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. 2016 Oct;37(8):629-36.
doi: 10.1097/DBP.0000000000000333.

Use of Sleep Evaluations and Treatments in Children with Down Syndrome

Anna J Esbensen  1 , Dean W Beebe, Kelly C Byars, Emily K Hoffman
Affiliations

Use of Sleep Evaluations and Treatments in Children with Down Syndrome

Anna J Esbensen et al. J Dev Behav Pediatr. 2016 Oct.

Abstract

Objective: To characterize practice patterns regarding sleep evaluation and intervention among children with Down syndrome (DS).

Method: Data were obtained from electronic health records from 2009 to 2013 for a retrospective cohort of 954 children with DS, aged 5 to 21 years during the time sampled. International Classification of Diseases, Ninth Revision, diagnoses were used to identify children with obstructive sleep apnea and/or behavioral sleep disturbances. Primary outcomes were confirmed by participation in an overnight diagnostic polysomnography (PSG) and/or documented provision of specified sleep interventions including positive airway pressure, otolaryngology (ENT) surgery, sleep medication, and behavioral sleep therapy.

Results: Overall, 47.7% of children with DS had undergone PSG, 39.1% had diagnosed sleep problems, and of those diagnosed with sleep problems, 81.2% had received sleep intervention. Consistent with best practice clinical care, sleep treatments matched the diagnosed sleep problems. Age, gender, and race, but not body mass index (BMI), were associated with PSG completion rate and occurrence rates for ENT surgery and sleep medication usage. BMI was associated with obstructive sleep apnea.

Conclusion: Despite high rates of reported sleep problems in children with DS, less than half underwent PSG. Children diagnosed with sleep problems received treatment consistent with their sleep diagnosis. However, age and gender were associated with differential rates of treatment delivery that was incongruous with prevalence rates for diagnosed sleep problems. These findings underscore the importance of screening for sleep problems in children with DS, and referring for and providing appropriate targeted sleep interventions.

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Conflict of interest statement

Dr Esbensen has served as a consultant to Roche Products. Dr Beebe is currently receiving a grant (R01 HL120879) from NIH. No other conflicts of interests were declared by the authors.

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