We received a question from an individual in Switzerland about preventing sleep apnea.
Sleep apnea occurs when air is not passed normally in and out of the lungs while sleeping. There are three types of sleep apnea:
Obstructive sleep apnea – the airway closes when the person is breathing in so air does not pass into the lungs
Central sleep apnea – the brain does not send appropriate signals to the respiratory muscles, so the muscles do not drive air in and out of the lungs
Combined obstructive and central sleep apnea
Risk factors for sleep apnea include obesity, large neck circumference, a narrowed airway, being male, being older, family history, use of alcohol or sedatives, smoking, and nasal congestion.
Sleep apnea is significantly more common in people with Down syndrome. The most likely reasons have to do with the anatomy and physiology of the airway. Obstructive sleep apnea is the most common type in people with Down syndrome.
What can be done to prevent or decrease the risk of sleep apnea?
Weight management is one way to reduce the risk of sleep apnea. While people with Down syndrome who have a normal body weight can have sleep apnea, being obese increases the chance of having sleep apnea and likely makes it more severe.
Minimizing nasal congestion can also reduce or prevent sleep apnea. Nasal congestion can be managed through a variety means depending on the cause.
Limiting alcohol and sedatives can also limit sleep apnea. Smoking cessation can be helpful. However, only a few of the individuals with Down syndrome we have served (out of more than 6,000 we have seen) have smoked so it seems to be a limited risk factor in people with Down syndrome.
What about surgical options?
There are some surgical treatments. These are not really prevention measures but they can assist with sleep apnea. In children, removing the tonsils and adenoids can open the airway and reduce (or eliminate) sleep apnea. Surgery to open a narrowed airway that is caused by other reasons can also be considered. Surgery to open the airway tends to be less effective in adults with Down syndrome compared to children with Down syndrome. There is one newer surgical procedure called Inspire that uses an implanted pacemaker-like device to move the tongue forward and open the airway. Again, this is really a treatment, not a prevention.
In summary, potential preventative measures for sleep apnea include:
Maintaining a healthy weight
Managing nasal congestion
Limiting alcohol and sedatives
For additional information, please see the Mayo Clinic website or other sleep apnea resources on this website.