Introduction. Obstructive sleep apnea (OSA) is more common in children with obesity. Episodic nocturnal hypoxemia, hypercapnia and sleep fragmentation result in reduced release of GH (growth hormone) during sleep and onset of the short stature. In children with Down syndrome predisposition to SAO is dependent on oropharyngeal anatomical peculiarities and obesity is an aggravating factor. The association of hypothyroidism emphasizes the cognitive deficit due to trisomy 21 and obstructive sleep

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... nea. Compromising somatic growth is a powerful long-term consequence in children with OSA. Material and method. We present the case of a 9 year and 11 months old boy with Down syndrome known with sleep apnea in which the periodic clinical and laboratory assessment identified the presence of thyroid hypofunction. Results. The patient is obese (BMI = 22. 5 kg / m2 at the 95th percentile for gender and age), with mild subclinical hypothyroidism (TSH = 5.71 uIU/mL, FT3 = 6.82 pmol/L, FT4 = 14. 27 pmol/L) and residual SAO after tonsils and adenoids ablation. Sleep polygraphy revealed mixed apnea, predominantly obstructive, with apnea-hypopnea index = 18. 3/hour, average SaO2 = 95%, desaturation index = 20.5/hour. Substitution with potassium iodide was initiated. It was recommended hypocaloric diet, lateral decubitus posture during sleep and reevaluation in order to initiate CPAP. Conclusions. Annual assessment of thyroid function in patients with Down's disease is mandatory. Hypothyroidism, obesity and obstructive sleep apnea require interdisciplinary and individualized management in these patients.