# Positive Airway Pressure For The Treatment Of The Obstructive Sleep Apnea Syndrome In Children With Down Syndrome

> **NIH NIH R33** · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · 2023 · $63,939

## Abstract

Abstract
Individuals with Down syndrome (DS) are predisposed to OSAS due to craniofacial features (midface
hypoplasia, glossoptosis) and studies have shown that the prevalence of OSAS in this population is markedly
increased compared to that of typically developing children. Adenotonsillectomy (AT) is considered first-line
treatment for childhood OSAS. However, OSAS resolves in only a portion of children with DS after AT. In fact,
many children with DS are referred for positive airway pressure (PAP) therapy initiation due to persistent
OSAS after AT, and PAP appears to be an important feature of the experience of living with DS. PAP has been
shown to be highly effective at treating OSAS and improve OSAS-associated neurobehavioral symptoms, such
as quality of life, behavior, mood, daytime sleepiness and school performance. However, PAP as a treatment
for OSAS has not been well-studied in children with DS. Therefore, we propose to leverage the HEalthy SLeeP
for Children with Down Syndrome (HELP-DS, U01HL125295-S1 and U01HL123507-S1) infrastructure and
conduct in two HELP-DS sites (Philadelphia and Cincinnati) plus the University of Miami, a randomized
controlled trial to test a 6-month intensive behavioral intervention (INT) to improve PAP adherence vs standard
clinical care (CON). Participants with DS and OSAS, aged 6-17.9 years, referred to PAP initiation for the
treatment of OSAS will be included. They will undergo standardized evaluations of quality of life, behavior,
attention, and family-relevant outcomes, PAP adherence, and health care utilization at baseline, 6, and 12
months. This rigorous design and comprehensive study will resolve existing uncertainties on initial
management approaches for children with DS and OSAS treated with PAP by addressing critical issues: a)
determine the efficacy of INT vs CON in promoting PAP adherence, b) elucidate which factors mediate or
moderate adherence to PAP in children with DS and OSAS, c) determine the effect of PAP use on
neurobehavioral and family-relevant outcomes, and quality of life.

## Key facts

- **NIH application ID:** 10912150
- **Project number:** 3R33HL151253-05S1
- **Recipient organization:** UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
- **Principal Investigator:** Ignacio Esteban Tapia
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $63,939
- **Award type:** 3
- **Project period:** 2023-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10912150

## Citation

> US National Institutes of Health, RePORTER application 10912150, Positive Airway Pressure For The Treatment Of The Obstructive Sleep Apnea Syndrome In Children With Down Syndrome (3R33HL151253-05S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10912150. Licensed CC0.

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