Adolescents and young adults with down syndrome presenting to a medical clinic with depression: Co‐morbid obstructive sleep apnea

Capone, George T.; Aidikoff, Jenna M.; Taylor, Katharine; Rykiel, Natalie

doi:10.1002/ajmg.a.36052

Cited by 49 publications

(40 citation statements)

References 39 publications

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“…Many individuals with DS experience high rates of sleep problems, including obstructive sleep apnea, reduced REM sleep, and poor sleep initiation and maintenance [Stores et al, ; Harvey and Kennedy, ; Dykens, ; Capone et al, ]. These difficulties are associated with significantly poorer performance on tasks of attention and EF [Beebe and Gozal, ; Chen et al, ; Breslin et al, ], as well as memory storage/consolidation [Breslin et al, ], and may exist in the context of co‐morbid depression [Capone et al, ]. Proper sleep hygiene and interventions are an essential component to optimizing cognitive functioning.…”

Section: Unique Characteristics Of the Down Syndrome Populationmentioning

confidence: 99%

Down syndrome: Cognitive and behavioral functioning across the lifespan

Grieco¹,

Pulsifer²,

Seligsohn³

et al. 2015

American J of Med Genetics Pt C

335

246

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Individuals with Down syndrome (DS) commonly possess unique neurocognitive and neurobehavioral profiles that emerge within specific developmental periods. These profiles are distinct relative to others with similar intellectual disability (ID) and reflect underlying neuroanatomic findings, providing support for a distinctive phenotypic profile. This review updates what is known about the cognitive and behavioral phenotypes associated with DS across the lifespan. In early childhood, mild deviations from neurotypically developing trajectories emerge. By school-age, delays become pronounced. Nonverbal skills remain on trajectory for mental age, whereas verbal deficits emerge and persist. Nonverbal learning and memory are strengths relative to verbal skills. Expressive language is delayed relative to comprehension. Aspects of language skills continue to develop throughout adolescence, although language skills remain compromised in adulthood. Deficits in attention/executive functions are present in childhood and become more pronounced with age. Characteristic features associated with DS (cheerful, social nature) are personality assets. Children are at a lower risk for psychopathology compared to other children with ID; families report lower levels of stress and a more positive outlook. In youth, externalizing behaviors may be problematic, whereas a shift toward internalizing behaviors emerges with maturity. Changes in emotional/behavioral functioning in adulthood are typically associated with neurodegeneration and individuals with DS are higher risk for dementia of the Alzheimer's type. Individuals with DS possess many unique strengths and weaknesses that should be appreciated as they develop across the lifespan. Awareness of this profile by professionals and caregivers can promote early detection and support cognitive and behavioral development.

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Section: Unique Characteristics Of the Down Syndrome Populationmentioning

confidence: 99%

Down syndrome: Cognitive and behavioral functioning across the lifespan

Grieco¹,

Pulsifer²,

Seligsohn³

et al. 2015

American J of Med Genetics Pt C

335

246

View full text Add to dashboard Cite

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“…Furthermore, we did not include patients with non-treated sleep apnea. Capone et al [23] reported 25 patients with major depressive episodes with functional decline in 68% of them. Twenty-four (86%) of them had OSA compared to 44% of controls without depression.…”

Section: Discussionmentioning

confidence: 99%

Acute Regression in Young People with Down Syndrome

et al. 2017

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Adolescents and young adults with Down syndrome (DS) can present a rapid regression with loss of independence and daily skills. Causes of regression are unknown and treatment is most of the time symptomatic. We did a retrospective cohort study of regression cases: patients were born between 1959 and 2000, and were followed from 1984 to now. We found 30 DS patients aged 11 to 30 years old with history of regression. Regression occurred regardless of the cognitive level (severe, moderate, or mild intellectual disability (ID)). Patients presented psychiatric symptoms (catatonia, depression, delusions, stereotypies, etc.), partial or total loss of independence in activities of daily living (dressing, toilet, meals, and continence), language impairment (silence, whispered voice, etc.), and loss of academic skills. All patients experienced severe emotional stress prior to regression, which may be considered the trigger. Partial or total recovery was observed for about 50% of them. In our cohort, girls were more frequently affected than boys (64%). Neurobiological hypotheses are discussed as well as preventative and therapeutic approaches.

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“…A survey of 28 adolescents and young adults with Down syndrome, who were diagnosed with major depression by a mental health clinic for people with Down syndrome, found that 86% had OSAHS when tested by polysomnography, in comparison with 44% of nondepressed controls. Moderate to severe OSAHS was evident in 54% of cases and 11% of controls [37]. …”

Section: Comorbid Down Syndrome and Osahsmentioning

confidence: 99%

Obstructive sleep apnoea/hypopnoea syndrome in adults with Down syndrome

Hill

2016

Breathe

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Key pointsAdults with Down syndrome are predisposed to obstructive sleep apnoea/hypopnoea syndrome (OSAHS) due to overlap between the Down syndrome phenotype and OSAHS risk factors.The prevalence of OSAHS in adults with Down syndrome is estimated at 35–42%. This is up to ten-times higher than in the general adult population.Symptoms of OSAHS, including behavioural and emotional disturbances as well as standard symptoms such as sleepiness, should be monitored as part of regular health surveillance in adults with Down syndrome.There is evidence that the use of continuous positive airway pressure (CPAP) therapy in adults with Down syndrome and comorbid OSAHS can lead to significant improvements in subjective sleepiness, behaviour and cognitive function, though further large-scale trials are required.Educational aimsTo discuss the relationship between the phenotypic features of Down syndrome and the risk factors for obstructive sleep apnoea/hypopnoea syndrome (OSAHS).To examine the prevalence of OSAHS in adults with Down syndrome.To review recent research into the effectiveness of treatment of OSAHS in adults with Down syndrome using continuous positive airway pressure (CPAP) therapy.Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is characterised by repeated cycles of upper airway obstruction during sleep, leading to diurnal symptoms. Individuals with Down syndrome are predisposed to OSAHS due to overlap between the Down syndrome phenotype and OSAHS risk factors. Recent large studies using subjective and objective measures estimate that OSAHS affects around 40% of adults with Down syndrome, in contrast to 2–4% of the general adult population. The “double-hit” of comorbid Down syndrome and OSAHS may accelerate cognitive decline in adults with Down syndrome. However, with the appropriate care and support, OSAHS can be treated effectively in this group using continuous positive airway pressure (CPAP) therapy, improving daytime function and behaviour. Symptoms of OSAHS should be routinely monitored in this population, with testing and treatment available to all adults with Down syndrome; however, this is not currently commonplace, and health inequalities are evident.

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Adolescents and young adults with down syndrome presenting to a medical clinic with depression: Co‐morbid obstructive sleep apnea

Cited by 49 publications

References 39 publications

Down syndrome: Cognitive and behavioral functioning across the lifespan

Down syndrome: Cognitive and behavioral functioning across the lifespan

Acute Regression in Young People with Down Syndrome

Obstructive sleep apnoea/hypopnoea syndrome in adults with Down syndrome

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