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The Significance of Sleep Disorders in Children with Down Syndrome

It is estimated one in every 691 babies is born with Down Syndrome in the United States, making Down Syndrome the most common genetic condition, according to the National Down Syndrome Society (NDSS). The NDSS also states approximately 400,000 Americans have Down Syndrome and each year in the United States around 6,000 babies are born with Down Syndrome. Every human body is made up of cells and inside every cell is a nucleus. It’s inside this nucleus that the genetic make-up of an individual is stored. Generally, the nucleus inside cells has 23 pairs of chromosomes and Down Syndrome occurs in an individual when there is a an extra copy of the chromosome 21. Down Syndrome takes no bias towards race or economic background and the exact cause is still unknown; although evidence has been able to link an increased risk with older women having children later in life. While children with Down Syndrome are able to be just as healthy as

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any other child, they also may have special medical problems such as respiratory issues, bone development problems, and even Sleep Apnea.

ChromosomeSleep disorders in children with developmental disorders are more common than children without; the most popular being Sleep
Apnea. According to the NDSS, there is a 50 – 100% chance of Obstructive Sleep Apnea (OSA) in individuals with Down Syndrome and with children between the ages 3.5 – 4 years old the prevalence is 60%. This number only grows as the children grow older. OSA is caused by an obstruction (either partially or completely) of the airway. This can be caused by enlarged tonsils, enlarged tissues,or even an enlarged tongue. Often children with Down Syndrome have smaller upper airways which is also a major culprit. OSA in any child, not just children with Down Syndrome can have severe consequences. There are physical, mental, and behavioral issues associated with untreated OSA. Obstructive Sleep Apnea greatly disrupts sleep multiple times a night, causing major disturbances in the restorative sleep, essential in the development of a child. OSA also restricts oxygen from being delivered to the brain and heart, increasing the risk of high blood pressure and diabetes while negatively affecting one’s mood and memory. These are just a few of the risk factors associated with OSA.

With such a high prevalence of Sleep Apnea in children and even adults with Down Syndrome it is very important to recognize the signs and know the plan of action to treat if the symptoms are noticed. Some of the most common symptoms are loud snoring, uncommon sleep positions, waking frequently throughout the night, or gasping for air while sleeping. Some symptoms while awake are excessive daytime sleepiness, a short attention span, or the child becoming easily irritated or frustrated. If any of these are noticed it is important to have the child checked by a primary care physician. The physician will then decide which direction to take as far as treatment. Most often a Polysomgnographic Test (sleep study) will be recommended. Sleep studies identify if any Sleep Apnea is present and how severe it is. One treatment of Sleep Apnea is CPAP, Continuous Positive Airway Pressure. CPAP is considered the gold standard for treatment of Sleep Apnea. CPAP delivers air pressure into the airway while sleeping to hold the airway open. Tonsillectomies also have been recommended to help curb Sleep Apnea, but these often are very painful and not often successful.

Whether it be child or adult, recognizing and proactively treating Sleep Apnea is important for anyone who may be suffering from it. With such a high risk rate in children with Down Syndrome that importance increases. A child’s rest is so vital to physical and mental development; it must not be comprised if at all possible. If symptoms are being experienced do not hesitate to speak with a physician about further testing and or treatment options.

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