{"id":{"repo_id":"utswmed","oai_identifier":"oai:utswmed-ir.tdl.org:2152.5/10626"},"canonical_url":"https://search.dev.ndltd.org/etd/utswmed/oai:utswmed-ir.tdl.org:2152.5/10626","repository":{"repo_id":"utswmed","name":"University of Texas Southwestern Medical Center","base_url":"https://utswmed-ir.tdl.org/server/oai/request"},"display":{"title":"Obstructive Sleep Apnea in Special Pediatric Populations: Down Syndrome and Sickle Cell Disease","abstract":"The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","abstract_html":"The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","abstract_has_math":false,"creators":["Abijay, Claire Anne Beltran"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Mitchell, Ron","Johnson, Romaine F.","Chorney, Stephen R."],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-06-03T19:58:31Z","date_published":"2025-06-03T19:58:31Z","updated_at":"2026-07-24T05:52:29Z","subjects":["Anemia, Sickle Cell","Adolescent","Child","Down Syndrome","Sleep Apnea, Obstructive"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["1522122181"],"render_values":[{"text":"1522122181","href":null,"code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/2152.5/10626","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Mitchell, Ron","Johnson, Romaine F.","Chorney, Stephen R."]},{"key":"dc:creator","label":"Author","values":["Abijay, Claire Anne Beltran"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025-06-03T19:58:31Z","2023-05","May 2023"]},{"key":"dc:type","label":"Dc Type","values":["Thesis","text"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Anemia, Sickle Cell","Adolescent","Child","Down Syndrome","Sleep Apnea, Obstructive"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://hdl.handle.net/2152.5/10626","1522122181"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","Pediatric obstructive sleep apnea (OSA) is a sleep-related disorder of breathing caused by upper airway obstruction. Polysomnography is the gold standard for diagnosis, and the first-line treatment of tonsillectomy with or without adenoidectomy (T&A) typically resolves OSA in most of the general pediatric population. However, several special populations with significant comorbidities are at high risk of OSA, as well as surgical and anesthetic complications. The purpose of this work is to further investigate OSA in two specific groups: children with (1) Down syndrome and (2) sickle cell disease. The first study involved children with Down syndrome, and its primary aim was to evaluate outcomes after T&A and predictors for persistent OSA. The second study focused on children with sickle cell disease, and the objective was to compare demographic, clinical, and polysomnographic characteristics of children with and without sickle disease prior to surgical intervention. Two separate retrospective chart review studies were conducted utilizing electronic medical records from UT Southwestern/Children's Medical Center in Dallas, TX. The final population included 81 children with Down syndrome who had both pre- and postoperative (within 12 months of T&A) polysomnography. The second study included 89 children with sickle cell disease and 192 children without sickle cell disease with preoperative polysomnography. In the study of children with Down syndrome, most of the final population (nearly 75%) had severe OSA, based on an apnea-hypopnea index (AHI) ≥ 10. T&A improved, based on a decrease in AHI, but did not completely resolve OSA. Approximately 60% of children had persistent moderate or severe OSA; outcomes depended on the baseline severity and obesity rates. Notably, 20% of patients had worsening AHI after T&A. Asthma (odds ratio 4.77; 95% CI, 1.61-14.09; P = .005) and increasing age (odds ratio, 1.25; 95% CI, 1.09-1.43; P = .001) were identified as predictors for persistent OSA. These findings suggest close follow-up in children with Down syndrome after T&A due to the high risk of persistent OSA that may worsen with age. In children with sickle cell disease, severe OSA was present in 43% of the study population versus 67% in the non-sickle cell group (P < .001). Children with sickle cell disease had a lower mean AHI compared to the non-sickle cell group but spent more percent sleep time below 90% oxygen saturation. Most children with sickle cell disease were of normal weight, particularly among the HbSS genotype, whereas most of the comparative group were either overweight or obese. Predicted probability for severe OSA in children with sickle cell disease decreased with increasing age (OR = .81, 95% CI: 0.70-0.93, P =.005). This study highlights the need to screen children with sickle cell disease as they are at high risk for severe OSA, despite being of normal weight, and suffer from longer periods of nocturnal hypoxemia compared to the general pediatric population."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Obstructive Sleep Apnea in Special Pediatric Populations: Down Syndrome and Sickle Cell Disease"]}]}],"canonical_facts":{"dc:contributor":["Mitchell, Ron","Johnson, Romaine F.","Chorney, Stephen R."],"dc:creator":["Abijay, Claire Anne Beltran"],"dc:date":["2025-06-03T19:58:31Z","2023-05","May 2023"],"dc:description":["The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","Pediatric obstructive sleep apnea (OSA) is a sleep-related disorder of breathing caused by upper airway obstruction. Polysomnography is the gold standard for diagnosis, and the first-line treatment of tonsillectomy with or without adenoidectomy (T&A) typically resolves OSA in most of the general pediatric population. However, several special populations with significant comorbidities are at high risk of OSA, as well as surgical and anesthetic complications. The purpose of this work is to further investigate OSA in two specific groups: children with (1) Down syndrome and (2) sickle cell disease. The first study involved children with Down syndrome, and its primary aim was to evaluate outcomes after T&A and predictors for persistent OSA. The second study focused on children with sickle cell disease, and the objective was to compare demographic, clinical, and polysomnographic characteristics of children with and without sickle disease prior to surgical intervention. Two separate retrospective chart review studies were conducted utilizing electronic medical records from UT Southwestern/Children's Medical Center in Dallas, TX. The final population included 81 children with Down syndrome who had both pre- and postoperative (within 12 months of T&A) polysomnography. The second study included 89 children with sickle cell disease and 192 children without sickle cell disease with preoperative polysomnography. In the study of children with Down syndrome, most of the final population (nearly 75%) had severe OSA, based on an apnea-hypopnea index (AHI) ≥ 10. T&A improved, based on a decrease in AHI, but did not completely resolve OSA. Approximately 60% of children had persistent moderate or severe OSA; outcomes depended on the baseline severity and obesity rates. Notably, 20% of patients had worsening AHI after T&A. Asthma (odds ratio 4.77; 95% CI, 1.61-14.09; P = .005) and increasing age (odds ratio, 1.25; 95% CI, 1.09-1.43; P = .001) were identified as predictors for persistent OSA. These findings suggest close follow-up in children with Down syndrome after T&A due to the high risk of persistent OSA that may worsen with age. In children with sickle cell disease, severe OSA was present in 43% of the study population versus 67% in the non-sickle cell group (P < .001). Children with sickle cell disease had a lower mean AHI compared to the non-sickle cell group but spent more percent sleep time below 90% oxygen saturation. Most children with sickle cell disease were of normal weight, particularly among the HbSS genotype, whereas most of the comparative group were either overweight or obese. Predicted probability for severe OSA in children with sickle cell disease decreased with increasing age (OR = .81, 95% CI: 0.70-0.93, P =.005). This study highlights the need to screen children with sickle cell disease as they are at high risk for severe OSA, despite being of normal weight, and suffer from longer periods of nocturnal hypoxemia compared to the general pediatric population."],"dc:format":["application/pdf"],"dc:identifier":["https://hdl.handle.net/2152.5/10626","1522122181"],"dc:language":["en"],"dc:subject":["Anemia, Sickle Cell","Adolescent","Child","Down Syndrome","Sleep Apnea, Obstructive"],"dc:title":["Obstructive Sleep Apnea in Special Pediatric Populations: Down Syndrome and Sickle Cell Disease"],"dc:type":["Thesis","text"]},"updated_at":"2026-07-24T05:52:29Z"}