R., Amin, R., Chini, B., Heubi, C., Hotze, S., & Akers, R. Tongue-Based Procedures in Treating Refractory Obstructive Sleep Apnea in Down Syndrome Patients: A Systematic Review and Meta-Analysis. Associations between obstructive sleep apnea severity and endoscopically proven gastroesophageal reflux disease. Treatment Considerations for Obstructive Sleep Apnea in Pediatric Down Syndrome. Gastelum, E., Cummins, M., Singh, A., Montoya, M., Urbano, G. Accuracy of Parental Perception of Nighttime Breathing in Children with Down Syndrome. Otolaryngology-head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery, 158(2), 364–367. “CPAP vs BIPAP Machines for Sleep Apnea.” American Sleep Association. Shott MD, Professor Department of Otolaryngology Head and Neck Surgery, University of Cincinnati, Cincinnati Children’s Hospital Medical Center for assisting with this article. All options should be discussed with a doctor to determine which is best for you or your loved one. Unfortunately, more research is needed on these treatment options for individuals with Down syndrome. For individuals who are medically overweight, getting to a healthy weight can improve symptoms.Dental devices worn at night that push the lower jaw forward.Myofunctional therapy (exercise-based therapy for the muscles of the mouth, tongue, and face).A high-flow nasal cannula used at night (oxygen provided through the nose in a tube).A recent review of five studies using a hypoglossal nerve stimulating device found it significantly decreased the number of times the individual stopped breathing during sleep (Lee et al., 2021). Hypoglossal nerve stimulation (an implanted medical device that electrically stimulates tongue movement with breathing) is a relatively new treatment researchers are hopeful about. Although many individuals with Down syndrome adjust to using the CPAP during sleep, some are unable to tolerate wearing the facial mask and require alternative treatments. It is used for individuals who cannot tolerate CPAP machines and to treat central sleep apnea.ĬPAP and BiPAP machines are typically life-long treatments. CPAP machines are primarily used to treat OSA.īiPAP: A machine that delivers a stream of oxygenated air at two pressures: an inhale pressure and an exhale pressure. The airstream pushes against any obstructions, maintaining an open airway for breathing. CPAP/BiPAP UseĬontinuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) therapy is often used as a secondary treatment after surgery.ĬPAP: A machine that delivers a steady stream of oxygenated air through a flexible tube to a mask sealed around a person’s nose and mouth. This can rule out regrowth of tonsils or adenoids and glossoptosis. A flexible lighted camera is inserted through the nose or mouth to examine the area behind the nose, the back of the tongue, and the throat. To determine the site(s) of residual airway obstruction, your doctor might perform a nasopharyngoscopy and laryngoscopy examination. MRI studies have shown a combination of relatively large tongues, glossoptosis (backwards movement of the tongue during sleep), and tonsil and adenoid regrowth are the most common causes of residual obstruction. Some individuals with Down syndrome experience OSA that continues even after surgery to remove tonsils and adenoids, known as “residual” OSA. Unfortunately, adenotonsillectomy does not always cure sleep apnea. A sleep study should be repeated after this surgery to determine whether the sleep apnea was resolved. Because of this, the most commonly used treatment is adenotonsillectomy (surgical removal of tonsils and adenoids). This can lead to airway obstruction when tonsils and adenoids are even slightly enlarged. Some people with Down syndrome have relatively smaller jaw bones, cheekbones, and eye sockets and narrow nasal passages. There are treatment options available for OSA.
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