Table 2

Indications for overnight monitoring of breathing in people with learning disability

IndicationNotes
Individuals with NMD with a vital capacity <60%The incidence of nocturnal hypoventilation has been found to increase with reduced vital capacity in a variety of neuromuscular diseases.47 64 246 247
Symptoms of OSAExcessive daytime sleepiness, habitual loud snoring, witnessed apnoea or gasping or choking during sleep and nocturia
Symptoms of hypoventilationExcessive daytime sleepiness, morning headache, morning nausea, poor concentration, reduced performance in school, changes in behaviour and reduced appetite.
Individuals with NMD who lose the ability to walk due to progressive weakness or children who never attain the ability to walkInability to walk is a cardinal sign of moderate to severe muscle weakness.18
Down syndrome (DS)An estimated 30%–79% of children with DS have OSA with an even higher prevalence reported in adults.247 248 Overnight sleep monitoring is recommended, using at least oximetry, at least once in infancy and then annually.248
Prader-Willi syndrome (PWS)Sleep-disordered breathing is a common finding in PWS.249 All children with PWS should be screened with oximetry and capnography on an annual basis.248
  • NMD, neuromuscular disorder; OSA, obstructive sleep apnoea.