Positive airway pressure (PAP) is the mainstay therapy for children presenting with sleep disordered breathing/ obstructive sleep apnea (SDB/OSA) who are either not a candidate for, or have failed other treatments. We describe PAP settings used to treat clinical groups of children with and without Down syndrome. A retrospective cohort study was performed in which records from children; aged 1-18 years with prescribed PAP therapy to treat sleep disordered breathing (OSA/SDB) between 1997 and 2011 were reviewed. Demographic and polysomnographic data were extracted for six sub-groups of children with OSA/SDB: nonobese, overweight and obese. 251 children comprised the total in the six groups of interest during the study period: otherwise typical children; nonobese (n=62), overweight (n=17) and Obese (n=59); children with Down syndrome; non-obese (n=75), overweight (n=15) and obese (n=13). Demographics and severity of OSA/SDB were comparable between the groups. Median positive airway pressure settings identified during laboratory titration studies using standardized laboratory protocols were significantly higher among non-obese and overweight children with Down syndrome, when compared to otherwise typical children. Interestingly, in obese children, Down syndrome status didn’t significantly influence PAP setting.

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