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  • Title: Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome.
    Author: Shete MM, Stocks RM, Sebelik ME, Schoumacher RA.
    Journal: Int J Pediatr Otorhinolaryngol; 2010 Mar; 74(3):241-4. PubMed ID: 20097432.
    Abstract:
    OBJECTIVE: To determine if adeno-tonsillectomy (T&A) in children with Down syndrome (DS) improves breathing, measured by apnea hypopnea index (AHI), rapid eye movement AHI (REM-AHI) and the lowest oxygen desaturation (SaO2), and sleep disruption, measured by arousal index (ArI) and time spent in stages 1-4 and rapid eye movement (REM) sleep and compare these results with a group of non-DS children with obstructive sleep apnea (OSA). STUDY DESIGN: Retrospective chart review at pediatric sleep center. PATIENTS: Eleven DS and nine non-DS children underwent pre- and post-T&A polysomnography between 1997 and 2005. OUTCOME MEASURES: Pre- and post-T&A polysomnography parameters were compared using paired t-test and independent samples test. RESULTS: Mean age in DS group was 101 months and non-DS group was 80 months (64% males in DS and 88% in non-DS group). The average BMI was 29.8 and 27.6 for DS and non-DS group. The total AHI showed significant improvement after T&A but this was not as marked as the non-DS group. REM-AHI and lowest SaO2 did not show significant change in the DS children. The non-DS group showed significant improvement in all respiratory parameters. Both groups showed mild improvement in sleep parameters. With the modest overall improvement, 27% of the DS children required no further treatment. However, 73% required CPAP, BiPAP or oxygen for persistent OSA. CONCLUSION: This study supports the fact that T&A in DS children improves some parameters of OSA, however not as markedly as in non-DS children.
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