Cognitive status in Down syndrome individuals with sleep disordered breathing deficits (SDB)

Ανδρέου, Γεωργία; Galanopoulou, C; Gourgoulianis, K.; Karapetsas, A.; Molyvdas, Paschalis-Adam

doi:10.1016/s0278-2626(02)00019-2

Cited by 72 publications

(71 citation statements)

References 16 publications

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“…One small study has linked the number of apneas during sleep to specific deficiencies in visual learning among children with trisomy 21. 6 Identifying patients with trisomy 21 for early interventions to treat OSDB should be a clinical research priority. Using oximetry scores among children with trisomy 21 appears to be as effective in identifying children with marked OSDB as it is for children with adenotonsillar hypertrophy, who have similar "pre-test" probability of having OSBD.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] As in the general population of children, OSDB may affect neurocognitive potential for children with trisomy 21. 6,7 The American Academy of Pediatrics (AAP) recommends that children with trisomy 21 should be assessed for OSDB by age 4 with overnight polysomnography. 8 Unfortunately, PSGs can at times be particularly challenging for children with trisomy 21.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

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Overnight Pulse Oximetry for Evaluation of Sleep Apnea among Children with Trisomy 21

Coverstone

Bird

Sicard

et al. 2014

Journal of Clinical Sleep Medicine

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Section: Discussionmentioning

confidence: 99%

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Overnight Pulse Oximetry for Evaluation of Sleep Apnea among Children with Trisomy 21

Coverstone

Bird

Sicard

et al. 2014

Journal of Clinical Sleep Medicine

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“…DS results from the triplication of the whole or distal part of human chromosome 21 (chr 21) (Lejeune et al, 1959). Patients with DS suffer from many health problems (Epstein, 2002) and are known to have disturbed sleep, a common cause of difficulties for family members and a possible contributor to cognitive difficulties (Andreou et al, 2002). A major contributor to sleep abnormalities in DS is sleep apnea, a consequence of the unique craniofacial profile of these patients, obesity and possible abnormalities in upper airway muscle tone (Donnelly et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…Beyond sleep apnea, however, sleep has been shown to be independently disturbed. Core sleep abnormalities include prolonged sleep latency, increased sleep fragmentation and light sleep and a reduction in rapid eye movement (REM) sleep with abnormal occulomotor movement frequency during this stage (Grubar et al, 1986, Hamaguchi et al, 1989, Diomedi et al, 1999, Levanon et al, 1999, Andreou et al, 2002. Only one study inspected quantitatively the EEG of DS patients during sleep and found a specific decrease of alpha power during REM sleep (Smigielska-Kuzia et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Sleep and EEG features in genetic models of Down syndrome

Colas

Valletta

Takimoto-Kimura

et al. 2008

Neurobiology of Disease

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Down syndrome is characterized by a host of behavioral abnormalities including sleep disturbances. Sleep and EEG was studied at the age of 3 months in two mouse models of the condition, Ts65Dn and Ts1Cje, carrying one extra copy of partially overlapping segments of the mmu chromosome 16 (equivalent to the human chromosome 21). We found that the Ts65Dn mice showed increased waking amounts at the expense of non-REM sleep, increased theta power during sleep and a delayed sleep rebound after sleep deprivation. In contrast, Ts1Cje had limited sleep and EEG abnormalities, showing only a delayed sleep rebound after sleep deprivation and no difference in theta power. We previously found that mice over-expressing the human APPwt transgene, a gene triplicated in Ts65Dn but not Ts1Cje, also show increased wake and theta power during sleep. These results demonstrate abnormalities in sleep and EEG in Ts65Dn mice and underscore a possible correlation between App overexpression and hippocampal theta oscillations.

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“…Previous studies have suggested that sleep apnea, measured by PSG and parent-reported sleep disruption, is associated with cognitive impairments in adults with Down syndrome without dementia. 14,15 However, no study has examined the relation between OSAS and cognition in young children with Down syndrome using a comprehensive battery of cognitive measures, and controlling for confounding background factors has not always been possible owing to the small sample sizes in previous studies. In the present study we used PSG to examine the correspondence between OSAS, defined by AHI, and cognition in children with Down syndrome as measured by the Arizona Cognitive Test Battery (ACTB), a battery specifically designed for this population.…”

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confidence: 99%

Obstructive sleep apnea syndrome and cognition in Down syndrome

Breslin

Spanò

Bootzin

et al. 2014

Develop Med Child Neuro

181

174

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ACTBArizona Cognitive Test Battery AHI Apnea-hypopnea index IED Intra-extra dimensional set shift OSAS Obstructive sleep apnea syndrome PSG PolysomnographyAIM Good-quality sleep is essential for normal learning and memory. Sleep fragmentation and disrupted sleep architecture are commonly observed throughout the lifespan of individuals with Down syndrome, a condition marked by cognitive deficits emerging within the first few months of life. While obstructive sleep apnea syndrome (OSAS) is known to contribute to the loss of sleep quality in Down syndrome, its relation to cognitive and behavioral impairment remains poorly understood.METHOD Using ambulatory polysomnography, we measured sleep in an unreferred community-based sample of 38 individuals with Down syndrome (15 males, 23 females; mean age 9y 7mo (SD 1y 9mo), range 7-12y). Cognitive outcomes were assessed with the Arizona Cognitive Test Battery, a set of psychometric measures designed and validated for this population.RESULTS Among children with Down syndrome, mean Verbal IQ score (p=0.006) was 9 points lower in those with comorbid OSAS (apnea-hypopnea index >1.5) than in those without OSAS, and performance on measures of cognitive flexibility was poorer (p=0.03). In addition, those with OSAS showed increased light-stage sleep (p=0.009) at the expense of slow-wave sleep (p=0.04).INTERPRETATION These findings demonstrate a relation between OSAS and cognitive outcomes in Down syndrome. More work is required to fully understand the mechanisms underlying the links between poor sleep and impaired cognitive function. Overall, these findings highlight the importance of adequate sleep in typically and atypically developing populations.Down syndrome (trisomy 21) is the most common genetically defined cause of intellectual disability, with over 300 000 affected individuals residing in the United States alone. 1 The condition is characterized by decline of IQ during the infant and toddler years, well-documented deficits in the assimilation and expressive use of language, and impairments in cognitive flexibility and memory.2 As a result of alterations in craniofacial and oral musculature development and low muscle tone, individuals with Down syndrome are exceptionally vulnerable to obstructive sleep apnea syndrome (OSAS) from infancy, with estimates of the prevalence of the condition ranging from 30% to as high as 80%. [3][4][5] Ashworth et al. 6 have recently described the extent of sleep disruption in individuals with Down syndrome, noting that such individuals displayed more fragmented sleep than those with Williams syndrome, another intellectual disability. Because of the extent of their sleep disruption, individuals with Down syndrome could potentially suffer ill effects during critical periods of cognitive development.OSAS occurs when the upper airway becomes intermittently obstructed during sleep, resulting in incomplete ventilation, blood gas irregularities, and sleep fragmentation. It is best diagnosed with polysomnography (PSG), the criterion standard for sle...

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Cognitive status in Down syndrome individuals with sleep disordered breathing deficits (SDB)

Cited by 72 publications

References 16 publications

Overnight Pulse Oximetry for Evaluation of Sleep Apnea among Children with Trisomy 21

Overnight Pulse Oximetry for Evaluation of Sleep Apnea among Children with Trisomy 21

Sleep and EEG features in genetic models of Down syndrome

Obstructive sleep apnea syndrome and cognition in Down syndrome

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