Joyce A, Dimitriou D
Centre for Research in Psychology, Behaviour and Achievement, Coventry University, Coventry, UK.
Lifespan Learning & Sleep Lab, Department of Psychology and Human Development, UCL Institute of Education, London, UK.
J Intellect Disabil Res. 2017 Aug;61(8):778-791. doi: 10.1111/jir.12387. Epub 2017 Jun 14.
Sleep affects children's cognitive development, preparedness for school and future academic outcomes. People with Down syndrome (DS) are particularly at risk for sleep-disordered breathing (SDB). To our knowledge, the association between SDB and cognition in preschoolers with DS is unknown.
We assessed sleep by using cardiorespiratory polygraphy in 22 typically developing (TD) preschoolers and 22 with DS. Cognition was assessed by using the Mullen Scales of Early Learning and behaviour by using the Strengths and Difficulties Questionnaire (SDQ). The MacArthur Communicative Development Inventory (MCDI) measured language level. We predicted that sleep problems would be associated with lower cognitive and behavioural functioning.
In TD children, longer sleep duration was associated with higher scores on MCDI expressive language and fewer emotional symptoms such as fear and unhappiness on the SDQ, whilst SDB was associated with increased conduct problems and less prosocial behaviour on the SDQ. Conversely, for children with DS, SDB was associated with increased language understanding and use of actions and gestures on the MCDI.
The findings in the TD group support our hypotheses. We recommend that sleep problems are screened for and treated as even mild SDB may prompt poorer cognition and behaviour. For children with DS, we expect that multiple factors in this complex syndrome mask or mediate the association between sleep and cognitive development and tighter controls are necessary to uncover effects of sleep. We propose longitudinal studies as a necessary tool to assess the precise impact of sleep on cognitive development in accounting for individual differences in DS.
睡眠会影响儿童的认知发展、入学准备情况及未来的学业成绩。唐氏综合征（DS）患者尤其容易出现睡眠呼吸障碍（SDB）。据我们所知，DS学龄前儿童中SDB与认知之间的关联尚不清楚。
我们使用心肺多导睡眠图对22名发育正常（TD）的学龄前儿童和22名患有DS的儿童进行睡眠评估。使用早期学习的马伦量表评估认知，并使用长处和困难问卷（SDQ）评估行为。麦克阿瑟沟通发展量表（MCDI）测量语言水平。我们预测睡眠问题将与较低的认知和行为功能相关。
在TD儿童中，较长的睡眠时间与MCDI表达性语言得分较高以及SDQ上恐惧和不快乐等情绪症状较少相关，而SDB与SDQ上的品行问题增加和亲社会行为减少相关。相反，对于患有DS的儿童，SDB与MCDI上语言理解及动作和手势使用的增加相关。
TD组的研究结果支持我们的假设。我们建议对睡眠问题进行筛查和治疗，因为即使是轻度的SDB也可能导致较差的认知和行为。对于患有DS的儿童，我们预计这种复杂综合征中的多种因素会掩盖或介导睡眠与认知发展之间的关联，需要更严格的对照来揭示睡眠的影响。我们提出纵向研究作为评估睡眠对DS个体差异中认知发展的精确影响的必要工具。
