Weight Gain and Severe Obstructive Sleep Apnea in Adolescents with Down Syndrome

Abstract

Objectives/hypothesis: To determine whether the severity of obstructive sleep apnea (OSA) is affected by weight gain velocity (WGV) in adolescents with Down syndrome.

Study design: Retrospective case series.

Methods: We performed a retrospective case series of children with Down syndrome, aged 9-19, referred for polysomnography (PSG) due to suspected OSA at an academic children's hospital. We determined the velocity (slope of change) of yearly weight gain using a mixed effect linear regression model. Subsequently, we determined if velocity of yearly weight gain was greater in adolescents with severe OSA (apnea-hypopnea index > 10). Significance was set at P < .05.

Results: A total of 77 adolescents with Down syndrome were identified. The average age was 12.5 years (standard deviation = 3.1); 44 (57%) were male and 46 (60%) were Hispanic. The majority, 51 (66%) had severe OSA. The velocity of yearly weight gain prior to PSG in Down syndrome adolescents was similar regardless of OSA severity (mean diff in weight gain at PSG between severe and nonsevere OSA = -1.42, 95% confidence interval = -5.8 to 2.9, P = .52). Down syndrome adolescents with severe OSA weighed more at PSG (58.4 kg vs. 40.9 kg, P < .001) and all years prior to PSG. These findings remained even when controlling for age at PSG.

Conclusions: Severe OSA in adolescents with Down syndrome is associated with weight. There was no significant difference in WGV in children with Down syndrome with or without severe OSA.

Level of evidence: 3 Laryngoscope, 131:2598-2602, 2021.

Keywords: Down syndrome; Obstructive sleep apnea; adolescents; obesity; weight gain.