Multisystem approach for management of OSA in Down syndrome: a case report

Obstructive sleep apnea (OSA) is common in children with Down syndrome, with reported prevalence rates as high as 69–76%. Multiple factors predispose children with Down syndrome for OSA, including craniofacial hypoplasia (maxillary and mandibular), airway abnormalities, macroglossia, generalized hypotonia, airway hypotonia, adenotonsillar hypertrophy, and obesity. Despite the fact that the pathophysiology for OSA in children with Down syndrome is multifactorial in nature, treatment methods have focused on soft tissue in the upper airway using adenotonsillectomy and/or continuous positive airway pressure therapy. Here we present a case of a patient with Down syndrome whose severe OSA was approached in a multisystem manner, including upper airway soft tissue, orthognathic, maxillofacial, and bariatric surgery, resulting in resolution of the OSA without reliance on a continuous positive airway pressure device.

Finch CE, Raol N, Roser SM, Leu RM. Multisystem approach for management of OSA in Down syndrome: A case report. J Clin Sleep Med. 2024;20(3):471–473.