Prevalence and treatments of Sleep-Disordered breathing in people with down syndrome: A narrative review.

Purpose: Sleep-disordered breathing (SDB) is accompanied by adverse effects like neurocognitive disorder, cardiovascular disease, and mood disorder, which are also common in people with Down syndrome (DS). As SDB needs to be managed in people with DS, this review described the prevalence, risk factors, unusual sleep postures (USPs), and treatments regarding SDB in people with DS.

Methods: This review included papers reporting on the prevalence, risk factors, and treatments of SDB in people with DS. MEDLINE, PubMed, Web of Science, and Scopus databases were searched up to March 2025. Case reports were excluded from this review.

Results: The estimated prevalence of SDB in adults and children with DS ranges from 72.6 to 100.0% and 37.5-100.0%, respectively. Craniofacial hypoplasia, obesity, and congenital heart disease, which are common in people with DS, were reported as risk factors for SDB. USPs such as leaning forward and sitting positions were also associated with SDB. Non-invasive ventilation therapy including positive continuous airway pressure therapy was effective and tolerable in people with DS. Hypoglossal nerve stimulation therapy was also effective, but complications like tongue/oral pain or discomfort (11.9%) and rash at surgical site (9.5%) were reported.

Conclusion: The prevalence of SDB is high in people with DS regardless of age and might be associated with characteristics of DS (craniofacial hypoplasia, obesity, and congenital heart disease). USPs might be an easy and useful screening tool for SDB in DS. Non-invasive ventilation therapy and hypoglossal nerve stimulation therapy would be effective and tolerable treatments in people with DS.