Sleep problems and obstructive sleep apnea in children with down syndrome, an overview

Maris, Mieke; Verhulst, Stijn; Wojciechowski, Marek; Heyning, Paul Van de; Boudewyns, An

doi:10.1016/j.ijporl.2015.12.014

Cited by 55 publications

(83 citation statements)

References 17 publications

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“…Among six studies with 504 participants in Europe, the pooled OSA prevalence was 71.5% (95% CI: 61.1 to 80.9) [6], [24], [59], [61], [62], [67], [75]. 49.5 to 79.4).…”

Section: Prevalence Of Osa and Potential Moderatorsmentioning

confidence: 98%

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Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Ridore

Debbarma

Nazir

et al. 2017

JSDR

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Abstract:Objective:Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design:Systematic literature review and meta-analysis. Methods:Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results:Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence.Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence.Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion:OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS.Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist

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“…Among six studies with 504 participants in Europe, the pooled OSA prevalence was 71.5% (95% CI: 61.1 to 80.9) [6], [24], [59], [61], [62], [67], [75]. 49.5 to 79.4).…”

Section: Prevalence Of Osa and Potential Moderatorsmentioning

confidence: 98%

“…Due to largely overlapping data, two more studies were eliminated [24], [60]. Finally, one study used primarily in home PSG, with a small subgroup using in laboratory PSG; however, separate statistics were not provided for the laboratory PSG subgroup so this study was eliminated [61].…”

Section: Included Studiesmentioning

confidence: 99%

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Ridore

Debbarma

Nazir

et al. 2017

JSDR

View full text Add to dashboard Cite

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“…Stores & Stores, 2014). Further, among young children with DS, questionnaires based on parent report have demonstrated poor reliability with PSGs (Maris, Verhulst, Wojciechowski, Van de Heyning, & Boudewyns, 2016; Shott et al, 2006), such that the American Academy of Pediatrics recommends all children with DS receive a PSG prior to the age of 4 years of age (Bull & Genetics, 2011). …”

Section: Measurementmentioning

confidence: 99%

Sleep in Neurodevelopmental Disorders

Esbensen

Schwichtenberg

2016

International Review of Research in Developmental Disabilities

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Individuals with intellectual and developmental disabilities (IDD) experience sleep problems at higher rates than the general population. Although individuals with IDD are a heterogeneous group, several sleep problems cluster within genetic syndromes or disorders. This review summarizes the prevalence of sleep problems experienced by individuals with Angelman syndrome, Cornelia de Lange syndrome, Cri du Chat syndrome, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Smith-Magenis syndrome, Williams syndrome, autism spectrum disorder, and idiopathic IDD. Factors associated with sleep problems and the evidence for sleep treatments are reviewed for each neurodevelopmental disorder. Sleep research advancements in neurodevelopmental disorders are reviewed, including the need for consistency in defining and measuring sleep problems, considerations for research design and reporting of results, and considerations when evaluating sleep treatments.

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“…Several investigations using short-term and longitudinal electroencephalogram (EEG) analysis have noted that: (1) these children arouse more during nighttime sleep than typically developing, chronological age-matched controls, (2) spend less time in deeper stages of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep, (3) shift more often from deeper NREM stages of sleep to lighter ones, and (4) exhibit less spindle activity [16], [17], [18], [19], [20]. Sleep-disordered breathing and poor sleep quality in the pediatric population with DS have been associated with restless nighttime movement and parasomnias, sleep anxiety, daytime fatigue, and decreased scores on inventories of adaptive function like the Life Habit Questionnaire (Life-H) [21], [22], [23], [24]. These findings suggest that poor sleep might have real-world consequences for the functional daily living and school performance of the average child with DS.…”

Section: Introductionmentioning

confidence: 99%

Young children with Down syndrome show normal development of circadian rhythms, but poor sleep efficiency: a cross-sectional study across the first 60 months of life

et al. 2017

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ObjectivesTo evaluate sleep consolidation and circadian activity rhythms in infants and toddlers with Down syndrome (DS) under light and socially entrained conditions within a familiar setting. Given previous human and animal data suggesting intact circadian regulation of melatonin across the day and night, it was hypothesized that behavioral indices of circadian rhythmicity would likewise be intact in the sample with DS.MethodsA cross-sectional study of 66 infants and young children with DS, aged 5–67 months, and 43 typically developing age-matched controls. Sleep and measures of circadian robustness or timing were quantified using continuous in-home actigraphy recordings performed over seven days. Circadian robustness was quantified via time series analysis of rest-activity patterns. Phase markers of circadian timing were calculated alongside these values. Sleep efficiency was also estimated based on the actigraphy recordings.ResultsThis study provided further evidence that general sleep quality is poor in infants and toddlers with DS, a population that has sleep apnea prevalence as high as 50% during the preschool years. Despite poor sleep quality, circadian rhythm and phase were preserved in children with DS and displayed similar developmental trajectories in cross-sectional comparisons with a typically developing (TD) cohort. In line with past work, lower sleep efficiency scores were quantified in the group with DS relative to TD children. Infants born with DS exhibited the worst sleep fragmentation; however, in both groups, sleep efficiency and consolidation increased across age. Three circadian phase markers showed that 35% of the recruitment sample with DS was phase-advanced to an earlier morning schedule, suggesting significant within-group variability in the timing of their daily activity rhythms.ConclusionsCircadian rhythms of wake and sleep are robust in children born with DS. The present results suggest that sleep fragmentation and any resultant cognitive deficits are likely not confounded by corresponding deficits in circadian rhythms.

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Sleep problems and obstructive sleep apnea in children with down syndrome, an overview

Cited by 55 publications

References 17 publications

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Sleep in Neurodevelopmental Disorders

Young children with Down syndrome show normal development of circadian rhythms, but poor sleep efficiency: a cross-sectional study across the first 60 months of life

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