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RCPCH Guideline on Sleep Related Breathing Disorders 2009 • Clinical history is a sensitive screen but low specificity • Pulse oximetry is a useful screen but “if positive is highly predictive, but a negative result does not exclude OSA” 1. All children with DS should be offered screening using as least pulse oximetry 2. Screen once in infancy and then annually until age 5yrs 3. Children with abnormalities in screening or strong suspicion of false negatives should then have polysomnography (oximetry, airflow, effort capnography and video if possible)
2011: Implementation at SGH • Following publication of RCPCH guideline, a new proforma for screening of OSA was implemented • Clinic checklist modified
Page 1 and 2: Dr I Hadjikoumi, Dr S Jheeta, Dr M
Page 3 and 4: What is it? • Upper airway at the
Page 5 and 6: Symptoms of OSA • Mouth breathing
Page 7 and 8: Why is it common in DS? • Anatomi
Page 9 and 10: Consequences of untreated OSA • P
Page 11 and 12: St George’s Hospital Study Stages
Page 13 and 14: Retrospective analysis • 44 patie
Page 15 and 16: Results • 16% - diagnosed OSA by
Page 17: Stage 2- repeat questionnaire • 8
Page 21 and 22: Sleep Apnoea Down Syndrome Study Un
Page 23 and 24: Telephone questionnaire n=10 • 3
Page 25 and 26: Equipment used • TOSCA 500 device
Page 27 and 28: Criteria for a screening programme
Page 29 and 30: Questions • Is capnography useful
Page 31 and 32: Conclusion - Need for robust data f
Page 33: Acknowledgements • Dr R Chavasse-

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