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Due to distinct body and facial morphology, people with Down syndrome appear to be at increased risk for obstructive sleep apnea (OSA). Additionally, adults with Down syndrome are at increased risk for Alzheimer dementia at younger ages than the general population, and OSA has been identified as a risk factor for Alzheimer dementia in the general population. This study aims to explore the prevalence of diagnosed OSA, as well as the association between OSA and Alzheimer dementia, in adults with Down syndrome using Medicaid claims data from2011 to 2019. Of 118,539 adults with Down syndrome who met inclusion criteria, 23,785 had at least one OSA claim from2011 to 2019 (20.1%, 95% CI 19.8%\u201320.3%). After weighting for age, sex, dual enrollment, race, ethnicity, and region, adults with Down syndrome and OSA claims had 1.08 times the hazard of having a claim for Alzheimer dementia compared to those without OSA claims (95% CI 1.05\u20131.10). OSA is common in adults, and our findings have clinical implications for its evaluation and treatment in those with Down syndrome.<\/jats:p>","DOI":"10.1002\/ajmg.a.64241","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T05:24:27Z","timestamp":1756963467000},"page":"129-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Occurrence of Obstructive Sleep Apnea and Its Association With Alzheimer Dementia in Medicaid\u2010Enrolled Adults With Down Syndrome, 2011\u20132019"],"prefix":"10.1002","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9515-0639","authenticated-orcid":false,"given":"Alianna","family":"Higgins","sequence":"first","affiliation":[{"name":"Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salina","family":"Tewolde","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayleigh D.","family":"Page","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9146-4497","authenticated-orcid":false,"given":"Eric","family":"Rubenstein","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2024.01.020"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.02.046"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011\u20101605"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1706537"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022\u2010057010"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab158"},{"key":"e_1_2_10_8_1","unstructured":"Chronic Conditions.2025.\u201cChronic Conditions Data Warehouse.\u201dhttps:\/\/www2.ccwdata.org\/condition\u2010categories\u2010chronic."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2019.10.018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26398"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10143012"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.838412"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7382"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci10110844"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.11452"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820954837"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14\u20100266"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.61853"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12465"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10832"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309\u20101735OC"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsac092"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.2320"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14287"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.35018"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.32097"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.4103\/2231\u20100770.94803"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.0161"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.11.006"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9692"},{"issue":"4","key":"e_1_2_10_31_1","first-page":"317","article-title":"Obstructive Sleep Apnea in Adults With Down Syndrome","volume":"5","author":"Trois M. 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