Sleep, function and behaviour in children with down syndrome referred to a tertiary sleep clinic

Abstract

Introduction: It is now well recognised that poor sleep has a negative impact on behaviour and cognition in typically developing children (TD). Children with Down syndrome (DS) have an increased risk of sleep disorders compared to typically developing (TD) children. Small cross-sectional studies have found difference in IQ, cognitive function and accomplishment of daily activities in children with DS and comorbid OSA compared to those without OSA. No studies have longitudinally evaluated the impact of standard sleep interventions on functional, developmental and behavioural outcomes in children with DS. Methods: A prospective longitudinal cohort study is underway to evaluate the outcomes in children aged 3-16yrs with DS receiving treatment for sleep disorders through a tertiary paediatric sleep medicine clinic. Baseline questionnaire and clinical data for children enrolled in this study was evaluated including CSHQ scores, parental Life-Habits questionnaire and Child Behaviour Checklist (CBCL) responses. Results: Data was available for 40 patients (Male=20). Mean age was 7.84yrs (SD ± 3.61) and BMI 19.76kg/m2. At enrolment, 35 patients had already received at least 1 ENT treatment with 8 in this group on CPAP currently. The remaining 5 patients had received no sleep interventions before baseline assessment. Mean CSHQ score was high at 54.59 (SD ± 9.91). Mean weighted total Life-H score was 4.6 (SD ± 1.45) and Mean Total CBCL T-Score was 58.81(SD ± 10.17). Children scored highest in the CBCL subscales of-attention problems-,-aggressive behaviour-and-other problems-. At baseline no obvious correlations were found between CSHQ score and either Life-H or CBCL scores. Discussion: In this referred sample CSHQ score was indicative of a sleep problem (defined as score>41) in all but 4 patients. However at baseline no relationship was seen between CSHQ score and functional ability as measures by the Life-H questionnaire. In general CBCL scores were high for problem behaviours for children in this study and were in fact at least 10 points higher than those reported in other studies of children with DS. This may suggest that children with DS who have co-existing sleep difficulties have more behavioural challenges than their peers without sleep issues. Longitudinal study is underway to evaluate the impact of sleep treatments on these outcomes in this population.L6246119902018-11-01 <br />