Using the modified OSA-questionnaire to determine the prevalence of a high risk of severe obstructive sleep apnea in children with Down syndrome

Abstract

Children with Down syndrome often experience obstructive sleep apnea (OSA), which can be severe and, if untreated, leads to serious complications. Polysomnography, the gold standard for diagnosing OSA, has long waiting lists and poses challenges for these children. The modified OSA-18 questionnaire may help determine the severity of OSA in this population, facilitating the study of its prevalence and risk factors. A cohort of 180 children with Down syndrome, aged 2–12 years, was enrolled from August 2020 to January 2022. Participants completed the modified OSA-18 questionnaire, where a score of 21+ indicated a high risk of severe OSA. Demographic data, prevalence, and associated risk variables were analyzed. A total of 180 participants were included. Their mean age was 8.9 ± 2.8 years, and a slight majority were male (52.2%). Most had normal weight (44.4%); 33.9% were overweight, and 21.7% had obesity. The prevalence of those at high risk for severe OSA was 19.4%. The only significant risk factor for severe OSA was obesity (p < 0.001; OR = 6.96; 95% CI = 2.65–18.28). The study found a lower prevalence of high-risk severe OSA in children than reported by polysomnography-based studies, with obesity as the sole risk factor. The research confirmed that the modified OSA-18 questionnaire is a more convenient and quicker assessment tool. Prompt assessment of obese children with Down syndrome for severe OSA is crucial to prevent sequelae.