{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:23:31Z","timestamp":1790630611450,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T00:00:00Z","timestamp":1606867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100014371","name":"LuMind Research Down Syndrome Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014371","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001465","name":"American Thoracic Society","doi-asserted-by":"publisher","award":["ASPIRE Sleep Fellowship"],"award-info":[{"award-number":["ASPIRE Sleep Fellowship"]}],"id":[{"id":"10.13039\/100001465","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Patients with Down syndrome have a high incidence of obstructive sleep apnea (OSA) and limited treatment options. Hypoglossal stimulation has shown efficacy but has not yet been approved for pediatric populations. Our objective is to characterize the therapy response of adolescent patients with down syndrome and severe OSA who underwent hypoglossal stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective longitudinal trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We are conducting a multicenter single\u2010arm trial of hypoglossal stimulation for adolescent patients with Down syndrome and severe OSA. Interim analysis was performed to compare objective sleep and quality of life outcomes at 12\u2009months postoperatively for the first 20 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 15.5 and baseline AHI 24.2. Of the 20 patients, two patients (10.0%) had an AHI under 1.5 at 12\u2009months; nine patients of 20 (45.0%) under five; and 15 patients of 20 (75.0%) under 10. The mean decrease in AHI was 15.1 (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Patients with postoperative AHI over five had an average baseline OSA\u201018 survey score of 3.5 with an average improvement of 1.7 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002); in addition, six of these patients had a relative decrease of apneas compared to hypopneas and seven had an improvement in percentage of time with oxygen saturation below 90%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with persistently elevated AHI 12\u2009months after hypoglossal implantation experienced improvement in polysomnographic and quality of life outcomes. These results suggest the need for a closer look at physiologic markers for success beyond reporting AHI as the gold standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:1663\u20131669, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29290","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T22:35:22Z","timestamp":1606948522000},"page":"1663-1669","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Redefining Success by Focusing on Failures After Pediatric Hypoglossal Stimulation in Down Syndrome"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-3269","authenticated-orcid":false,"given":"Phoebe K.","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asitha D. L.","family":"Jayawardena","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Stenerson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret B.","family":"Pulsifer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston Massachusetts U.S.A."},{"name":"Department of Psychiatry Massachusetts General Hospital  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Grieco","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Abbeduto","sequence":"additional","affiliation":[{"name":"MIND Institute and Department of Psychiatry and Behavioral Sciences University of California Davis  Sacramento California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5568-0427","authenticated-orcid":false,"given":"Raj C.","family":"Dedhia","sequence":"additional","affiliation":[{"name":"CPAP Alternatives Clinic and Division of Sleep Surgery University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Soose","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Division of Sleep Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Tobey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Division of Sleep Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhila","family":"Raol","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Children's Healthcare of Atlanta  Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-9692","authenticated-orcid":false,"given":"Stacey L.","family":"Ishman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally R.","family":"Shott","sequence":"additional","affiliation":[{"name":"Department 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