{
  "abstract": "Introduction Children with Trisomy 21 (T21) are at increased risk of obstructive sleep apnoea (OSA): challenging to diagnose and manage, it is associated with adverse developmental and health outcomes. We aimed to describe presenting symptoms, assessment methods, ENT interventions, and NIV initiation success rates.Methods Children with T21 referred with suspected OSA January 2019 - October 2024 were identified from electronic records. Data were collected included demographics, presenting symptoms, investigations, ENT interventions, psychology input and outcomes of attempted NIV set up.Results 123 patients were included (54% female). Median age was 5 years (range 5 months-18 years). Presenting symptoms included snoring (72%), pauses in breathing (33%), heavy breathing (28%), mouth breathing (20%), restless sleep (20%), and daytime sleepiness (20%). Polysomnography (PSG) was performed in 76%, with 92% success rate. Other investigations included saturation (11%) and TCCO2 (15%) studies.Among those undergoing PSG, the apnoea-hypopnea index (AHI) ranged from 0 to 47, (median 5). OSA was diagnosed in 55.4% patients (17.9% mild, 15.45% moderate, and 15.45% severe), with 2% having central sleep-disordered breathing (SDB) and 3% mixed SDB. Adenotonsillectomy was performed in 45% of patients. NIV was attempted in 27% of patients (n=33), 96% of whom had an AHI >5. 33% of these patients had previous adenotonsillectomy. Of those starting NIV, 48% were outpatient set-ups. Overall, 47% of patients established successful use of NIV (> 4 hours night). Of these, 59% started NIV as an inpatient and 47% had psychology support.Conclusions PSG can be used effectively in Trisomy 21. A substantial proportion demonstrated moderate to severe OSA. Adenotonsillectomy was the most common intervention. NIV can often be successfully commenced. Psychology involvement highlights the importance of a multidisciplinary approach in supporting NIV adherence. These findings underscore the need for individualised management strategies, especially in cases not resolved by surgical intervention alone.",
  "authors": [
    {
      "affiliations": [
        "Alder Hey Children’s Hospital, Liverpool, UK"
      ],
      "name": "Heather Thomas"
    },
    {
      "affiliations": [
        "Alder Hey Children’s Hospital, Liverpool, UK"
      ],
      "name": "Sarah Murphy"
    },
    {
      "affiliations": [
        "Alder Hey Children’s Hospital, Liverpool, UK"
      ],
      "name": "Gemma Saint"
    },
    {
      "affiliations": [
        "Alder Hey Children’s Hospital, Liverpool, UK"
      ],
      "name": "Ruth Trinick"
    }
  ],
  "title": "P60 Presentation, evaluation and management of obstructive sleep apnoea in children with trisomy 21: a service evaluation from a tertiary centre",
  "uid": "5c20cdeb-1fa6-5e6e-848f-05e7312111d2"
}