Department of Paediatrics and The Ritchie Centre, Monash University, Melbourne, VIC, Australia.
Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, VIC, Australia.
Pediatr Res. 2022 Apr;91(5):1248-1256. doi: 10.1038/s41390-021-01642-z. Epub 2021 Jul 6.
Children with Down syndrome (DS) are at increased risk of sleep-disordered breathing (SDB), which is associated with intermittent hypoxia and sleep disruption affecting daytime functioning. We aimed to compare the impact of SDB on sleep quality in children with DS compared to typically developing (TD) children with and without SDB.
Children with DS and SDB (n = 44) were age- and sex-matched with TD children without SDB (TD-) and also for SDB severity with TD children with SDB (TD+). Children underwent overnight polysomnography with sleep macro- and micro-architecture assessed using electroencephalogram (EEG) spectral analysis, including slow-wave activity (SWA, an indicator of sleep propensity).
Children with DS had greater hypoxic exposure, more respiratory events during REM sleep, higher total, delta, sigma, and beta EEG power in REM than TD+ children, despite the same overall frequency of obstructive events. Compared to TD- children, they also had more wake after sleep-onset and lower sigma power in N2 and N3. The DS group had reduced SWA, indicating reduced sleep drive, compared to both TD groups.
Our findings suggest that SDB has a greater impact on sleep quality in children with DS compared to TD children.
SDB in children with DS exacerbates disruption of sleep quality, compared to TD children. The prevalence of SDB is very high in children with DS; however, studies on the effects of SDB on sleep quality are limited in this population. Our findings suggest that SDB has a greater impact on sleep quality in children with DS compared to TD children, and should be screened for and treated as soon as possible.
唐氏综合征（DS）患儿发生睡眠呼吸障碍（SDB）的风险增加，SDB 与间歇性缺氧和睡眠中断有关，会影响日间功能。我们旨在比较 SDB 对 DS 患儿与无 SDB 的典型发育（TD）患儿睡眠质量的影响，以及 SDB 严重程度对有 SDB 和无 SDB 的 TD 患儿睡眠质量的影响。
DS 合并 SDB（n=44）患儿按年龄和性别与无 SDB 的 TD 患儿（TD-）匹配，也按 SDB 严重程度与有 SDB 的 TD 患儿（TD+）匹配。患儿接受夜间多导睡眠图检查，使用脑电图（EEG）频谱分析评估睡眠宏观和微观结构，包括慢波活动（SWA，睡眠倾向的指标）。
DS 患儿的低氧暴露更严重，快速眼动（REM）睡眠期间的呼吸事件更多，总 EEG 功率、δ 波、σ 波和β波在 REM 睡眠中高于 TD+患儿，尽管阻塞性事件的总频率相同。与 TD-患儿相比，他们的睡眠起始后觉醒更多，N2 和 N3 中的 σ 波功率更低。与两个 TD 组相比，DS 组的 SWA 减少，表明睡眠驱动力降低。
我们的研究结果表明，与 TD 患儿相比，SDB 对 DS 患儿睡眠质量的影响更大。
与 TD 患儿相比，DS 患儿的 SDB 更严重地破坏睡眠质量。DS 患儿 SDB 的患病率非常高；然而，在该人群中，关于 SDB 对睡眠质量影响的研究非常有限。我们的研究结果表明，与 TD 患儿相比，SDB 对 DS 患儿睡眠质量的影响更大，应尽快进行筛查和治疗。
