Health problems related to Down syndrome

Certain health conditions are more likely to develop in people with Down syndrome than in the general population. These are often a result of body structures that did not develop normally. Common health problems include:

  • Respiratory infections. Most children with Down syndrome have abnormal respiratory tract structures, such as a narrow nose and airway passage, which makes them more prone to respiratory infections and persistent fluid in the middle ear. Some children also have an impaired immune system, which makes it hard for them to fight off infections. Respiratory infection can lead to serious problems, especially in children who also have heart defects. Respiratory infections are a leading cause of death among children with Down syndrome, especially during the first year of life.
  • Hearing problems. The risk of developing some hearing loss is about 75% in children with Down syndrome.1 This may result from frequent infections and fluid buildup in the ear or, less often, nerve damage in the ear. Hearing loss affects listening skills and language development.
  • Dental problems. Periodontal disease affects the tissues that surround the teeth. It is more common in people with Down syndrome, especially adults, than the general population. People who have Down syndrome have the same risk for dental cavities as people who do not have the condition.
  • Seizures. Although the cause is unknown, seizures occur more often in people with Down syndrome than the general population.
  • Sleep problems. Down syndrome causes some children to have sleep problems, such as frequent waking and restlessness. About 50% to 75% of children with Down syndrome develop sleep apnea, in which there are short periods during sleep when breathing stops.1 This high rate may be caused by a combination of a small airway, poor muscle tone, and enlarged tonsils and/or adenoids.
  • Unstable joints, poor muscle strength, and weak ligaments. These factors increase the risk of spinal problems and neck injury, especially dislocation of the first two neck bones (atlantoaxial dislocation). Children and adults younger than 21 are at more risk than older adults for some of these problems. Although serious spinal cord injury is rare, some people have exercise and physical activity restrictions. Surgery may be needed for spinal cord damage or suspected damage. Adults have an increased risk for arthritis of the spine, which can be disabling. Foot problems are also more common in people with Down syndrome than the general population, probably because of loose ligaments.
  • Weight problems. Many children with Down syndrome are overweight. They burn calories at a slower rate and may not exercise regularly. Weight problems can be minimized by emphasizing a balanced diet and providing frequent opportunities for exercise.
  • Skin problems. Skin conditions that can affect teenagers with Down syndrome include folliculitis, dry skin (xerosis), acne, atopic dermatitis, chronic skin inflammation with scaling and crusted patches (seborrheic dermatitis), and fungal infections of the skin and nails.

Children and adults with Down syndrome may not be able to tell you or the doctor if they don't feel well or are in pain. Instead, their behavior may change. Or they may stop doing things that they used to do. These may be signs of a medical problem. Talk to the doctor if you notice that the person with Down syndrome behaves in a new way. Also be alert for signs of depression, anxiety, or other mental or behavioral health problems.


  1. Committee on Genetics, American Academy of Pediatrics (2001, reaffirmed 2007). Health supervision for children with Down syndrome. Pediatrics, 107(2): 442–449.

Last Updated: August 4, 2009

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