Authors Explore the Dentist's Role in Recognizing and Treating Sleep-Disordered Breathing in Children with Down Syndrome

March 27, 2009

"Oral health professionals may be in a unique position to recognize sleep-disordered breathing and screen for it in children with DS [Down syndrome]," state the authors of an article published in the March 2009 issue of the Journal of the American Dental Association. Sleep-disordered breathing has been found to occur in 50-80 percent of children with Down syndrome (DS). However, in many children, the association between DS and sleep-disordered breathing may go unrecognized by parents and health professionals. Obstructive sleep apnea (OSA), characterized by episodic obstruction of the upper airway during sleep, results in hypoxemia (insufficient oxygenation of the blood) and frequent arousals; it is associated with symptoms such as snoring and excessive daytime sleepiness.

The treatment approach for children has focused on surgical options such as tonsillectomy and adenoidectomy, but research has shown that OSA in children with DS often persists even after surgery. Some clinicians recommend the use of oral appliances and other surgical approaches, which require the collaboration of health professionals in several disciplines. The authors of the article discuss the clinical features of DS and association with OSA, recognition of OSA, and the role for oral devices. Topics include terms and definitions, medical history and anatomical considerations for oral health professionals suspecting sleep-disordered breathing, screening children for OSA (e.g., quantifying excessive daytime sleepiness), and severity of OSA and treatment.

The authors conclude that

  • Oral health professionals should recognize the impact of sleep impairment and the need for diagnostic testing to confirm suspicions when evaluating a child's breathing management.
  • Oral health professionals should collaborate with a physician who is a sleep specialist and with the child's primary physician when evaluating and treating children with DS and OSA.

Waldman HB, Hasan FM, Perlman S. 2009. Down syndrome and sleep-disordered breathing: The dentist's role. Journal of the American Dental Association 149(3):307-312. Abstract available online here.

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