Medications for Obstructive Sleep Apnea to Improve Cognition in Children With Down Syndrome

Exclusion Criteria

• •1. Presence of central sleep apnea on polysomnography (central AHI ≥ 5)
• •2. Currently using and adherent to positive airway pressure therapy (\>4 hours per night for 70% of nights in the past 30 days based on device download or parent report)
• •3. Monoamine oxidase inhibitor use
• •4. Urinary retention
• •5. Prematurity \< 32 weeks estimated gestational age
• •6. Seizure disorder
• •7. Untreated or inadequately treated hypothyroidism
• •8. Significant traumatic brain injury
• •9. Congenital heart disease and not cleared to participate by the patient's cardiologist
• •10. History of current, untreated depression
• •11. History of liver disease
• •12. 3+ or greater tonsillar hypertrophy
• •13. Positive urine pregnancy test
• •14. Hypoxemia independent of respiratory events on baseline polysomnography (≥5 minutes with oxygen saturation \<90%)
• •15. Presence of central sleep apnea on baseline polysomnography (central AHI ≥ 5)
• •3\. Absence of OSA defined as total AHI \<5 on baseline polysomnography