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Obstructive sleep apnoea in Down syndrome — RACP Paediatrics MCQ

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ModerateRespiratoryObstructive sleep apnoea in Down syndromeRACP Paediatrics

A 5-year-old with trisomy 21 has loud snoring, restless sleep and daytime behavioural deterioration. Examination shows midface hypoplasia and enlarged tonsils. Growth has crossed down one centile band. What is the most appropriate investigation?

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Correct answer: C — Overnight polysomnography

Children with Down syndrome are at high risk of obstructive sleep apnoea, and polysomnography assesses severity and guides management. Tonsillar size alone does not quantify obstruction during sleep. Behavioural change and growth faltering can be manifestations of sleep-disordered breathing.

Reference: RACP Knowledge Guides; Down Syndrome Health Care Guidelines