The significance of aspects of screening for obstructive sleep apnoea in children with Down syndrome.
Parent reports of restless sleep and noisy breathing are valid red flags for obstructive sleep apnea and predict daytime behavior issues in children with Down syndrome.
01Research in Context
What this study did
Doctors asked parents of children with Down syndrome about sleep. They also wired the kids to machines that track breathing and oxygen all night.
The team then compared parent words to machine numbers. They looked at how night breathing linked to day behavior.
What they found
When parents said "restless sleeper" or "noisy breather," the machines agreed. Kids who snored had big oxygen dips.
Every bad sleep sign matched more daytime behavior trouble. Parent reports were right.
How this fits with other research
Amore et al. (2011) already showed a sleep checklist works for people with intellectual disability. McGonigle et al. (2014) now show that even a simple parent question works for Down syndrome alone.
Austeng et al. (2013) found one in three 8-year-olds with Down syndrome has hidden hearing loss. Together these papers say: screen for hidden health issues early and often.
Wuang et al. (2011) linked sensory problems to lower school joining. J et al. add sleep problems to the list of things that hurt day function.
Why it matters
You can trust parents when they say their child with Down syndrome snores or sleeps poorly. Ask two quick questions at intake: "Is sleep restless?" and "Do you hear loud breathing?" If the answer is yes, refer for a sleep study. Fixing sleep may cut daytime behavior problems without extra ABA hours.
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02At a glance
03Original abstract
BACKGROUND: The sleep problems of children with intellectual disabilities remains a relatively neglected topic in spite of the consistent reports that such problems are common, often severe and persistent with potentially serious consequences for the children and their families. Children with Down syndrome (DS) are a case in point. They often suffer from obstructive sleep apnoea (OSA), early detection of which is recommended because of its potentially adverse effects on development. This study is concerned with aspects of assessment that have been considered important in helping to recognise OSA in children with DS. The relationships between different objective measures, and between these measures and parental reports of their child's sleep and daytime behaviour, were explored. METHOD: Overnight recordings were carried out on a group of children with DS (n = 31) involving video and audio recording, oximetry and activity monitoring during sleep. Parents also completed questionnaires concerning their child's sleep and daytime behaviour. RESULTS: Parents' reports of restless sleep and noisy breathing were supported by objective measures of activity during sleep and audio recording respectively. No significant association was found between objective measures of restlessness during sleep and 'snoring' (see later for definition), nor were objective measures of restlessness related to reductions in overnight blood oxygen levels. However, the objective measure of snoring was significantly associated with reductions in overnight blood oxygen levels. All three of the objective measures were significantly associated with parental reports of various types of disturbed daytime behaviour. CONCLUSIONS: The findings have implications for aspects of screening for OSA in children with DS and for the interpretation of the relevance of the results to the children's daytime behaviour.
Journal of intellectual disability research : JIDR, 2014 · doi:10.1111/jir.12033