Obstructive sleep apnea, is fairly common in children with Down syndrome. By adulthood, one out of every two persons with Down syndrome has sleep apnea. It is not always associated with obesity in this population, and may be related to low tone in the airways and structural abnormalities. It’s important for nurses to report any symptoms of sleep apnea, including:

• snoring and periods of apnea during sleep
• unusual sleeping positions
• daytime sleepiness
• irritability, depression, or paranoia
• significant behavioral changes
  

In some cases, surgery is indicated to avoid hypoxia and cor pulmonale. Other children may benefit from supplemental oxygen under pressure, such as a CPAP machine provides. Nurses working with this population can play a key role in promoting and reinforcing correct and regular use of these devices.