Sleep Architecture in Children With Down Syndrome With and Without Obstructive Sleep Apnea

Area of Science:

• Pediatric Sleep Medicine
• Genetics and Developmental Disorders

Background:

• Down syndrome is associated with various health complications, including sleep-disordered breathing.
• Characterizing polysomnographic sleep architecture is crucial for understanding sleep disturbances in this population.

Purpose of the Study:

• To define the polysomnographic sleep architecture in children with Down syndrome.
• To compare sleep findings between children with Down syndrome who have obstructive sleep apnea and those who do not.

Main Methods:

• Retrospective case series analysis of electronic health records from a single tertiary pediatric hospital (2005-2018).
• Inclusion criteria: patients with Down syndrome (age ≥12 months) undergoing polysomnography, excluding titration and split-night studies.
• Data collected included sleep efficiency, latency, total sleep time, REM latency, REM sleep time, arousal index, and time spent supine.

Main Results:

• A total of 397 children with Down syndrome were analyzed; 79.4% had obstructive sleep apnea.
• Significant proportions exhibited poor sleep: 32.5% had sleep efficiency <80%, 75.6% had an elevated arousal index, and 15.9% had total sleep time <360 minutes.
• No significant differences in sleep variables were found between children with and without obstructive sleep apnea; REM sleep time decreased with age.

Conclusions:

• Children with Down syndrome frequently present with multiple markers of poor sleep architecture, irrespective of obstructive sleep apnea status.
• A substantial percentage of these children experience clinically significant sleep disturbances, highlighting the need for comprehensive sleep assessments.