Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Sleep Medicine

Outcomes in Patients With Trisomy 21 and Obstructive Sleep Apnea

Tuesday, October 3, 2023
9:27 AM - 9:33 AM East Coast USA Time
Location: 103A

    Presenting Author(s)

  • Somya Shankar, BS

    Medical Student
    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

    • Co-Author(s)

  • AM

    Annie E. Moroco, MD

    Resident Physician
    Thomas Jefferson University
    Philadelphia, PA, United States

  • Zachary T. Elliott, BS

    Medical Student / Research Fellow
    Thomas Jefferson University
    Greenville, NC, United States

  • Maurits S. Boon, MD

    Professor
    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

    • Senior Author(s)

  • Colin T. Huntley, MD

    Associate Professor
    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

Disclosure(s):
Maurits S. Boon, MD: No relevant relationships to disclose.
Introduction: The prevalence of Obstructive Sleep Apnea (OSA) is as high as 75% in patients with Trisomy 21 (T21). As patients with T21 have unique treatment needs with poor long-term effects when untreated or under-treated, we sought to examine the cardiovascular, neurological, and endocrinological outcomes of patients with T21 at five, ten, and twenty years after their diagnosis of OSA to further characterize the long-term implications of OSA on patients with T21.

Methods: TriNetX, an electronic medical record database, was queried for cardiovascular, neurological, and endocrinological outcomes in patients with T21 at five, ten, and twenty years after diagnosis of OSA in October 2022. A total of 14,871 patients were identified in the T21+OSA cohort. The group was further analyzed to identify those who underwent sleep surgery, including hypoglossal nerve stimulation, palatopharyngoplasty, or tonsillectomy.

Results: At all timepoints, patients with OSA and T21 had a significantly higher (p < 0.05) incidence of death, myocardial infarction, cerebral infarction, heart failure, cardiac arrhythmia, pulmonary hypertension, and Alzheimer’s disease compared to patients with T21 alone and to patients with OSA alone. Patients with OSA and T21 also had significantly higher incidence of ischemic heart disease, atrial fibrillation, hypertension, metabolic syndrome, and diabetes when compared to patients with T21 alone, but not patients with OSA alone. Patients with OSA and T21 who underwent sleep surgery had significantly reduced (p < 0.05) incidence of adverse health outcomes compared to patients using continuous positive airway pressure (CPAP).

Conclusions: Our findings suggest that patients with T21 and OSA are at higher risk of poor health outcomes, which may require closer monitoring for earlier diagnosis and management of comorbid conditions. Sleep surgery is a suitable treatment modality for mitigating the risk of adverse outcomes in this population when compared to CPAP and should be considered in patients who are eligible surgical candidates.