OSA in Down Syndrome — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRespiratoryOSA in Down SyndromeRACP Paediatrics

A 3-year-old child with Down syndrome has noisy breathing and feeding difficulties. Sleep study confirms moderate OSA (OAHI 8/hr). He has large tonsils (grade 3-4). What is the first-line treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Adenotonsillectomy

Adenotonsillectomy is first-line for paediatric OSA with adenotonsillar hypertrophy. Children with Down syndrome have higher rates of residual OSA post-surgery (due to midface hypoplasia, macroglossia, hypotonia) and require post-operative sleep study reassessment. Perioperative airway management requires extra caution.

Reference: Australasian Sleep Association – 2024 – Paediatric OSA Guidelines