0813 Increasing accessibility of assessment of obstructive sleep apnea syndrome in youth with Down syndrome

Abstract Introduction Because of the high risk for obstructive sleep apnea syndrome (OSAS) in youth with Down syndrome (DS), in-lab polysomnogram (PSG) is recommended by age 4-years and if symptom screening warrants. Unfortunately, screening for “traditional” OSAS symptoms has been considered unreliable DS. Further, while in-lab polysomnography (PSG) is the gold standard in assessment of OSAS, undergoing in-lab PSG is time and cost intensive and often stressful for youth with DS and their families. This study examined the relationship of sleep disturbance questionnaires with in-lab PSG and home sleep apnea testing (HSAT) in youth with DS. Methods As part of a larger study comparing PSG to HSAT in individuals with DS aged 6-25y, caregivers completed the parent-proxy Pediatric Promis Sleep Disturbance Measure (PPSDM) and Modified Epworth Sleepiness Scale (ESS). The relationships of the PPSDM and ESS and sleep study variables (total sleep time, oxygen desaturation nadir (SpO2 nadir), wake after sleep onset (WASO), sleep efficiency, obstructive hypopnea index (OAHI), and arousal index) were examined using Spearman correlation. Results Caregiver-completed questionnaires were available for 38 individuals with DS (18 males; mean age of 15.0±4.7, 84% White; 95% Non-Hispanic). PSG OAHI median [IQR] was 12.9[5.5-22.8] events per hour, SpO2 nadir 86.5[81-89] %, PPSDM 25[20-33], ESS 2.5[1-8]. The PPSDM was negatively correlated with PSG SpO2 nadir (r=-0.437; p=0.006) but with no additional HSAT or PSG variables. ESS was positively correlated with the obstructive apnea hypopnea index (OAHI) on both PSG (r=0.340, p=0.03) and HSAT (r=0.372; p=0.02) and negatively correlated with HSAT WASO (r=-0.369; p=0.02). Conclusion Given the limited availability of sleep specialists and labs equipped to complete PSG in individuals who may require increased attention, overnight pulse oximetry overnight coupled with ESS and caregiver completed sleep disturbance questionnaires may provide an initial, noninvasive, cost-effective method to screen for OSAS in individuals with DS. Considering that ESS correlated with OAHI, this questionnaire could be used to decide repeat PSG in youth with DS. Support (if any) This study was support by NICHHD grant R21HD101003 (PIs: Kelly and Tapia).