Sleep-Related Rhythmic Movement Disorder in Young Children with Down Syndrome: Prevalence and Clinical Features

Abstract

Sleep-related Rhythmic Movement Disorder (RMD) affects around 1% of UK pre-school children. Little is known about RMD in Down syndrome (DS). We aimed to determine: (a) the prevalence of RMD in children with DS aged 1.5–8 years; (b) phenotypic and sleep quality differences between children with DS and RMD and sex- and age-matched DS controls; and (c) night-to-night variability in rhythmic movements (RMs). Parents who previously reported RMs from a DS research registry of 202 children were contacted. If clinical history suggested RMD, home videosomnography (3 nights) was used to confirm RMs and actigraphy (5 nights) was used to assess sleep quality. Phenotype was explored by demographic, strengths and difficulties, Q-CHAT-10/social communication and life events questionnaires. Eight children had confirmed RMD. Minimal and estimated maximal prevalence were 4.10% and 15.38%, respectively. Sleep efficiency was significantly lower in RMD-cases (69.1%) versus controls (85.2%), but there were no other phenotypic differences. There was considerable intra-individual night-to-night variability in RMs. In conclusion, RMD has a high prevalence in children with DS, varies from night to night and is associated with poor sleep quality but, in this small sample, no daytime phenotypic differences were found compared to controls. Children with DS should be screened for RMD, which is amenable to treatment.

Sleep and behavioral problems in preschool-age children with Down syndrome

“…In spite of the crucial role of sleep in pediatric age, especially for population with DS, very few studies specifically investigated the distribution of sleep difficulties and their behavioral correlates in preschool-age children with DS. On the other hand, the studies that investigated sleep problems in preschoolers with DS included wide age ranges ( Levanon et al, 1999 ; Carter et al, 2009 ; Nisbet et al, 2014 ; Bassell et al, 2015 ; Anand et al, 2021 ; Chawla et al, 2021 ; Fucà et al, 2021 ; Kose et al, 2021 ). Moreover, studies focusing on preschoolers with DS were conducted on small sample sizes ( Edgin et al, 2015 ; Joyce and Dimitriou, 2017 ; D’Souza et al, 2020 ; Lukowski et al, 2020 ; Arias-Trejo et al, 2021 ).…”

Sleep-related rhythmic movement disorder in children: a mini-review

“…SRRMD rarely occurs in adolescence and adulthood but can persist in children with an autism spectrum disorder or developmental delay into adulthood ( 23 ). SRRMD is also more common in children with Down syndrome (up to 15%) and is associated with poor sleep quality ( 18 ). The prevalence is common in male patients, with a ratio of 5:3 when confirmed with home videosomnography ( 15 ).…”

“…However, over the past 5 years, original research articles have been published on the prevalence, maternal characteristics, and behavioral/emotional problems ( 1 , 15 , 17 ). One article examined the prevalence and clinical features of children with DS in a specific population ( 18 ).…”

“…(1,15,17). One article examined the prevalence and clinical features of children with DS in a specific population (18).…”