Hill Elizabeth A, Williams Linda J, Cooper Sally-Ann, Riha Renata L
Sleep Research Unit, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh EH16 4SB, UK.
Edinburgh Clinical Trials Unit, The Usher Institute, The University of Edinburgh, Edinburgh EH16 4UX, UK.
Brain Sci. 2021 Aug 31;11(9):1160. doi: 10.3390/brainsci11091160.
Prior to this study, the prevalence of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) in adults with Down syndrome was unknown. We hypothesized that unrecognised OSAHS could have an additional deleterious impact on mood and behavioural disturbances in this group of people.
To assess the prevalence of OSAHS in adults with Down syndrome in the United Kingdom, subjectively and objectively, and ascertain its association with diurnal behavioural disturbances.
Cross-sectional questionnaire study with home sleep apnoea testing (HSAT) during 2011-2015 across the four nations of the United Kingdom. Participants were adults aged ≥16 years with Down syndrome. Main outcome measures were: self- or caregiver-completed questionnaire data, including the Pictorial Epworth Sleepiness Scale (pESS), selected domains of the Developmental Behavioural Checklist for Adults (DBC-A), anthropometric measures, and symptoms of OSAHS. Objective prevalence was undertaken in a sample of responders using HSAT.
Responses were received from 1321/5270 participants (25%), with 1105 valid responses (21%). Eighty-one participants (7%) reported a prior diagnosis of OSA, of whom 38 were receiving therapy. Using validated algorithms, a diagnosis of OSAHS was probable in 366 participants (35%), who were younger, with higher BMI and higher mean total pESS ( < 0.0001). A total of 23% of participants had a pESS > 10. OSAHS was a strong marker for behavioural disturbances on the DBC-A depression, disruption and anti-social subscales ( < 0.001). Of 149 individuals who underwent HSAT, 42% were diagnosed with OSAHS.
Untreated OSAHS in Down syndrome is common and associated with behavioural and mood disturbances. Improving awareness of OSAHS amongst adults with Down syndrome, their families and healthcare professionals is essential.
在本研究之前，唐氏综合征成人患者中阻塞性睡眠呼吸暂停/低通气综合征（OSAHS）的患病率尚不清楚。我们推测，未被识别的OSAHS可能会对这组人群的情绪和行为障碍产生额外的有害影响。
主观和客观地评估英国唐氏综合征成人患者中OSAHS的患病率，并确定其与日间行为障碍的关联。
2011年至2015年期间，在英国四个国家进行了一项横断面问卷调查研究，并进行家庭睡眠呼吸暂停测试（HSAT）。参与者为年龄≥16岁的唐氏综合征成人。主要结局指标包括：自我或照料者填写的问卷数据，包括图片版爱泼沃斯嗜睡量表（pESS）、成人发育行为清单（DBC-A）的选定领域、人体测量指标以及OSAHS症状。使用HSAT对部分应答者进行客观患病率评估。
共收到1321/5270名参与者（25%）的回复，其中1105份有效回复（21%）。81名参与者（7%）报告曾被诊断为OSA，其中38人正在接受治疗。使用经过验证的算法，366名参与者（35%）可能被诊断为OSAHS，这些参与者更年轻，BMI更高，平均总pESS得分更高（<0.0001）。共有23%的参与者pESS>10。OSAHS是DBC-A抑郁、扰乱和反社会子量表上行为障碍的有力指标（<0.001）。在149名接受HSAT的个体中，42%被诊断为OSAHS。
唐氏综合征患者中未经治疗的OSAHS很常见，且与行为和情绪障碍有关。提高唐氏综合征成人患者及其家庭和医疗保健专业人员对OSAHS的认识至关重要。
