Sleep problems and associated comorbidities among adults with Down syndrome.
Treat snoring and bedtime refusal as two different alarms in adults with Down syndrome—each points to its own medical or mood problem.
01Research in Context
What this study did
Caregivers of adults with Down syndrome filled out a survey about sleep. They noted nights of loud breathing, snoring, or bedtime refusal.
The team then looked at medical charts to see which adults also had heart, lung, or mental-health issues.
What they found
Two clear sleep pictures showed up. Picture one: adults who stopped breathing at night also saw doctors more often for chest colds and asthma.
Picture two: adults who simply would not settle at bedtime were the ones with mood swings, heart trouble, and rough daytime behavior.
How this fits with other research
Marchal et al. (2013) asked parents of young children with Down syndrome the same sleep questions. They found that lost sleep hurt parent well-being more than child skills. Esbensen (2016) flips the lens: it shows how the same lost sleep signals hidden illness in the adult with Down syndrome.
Burack et al. (2004) linked night screaming and short sleep to worse autism traits in kids. Esbensen (2016) mirrors this pattern in adults with Down syndrome, adding medical red flags to the list.
Andrés-Roqueta et al. (2021) showed that adults with Down syndrome struggle to read emotions. Poor sleep from Esbensen (2016) may be one reason—tired brains read faces poorly.
Why it matters
When an adult with Down syndrome presents cranky or withdrawn, do not assume "that’s just Down syndrome." Ask about snoring and bedtime battles. If snoring is loud, request a sleep-apnea test and check lungs. If bedtime is the fight, screen heart and mood. Treat the right sleep root and daytime behavior often smooths out.
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02At a glance
03Original abstract
BACKGROUND: Sleep problems, including sleep apnoea and behavioural sleep disturbances, are common among adults with Down syndrome (DS). Despite a preliminary understanding of potential medical and behavioural comorbidities of these sleep problems among children with DS, little is known about comorbid conditions associated with these sleep problems among adults with DS. Understanding causes and sequelae of sleep problems in this ageing population is essential to providing quality health screening and treatment. The current study examines the physical health problems, mental health conditions, functional abilities and behavioural problems associated with sleep apnoea and behavioural sleep disturbances among adults with DS. METHOD: Family caregivers participated in clinical interviews and completed questionnaires, providing reports regarding 75 adults with DS. Caregivers reported on sleep problems, physical and mental health conditions, daily living skills and behaviours regarding their ageing family member with DS. RESULTS: Sleep apnoea was associated with more common other respiratory concerns, and more frequent visits to physicians, but not with some expected medical comorbidities (cardiac). Behavioural sleep disturbances (delayed sleep onset, night-time awakenings and morning awakenings) were associated with poorer health, more frequent overnight hospital and emergency department visits, more common cardiac conditions, less common thyroid condition, more common mental health conditions (anxiety, depression and dementia) and a higher rate of daytime behaviour problems. CONCLUSION: The study findings suggest that there are differential correlates for the various sleep problems in adults with DS, which warrant attention when screening for medical and mental health comorbidities, assessing behavioural problems and in treatment planning for ageing adults with DS.
Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12236