Priya Chandrasekhar¹*, Varshini Chandrasekhar¹ and Surekha Ramachandran²

¹Department of Paediatrics, Indira Health Care, Chennai, India
²Department of Rehabilitation, Down Syndrome Federation of India, Chennai, India

*Corresponding Author: Priya Chandrasekhar, Department of Pediatrics, Indira Child Care, Chennai, Tamil Nadu, India.

Received: May 31, 2021; Published: September 24, 2021

Citation: Priya Chandrasekhar., et al. “A Systemic Investigation to Compare the Relationship of Sleep Disturbances and its Outcomes in Normal and DS Children" Acta Scientific Paediatrics 4.10 (2021): 63-70.

Abstract

Background: Down syndrome (trisomy 21) is a genetic disorder caused by the presence of all or a portion of a third chromosome 21. OSA is one of the most common co- morbidities in people who have DS. There are lot of research happening to understand the correlation between the DS and OSA in children.

Objective: The main objective of this pilot study was to determine the sleep characteristics and daily life habits in a group of children with Down syndrome, as well as to find out the relation between sleep disturbances and daily life habit achievement when compared to normal children in relation to sleep pattern with age differences.

Methods: Totally 49 DS children were identified at different ages. We selected 3- 5 yrs 15 children, 5 - 8 yrs 8 children, 8 - 10 yrs 11 children, more than 10yrs we selected 15 children randomly. Normal children served as control and the normal children data was used only for comparison only.

Results: The bedtime resistance of the children with DS had symptoms of falling asleep in own bed. The sleep behaviour of the children with DS had earlier wake times and bedtimes, leading to significantly (**p < 0.01) more hours of sleep during nights, largely due to significantly earlier bedtimes. There was mild statistically significant (*p < 0.05) difference in the amount of sleep time compared to normal children. In night waking of the children with DS had difference when compared to normal children, leading to troubling in getting sleep during nights after the child wake up. The morning waking of the children with DS was identified that the child wakes up by own. It is also noted that the child is tired during day and some sleep during day time which is also significant (*p < 0.05).

Conclusion: The behaviour and growth of the children improve after successful treatment of obstructive sleep apnea syndrome. The understanding of the sleep fragmentation in children with DS may lead to more appropriate treatment, resulting in an improvement of their psychomotor development.

Keywords: Down Syndrome; Obstructive Sleep Apnea; Sleep Behaviour

Bibliography

1. Punjabi NM. “The epidemiology of adult obstructive sleep apnea”. Proceedings of the American Thoracic Society - ATS Journals2 (2008): 136-143.
2. Heinzer R., et al. “Prevalence of sleep-disordered breathing in the general population: the Hypnolaus study”. The Lancet Respiratory Medicine4 (2015): 310-318.
3. Antic NA., et al. “The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA”. Sleep1 (2011): 111-119.
4. Choi JH., et al. “Predictive models of objective oropharyngeal OSA surgery outcomes: success rate and AHI reduction ratio”. PLoS One9 (2017): e0185201.
5. Simpson L., et al. “High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls”. Sleep Breath3 (2013): 967-973.
6. Gray EL., et al. “Obstructive Sleep Apnea without Obesity Is Common and Difficult to Treat: Evidence for a Distinct Pathophysiological Phenotype”. Journal of Clinical Sleep Medicine1 (2017): 81-88.
7. Spicuzza L., et al. “Obstructive sleep apnoea syndrome and its management”. Therapeutic Advances in Chronic Disease5 (2015): 273-285.
8. Antonopoulos C., et al. “Nasal continuous positive airway pressure (nCPAP) treatment for obstructive sleep apnea, road traffic accidents and driving simulator performance: a meta-analysis”. Sleep Medicine Reviews 15 (2011): 301-310.
9. Horner RL., et al. “State-dependent and reflex drives to the upper airway: basic physiology with clinical implications”. Journal of Applied Physiology3 (2014): 325-336.
10. Kapur VK., et al. “Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline”. Journal of Clinical Sleep Medicine3 (2017): 479-504.
11. Temirbekov D., et al. “The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome: The Oxygen Desaturation Index”. Turkish Archives Of Otorhinolaryngology1 (2018): 1-6.
12. Eckert DJ. “Phenotypic approaches to obstructive sleep apnoea – new pathways for targeted therapy”. Sleep Medicine Reviews 37 (2018): 45-59.
13. Eckert DJ., et al. “Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets”. American Journal of Respiratory and Critical Care Medicine8 (2013): 996-1004.
14. Dewan NA., et al. “Intermittent hypoxemia and OSA: implications for comorbidities”. Chest1 (2015): 266-274.
15. Sankari A., et al. “Characteristics and Consequences of Non-apneic Respiratory Events During Sleep”. Sleep1 (2017).
16. Wellman A., et al. “A method for measuring and modeling the physiological traits causing obstructive sleep apnea”. Journal of Applied Physiology6 (2011 1985): 1627-1637.
17. Peppard PE., et al. “Prospective study of the association between sleep-disordered breathing and hypertension”. The New England Journal of Medicine 342 (2000): 1378-1384.
18. Dempsey JA., et al. “Pathophysiology of sleep apnea”. Physiological Reviews 1 (2010): 47-112.
19. Strohl KP., et al. “Mechanical properties of the upper airway”. Comprehensive Physiology 3 (2012): 1853-1872.
20. Chi L., et al. “Identification of craniofacial risk factors for obstructive sleep apnoea using three-dimensional MRI”. European Respiratory Journal 2 (2011): 348-358.
21. Ch'ng CL., et al. “Celiac disease and autoimmune thyroid disease”. Clinical Medicine and Research 3 (2007): 184-192.
22. MA Carno., et al. “Symptoms of sleep apnea and polysomnography as predictors of poor quality of life in overweight children and adolescents”. Journal of Pediatric Psychology 3 (2008): 269-278.
23. Maris M., et al. “Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome”. Sleep3 (2016): 699-704.
24. Simpson R., et al. “Obstructive sleep apnea in patients with Down syndrome: current perspectives”. Nature and Science of Sleep 10 (2018): 287-293.
25. Eckert DJ., et al. “Central sleep apnea: Pathophysiology and treatment”. Chest 131.2 (2007): 595-607.
26. Bonuck KA., et al. “Modified Children's sleep habits questionnaire for behavioral sleep problems: A validation study”. Sleep Health3 (2017): 136-141.
27. Grantham-Hill S., et al. “Psychometric Properties and Predictive Value of a Screening Questionnaire for Obstructive Sleep Apnea in Young Children With Down Syndrome”. Front Psychiatry 11 (2020): 285.
28. Esbensen AJ and Hoffman EK. “Reliability of parent report measures of sleep in children with Down syndrome”. Journal of Intellectual Disability Research3 (2017): 210-220.
29. Martin GE., et al. “Language Characteristics of Individuals with Down Syndrome”. Public Language Discord2 (2009): 112-132.
30. Abbeduto L., et al. “Receptive language skills of adolescents and young adults with Down or fragile X syndrome”. American Journal on Mental Retardation 108 (2003): 149-160.
31. Ogundele MO. “Behavioural and emotional disorders in childhood: A brief overview for paediatricians”. World Journal of Clinical Pediatrics 1 (2018): 9-26.
32. Moturi S and Avis K. “Assessment and treatment of common pediatric sleep disorders”. Psychiatry 6 (2010): 24-37.

Copyright: © 2021 Priya Chandrasekhar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.