{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T02:19:57Z","timestamp":1767838797990,"version":"3.49.0"},"reference-count":61,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Children with Down syndrome (DS) have an increased prevalence of obstructive sleep apnea (OSA). Noninvasive ventilation (NIV) is a common modality of OSA treatment in this cohort. This study aimed to measure adherence and efficiency of NIV delivery in children with DS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>This was a retrospective cohort study involving 106 children with confirmed OSA and home NIV with downloadable data capacity. Children were divided into DS (<jats:italic>n<\/jats:italic>\u2009=\u200944) and non\u2010DS cohorts (<jats:italic>n<\/jats:italic>\u2009=\u200962). Adherence, clinical outcomes apnea\u2010hypopnoea index (AHI), positive airway pressure delivery, and leakage were recorded and compared between DS and non\u2010DS cohorts and within the DS cohort based on past surgical history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly greater NIV usage was observed in the DS cohort, they showed more consistent use with an increased percentage of days used relative to their non\u2010DS counterparts (78.95\u2009\u00b1\u20092.26 vs. 72.11\u2009\u00b1\u20092.14, <jats:italic>p<\/jats:italic>\u2009=\u2009.031). However, despite greater usage, poorer clinical outcomes in the form of increased AHI (<jats:italic>p<\/jats:italic>\u2009=\u2009.0493) was observed in the DS cohort, where significantly greater leakage was also shown 41.00\u2009\u00b1\u20091.61\u2009L\/min versus 36.52\u2009\u00b1\u20091.18\u2009L\/min (<jats:italic>p<\/jats:italic>\u2009=\u2009.022). Twenty children with DS had prior cardiac surgery; compliance across all parameters was significantly reduced relative to those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data confirm that satisfactory NIV adherence is achievable in children with DS. However, we have identified excessive system leak at the machine\u2010patient interface as a factor, which could undermine NIV efficacy in children with DS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25308","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T19:37:31Z","timestamp":1616009851000},"page":"1704-1715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy and adherence of noninvasive ventilation treatment in children with Down syndrome"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-3343","authenticated-orcid":false,"given":"Lauren","family":"MacDonagh","sequence":"first","affiliation":[{"name":"School of Medicine, Department of Health Sciences University College Dublin  Belfield Dublin 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