Management of obstructive sleep apnea associated with Down syndrome and other craniofacial dysmorphologies

Purpose of review Obstructive sleep apnea (OSA) is very common in children with Down syndrome and other craniofacial abnormalities and causes significant deleterious physical, developmental, and behavioral outcomes. OSA in these individuals is generally more difficult to treat than in other children, because of increased postoperative complications and lower success rates for adenotonsillectomy, the mainstay of treatment for otherwise healthy children with OSA. Recent findings There is a growing number of treatment options for these children, which can provide an alternative to continuous positive airway pressure or tracheostomy. Through the use of dynamic cine MRI studies, the level of obstruction can be identified and treatment made more focused. Summary Screening for OSA in this population should be increased, and utilization made of the recent advances in imaging and surgical technique to treat it.