Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2020 Jan;119(1 Pt 3):516-523. doi: 10.1016/j.jfma.2019.07.015. Epub 2019 Aug 1.
The prevalence rate of obstructive sleep apnea (OSA) in the community Down syndrome (DS) children is not clear. Moreover, the impact of OSA and sleep structure on the cognitive function is inconclusive. The present study aimed to investigate 1) the prevalence rate of OSA in the community DS children and 2) the impact of OSA and sleep structure on cognitive performance.
Thirty DS children aged 6-18 years were recruited and evaluated with the performance of the language domain and sensorimotor domain, combining neuropsychological tests and parent-rated behavior. The outcomes were the age-adjusted scores, of which the lower the score was, the better was the patient's ability. The association of score with OSA and sleep structures was determined by linear regression. To diminish the age-related difference, all analyses were conducted separately for all subjects and 6-12-year-old subjects.
The median age was 11.3 years and median Full-Scale Intelligence Quotient (FSIQ) was 44. The prevalence of OSA (apnea-hypopnea index ≥ 1/h) was 80% and 62.5% in all subjects and 6-12-year-old subjects, respectively. For 6-12-year-old subjects, after adjustment for age and FSIQ, both %REM and OSA were associated with lower score of the subtest of language domain, WPPSI-R Vocabulary, while %REM was also associated with lower score of VABS-II Communication - Expressive. In contrary, % slow wave sleep was not associated with any subtest.
This study identified that OSA may be highly prevalent in community DS children. Among 6-12-year-old DS children, OSA and % REM were associated with their language function.
社区唐氏综合征（DS）儿童阻塞性睡眠呼吸暂停（OSA）的患病率尚不清楚。此外，OSA 和睡眠结构对认知功能的影响尚无定论。本研究旨在调查：1）社区 DS 儿童 OSA 的患病率；2）OSA 和睡眠结构对认知表现的影响。
招募了 30 名 6-18 岁的 DS 儿童，并通过语言域和感觉运动域的表现，结合神经心理学测试和家长评定行为进行评估。结果是年龄调整后的分数，分数越低，患者的能力越好。通过线性回归确定分数与 OSA 和睡眠结构的关系。为了减少年龄相关的差异，所有分析均针对所有受试者和 6-12 岁的受试者分别进行。
中位数年龄为 11.3 岁，全量表智商（FSIQ）中位数为 44。所有受试者和 6-12 岁受试者的 OSA（呼吸暂停低通气指数≥1/小时）患病率分别为 80%和 62.5%。对于 6-12 岁的受试者，在校正年龄和 FSIQ 后，%REM 和 OSA 均与 WPPSI-R 词汇的语言域子测试分数降低相关，而%REM 也与 VABS-II 沟通-表达分数降低相关。相反，%慢波睡眠与任何子测试均无关。
本研究发现 OSA 在社区 DS 儿童中可能高度流行。在 6-12 岁的 DS 儿童中，OSA 和%REM 与他们的语言功能有关。
