Tapia, Ignacio Esteban MD

In children, obstructive sleep apnea (OSA) is evaluated by overnight polysomnography (PSG) in a sleep laboratory, but these facilities are limited, and the test requires caregivers to spend a night away from home with their child. Home sleep apnea testing (HSAT) is a similar test conducted in the home environment, but it is not currently used in children because it has not been directly evaluated against PSG. This trial will compare HSAT with PSG in terms of its accuracy and impact on therapeutic decision for children being evaluated for OSA, and family factors be assessed to determine if HSAT is a good alternative test to PSG.

The prevalence of OSAS in children with DS is markedly increased compared to that of typically developing children and most are not cured by adenotonsillectomy (AT). Many children with DS are referred for positive airway pressure (PAP) therapy initiation due to persistent OSAS after AT but PAP adherence can be challenging. The purpose of this proposal is to conduct a randomized controlled trial, during which participants will be randomized to a 6-month intensive behavioral intervention (INT) to improve PAP adherence vs standard clinical care (CON) and undergo standardized evaluations of behavior, attention, quality of life, family-relevant outcomes identified during the R61 phase, PAP adherence, and health care utilization at baseline, 6, and 12 months.

Obstructive sleep apnea syndrome (OSAS) is common in children and adults with Down syndrome (DS). Because testing for OSAS can be inaccessible, expensive, and not well-tolerated, studying the impact of OSAS and its treatment upon learning, behavior, and heart disease risk is challenging. This study will explore how well the use of in-home testing for OSAS is tolerated by adolescents with DS and effective in diagnosing OSAS.