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Updated: Oct 29, 2025

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Sleep-disordered breathing and sleep macro- and micro-architecture in children with Down syndrome

Christy R Sibarani1, Lisa M Walter1, Margot J Davey1,2

  • 1Department of Paediatrics and The Ritchie Centre, Monash University, Melbourne, VIC, Australia.

Pediatric Research
|July 7, 2021
PubMed

Insights

Children with Down syndrome (DS) experience worse sleep quality due to sleep-disordered breathing (SDB). SDB significantly disrupts sleep in DS children more than in typically developing children.

Area of Science:

  • Pediatric Sleep Medicine
  • Genetics and Sleep Disorders
  • Neuroscience and Sleep

Background:

  • Children with Down syndrome (DS) have a higher prevalence of sleep-disordered breathing (SDB).
  • SDB in DS is linked to intermittent hypoxia and sleep disruption, impacting daily function.
  • Limited research exists on SDB's specific effects on sleep quality in children with DS.

Purpose of the Study:

  • To compare the impact of SDB on sleep quality in children with DS versus typically developing (TD) children.
  • To investigate differences in sleep architecture and EEG spectral analysis between these groups.

Main Methods:

  • Matched case-control study comparing children with DS and SDB (n=44) to TD children with (TD+) and without SDB (TD-).
  • Overnight polysomnography was conducted.
  • Sleep macro- and micro-architecture were assessed using electroencephalogram (EEG) spectral analysis, including slow-wave activity (SWA).

Main Results:

  • Children with DS and SDB exhibited greater hypoxic exposure and more respiratory events during REM sleep compared to TD+ children.
  • The DS group showed higher REM EEG power (delta, sigma, beta) than TD+ children, despite similar obstructive event frequency.
  • Compared to TD- children, the DS group had increased wake after sleep onset and reduced SWA, indicating diminished sleep drive.

Conclusions:

  • Sleep-disordered breathing has a more profound negative impact on sleep quality in children with Down syndrome than in typically developing children.
  • Early screening and treatment of SDB in children with DS are crucial due to its significant exacerbation of sleep disruption.
Abstract

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