Hypotonia, commonly seen in infants with Down syndrome (I-DS), can contribute to masticatory and oropharyngeal muscle weakness increasing the risk for dysphagia and sleep-disordered breathing (SDB). Data describing the occurrence of dysphagia and SDB in I-DS is limited. This study aims to determine the frequency and severity of dysphagia and its relationship to polysomnogram parameters in infants with Down syndrome.

We includedI-DS who underwent polysomnography at a single academic center over 6 year period Data collected included sex, age, presence of dysphagia (low suspicion of dysphagia vs. dysphagia vs. feeding tube), and polysomnographic data. Dysphagia was determined by video fluoroscopic swallow study in the presence of clinical suspicion.

A total of 40 I-DS were identified.(Mean age 6.6 months ± 3, male 65%). There were 11, 13 and 16 I-DS with low suspicions of dysphagia, dysphagia and feeding tube respectively. OSA was more severe in I-DS with feeding tube group when compared to the group with the low suspicion of dysphagia and (AHI mean [SE]= 49.3/hr [7.6] vs. 19.2 [9.2], p=0.016). Dysphagia severity was positively correlated with a higher oAHI (r=0.43, p=0.006).

There is a high incidence of dysphagia and SDB in I-DS. Dysphagia severity correlated with oAHI severity. Our results suggest that I-DS need early evaluation of both SDB and dysphagia.