To Örebro University

Study Objectives: Persons with Down syndrome (DS) have an increased risk of obstructive sleep apnea (OSA) needing continuous positive airway pressure (CPAP), but data on the therapy and outcomes in this population are scarce. We aimed to compare patient characteristics and outcomes of CPAP treatment for patients with OSA with and without DS.

Methods: This was a population-based, longitudinal study on patients initiating CPAP therapy between July 2010 and March 2018 in Sweden and a population-based sex-and age-matched control group (control:case ratio 5:1), with linked data from the Swedish National Patient Registry and the Prescribed Drug Registry (DISCOVERY study cohort).

Results: Patients with DS (n = 64) had a higher apnea-hypopnea index (51.7 & PLUSMN; 30.3 vs 36.8 & PLUSMN; 29.1 events/h, P < .001), Epworth Sleepiness Scale score (13.7 & PLUSMN; 5.9 vs 11.0 & PLUSMN; 4.9, P = .001), rate of previous surgery of tonsils and/or adenoids (21.9% vs 8.2%, P = .001), and more thyroid replacement hormone therapy (45.3% vs 7.8%, P < .001), but lower use of cardiovascular drugs (7.8% vs 22.3%, P = .003) compared with controls. At follow-up after 1.3 & PLUSMN; 0.9 years, there were no differences in nocturnal CPAP usage time (5.6 & PLUSMN; 2.4 vs 5.5 & PLUSMN; 2.0 hours, P = .77), CPAP adherence & GE; 4 hours/night (62% vs 65%, P = .93), or improvement in Epworth Sleepiness Scale score (-5.4 & PLUSMN; 6.8 vs-5.0 & PLUSMN; 2.0, P = .84) between DS and non-DS patients.

Conclusions: OSA severity was substantially higher in patients with DS despite an increased rate of tonsil surgery. Treatment outcomes in terms of adherence and improved daytime sleepiness were comparable between groups, underlining the importance of both OSA diagnosis and treatment in patients with DS.