptoms beyond the cessation of respiration for a few seconds. In addition, the Down syndrome infant may often appear to be sleeping in an odd position, a natural bodily manipulation done to improved breathing, may sweat during periods of sleep and may even appear overly sleepy during the day due to disturbed sleeping patterns. Beyond acute conditions, Down syndrome children, suffering from OSA may also experience an increase in blood pressure, or hypertension, as a direct result of the OSA and lack of oxygen flow into the body as well as delay or impact the child’s growth and development. So, how is Obstructive Sleep Disorder, OSA, treated in a Down syndrome child?
Treatment of OSA, in Down syndrome children often involves, first, the diagnosis of the sleep disorder. Simply achieved, in collaboration with a sleep study center, OSA, in the Down syndrome child involves a study of the child’s respiration during nap, often referred to as a nap somnography.
Once diagnosed with OSA, there are a variety of treatment options available to the Down syndrome infant including surgical removal of the adenoids and tonsils, which, by coincidence, may improve the child’s overall health by avoiding throat disorders and complications. Unfortunately, for Down syndrome children, the surgical procedure to improve OSA may result in not only hospital admission, but also in the prolonged recovery as Down syndrome children suffer a greater delay in recovery when compared to children who do not suffer from Down syndrome.
Beyond surgical intervention, to treat OSA in Down syndrome children, the pediatrician may recommend the child may undergo a less invasive procedure known as CPAP, or Continuous Positive Airway Pressure in which the child is provided with additional oxygen and pressure, during sleep, as a method to improve respiration.
As parents, caring for a Down syndrome child, using CPAP is often a frustrating medical form of treatment for OSA in the Down’s child. With the frequency of office visits, regular mask adjustments and the difficulty in administered the mask onto the child, parents of Down syndrome children are often left fatigued and frustrated with the CPAP device. However, when caring for a Down syndrome child, any method available, to improve OSA, is crucial to the improved health and welfare of the child, especially during crucial years of child growth and development. As a viable option, however, parents of Down syndrome children may want to discuss the use of nasal steroids as an alternative to the initial use of CPAP.
For more information regarding Obstructive Sleep Apnea in Down syndrome children, visit www.ndss.org.