Sleep Apnea 2 1/2 year old

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Last week Tristen (2 1/2 yrs old, Ds) had a Sleep Study overnight at the hospital. His results - SEVERE sleep apnea. I was shocked! I know that this is common in children with Ds, but I had no idea that Tristen had it or that it was this severe. One of his scores from the test was the number of Apneas & Hypopneas per hour (AHI). Abnormal for a child is anything above 1, abnormal for an adult is anything above 5, severe for an adult is above 30. . . . Tristen's score was 56!! He avereaged 56 Apneas and Hypopneas Per Hour of Sleep!! His recorded Oxygen saturation fell as low as 72% while sleeping. Of course the recommended treatment is removal of his adnoids and tonsils and possible CPAP machine. My question is this. . is there anything else I should ask them to look at as a cause of his sleep apnea? Could anything else be causing his apnea to be so severe? Tristen does have reflux - could this be related to his restricted airflow? His nasal bridge is quite flat (which I know is a common characteristic) but do kids with Ds ever have Deviated Septums? We see the ENT tomorrow afternoon and I want to be sure to ask all relevant questions then - before he has surgery. Thanks for your input.

Christy