Table 1.
Outcomes of interventions in studies of obstructive sleep apnea in pediatric Down syndrome.
| Study, Year | N | Age (Years) | Design Method | Intervention | Outcome of Intervention |
|---|---|---|---|---|---|
| Caloway et al. (2020) [33] | 20 | 10 to 21 | Case series | HGN stimulation | Significant improvement in AHI and OSA-18 scores |
| Nerfeldt and Sundelin (2020) [34] | 14 | 1 to 17 | Retrospective cohort study | AT | Minimal reduction in AHI; significant improvement in OSA-18 scores one year after AT |
| Yu et al. (2020) [35] | 29 | Median age: 7.4 | Retrospective chart review | Pharmacologic (intranasal corticosteroids and/or montelukast) | Medication therapy was not found to be effective in treating mild OSA |
| Howard et al. (2020) [36] | 23 | 0 to 10 | Retrospective chart review | Pharmacologic (montelukast; fluticasone) | Low rates of resolution of mild OSA |
| Lukowicz et al. (2019) [37] | 42 | 2 to 11 | Prospective longitudinal study | One-week intensive myofunctional therapy training camp | Marginal effect on OSA symptoms |
| Amaddeo et al. (2019) [38] | 6 | 0 to 17 | Prospective study | HFNC | Three of the six participants successfully managed OSA with HFNC |
| Diercks et al. (2018) [39] | 6 | 10 to 21 | Case series | HGN stimulation | Significant improvement in AHI and OSA-18 scores at 6- and 12-month follow ups |
| Prosser et al. (2017) [40] | 21 | Mean age: 9.3 ± 4.3 | Retrospective case series | LT | Significant improvement in median AHI and mean oxygen saturation nadir |
| Ingram et al. (2017) [41] | 75 | 0 to 16 | Retrospective chart review | Tonsillectomy with concurrent or previous adenoidectomy | Improvement in AHI from baseline 21.3 ± 19.7 to 8.0 ± 8.1 six months after tonsillectomy |
| Propst et al. (2017) [42] | 13 | 6 to 18 | Prospective study | MPG and LT | Improvement in AHI in normal weight or overweight children with DS, but not obese children with DS. |
| Sudarsan et al. (2014) [43] | 124 | 6 to 12 | Prospective, randomized, cohort study | AT or CPAP | Improvement in AHI from baseline 3.83 ± 1.36 to 2.62 ± 0.87 six months after AT Improvement in AHI from baseline 3.46 ± 1.67 to 1.09 ± 0.61 six months after nightly CPAP use |
| Wooten and Shott (2010) [44] | 19 | Mean age: 11.5 | Retrospective institutional review | GGA and RFA | Significant improvement in mean AHI and mean nadir oxygen saturation |
| Shete et al. (2010) [45] | 11 | Mean age: 8.5 | Retrospective chart review | AT | Improvement in total AHI from 15.3 to 9.1 No change in REM-AHI, oxygen saturation, distribution in stages of sleep, sleep efficiency, and mean ArI 73% of participants required CPAP, BIPAP, or nocturnal oxygen for persistent OSA |
AHI: apnea–hypopnea index; ArI: arousal index; AT: adenotonsillectomy; BIPAP: bi-level positive airway pressure; CPAP: continuous airway pressure; GGA: genioglossus advancement; HFNC: high-flow nasal cannula; HGN: hypoglossal nerve; LT: lingual tonsillectomy; MPG: midline posterior glossectomy; OSA: obstructive sleep apnea; OSA-18: Obstructive Sleep Apnea-18; REM-AHI: rapid eye movement apnea–hypopnea index; RFA: Radiofrequency ablation.