Children with Down syndrome and OSA do not necessarily snore

We read with interest the article “Severity of obstructive apnoea in children with Down syndrome who snore” by Fitzgerald et al .1 Fitzgerald et al reported that 97% of children with Down syndrome (DS) who snored had obstructive sleep apnea (OSA). In light of the limited access to sleep polysomnography (PSG) in children,2 it would seem appropriate that children with DS who have tonsil hypertrophy and who snore be offered tonsillectomy and adenoidectomy without the need …