Sleep assessment in adults with Down syndrome: correlation between functionality and polysomnographic findings

Abstract

Background Sleep disorders have a negative impact on health, being associated with neurocognitive problems, cardiovascular diseases and obesity, influencing children's development and learning.

Objective To assess the sleep pattern of people with Down syndrome (DS) and correlate changes with functionality and behavior.

Methods A cross-sectional study was conducted to evaluate the sleep pattern in adults with DS > 18 years old. Twenty-two participants were assessed using the Pittsburgh Sleep Quality Index, the Functional Independence Measure and the Strengths and Difficulties Questionnaire, and the 11 who presented indications of disorders by the screening questionnaires were referred to polysomnography. Statistical tests were performed using a significance level of 5%, including sample normality tests and correlation tests (sleep and functionality).

Results Impairment in sleep architecture was found due to an increase in the rate of awakenings in 100% of the participants, a decrease in the number of slow waves, and a high prevalence of sleep disordered breathing (SDB), with higher averages in the Apnea and Hypopnea Index (AHI) in the group. There was a negative correlation between sleep quality and global functionality (p = 0.011) and the motor (p = 0.074), cognitive (p = 0.010), and personal care (p = 0.072) dimensions in the group. Global and hyperactivity behavior changes were related to worse sleep quality (p = 0.072; p = 0.015, respectively).

Conclusion There is an impairment in the sleep quality of adults with DS, with an increase in the rate of awakenings, a decrease in the number of slow waves, and a high prevalence of SDB affecting this population in the functional and behavioral aspects.

Resumo

Antecedentes Os distúrbios de sono têm impacto negativo na saúde, estando associados a problemas neurocognitivos, doenças cardiovasculares e obesidade, influenciando no desenvolvimento e aprendizado.

Objetivo Avaliar o padrão de sono de pessoas com síndrome de Down (SD) e correlacionar as alterações com a funcionalidade e comportamento.

Métodos Foi realizado um estudo transversal para avaliação do padrão de sono em adultos com SD > 18 anos. Foram avaliados 22 participantes, através do Índice de Qualidade do Sono de Pittsburgh, da Medida de Independência Funcional e do Questionaário de Capacidades e Dificuldades. Os 11 participantes que apresentaram indicativos de presença de distúrbios pelos questionários de triagem foram indicados a polissonografia. Os testes estatísticos foram realizados com nível de significância de 5%, incluindo testes de normalidade e testes de correlação (sono e funcionalidade).

Resultados Foi encontrado prejuízo na arquitetura de sono pelo aumento do índice de despertares em 100% dos participantes, diminuição na quantidade de ondas lentas, e alta prevalência de distúrbio respiratório do sono (DRS), com maiores médias nos Índices de Apneia e Hipopneia (IAH). Houve correlação negativa entre a qualidade de sono e a funcionalidade global (p = 0,011), e as dimensões motora (p = 0,074), cognitiva (p = 0,010) e cuidados pessoais (p = 0,072). As alterações de comportamento global e comportamentos de hiperatividade foram relacionados à pior qualidade do sono (p = 0,072; p = 0,015, respectivamente).

Conclusão Existe prejuízo na qualidade de sono de adultos com SD, com aumento de índice de despertares, diminuição na quantidade de ondas lentas, e alta prevalência de DRS, afetando essa população nos aspectos funcionais e comportamentais.

Keywords

Down Syndrome - Sleep - Sleep Wake Disorders - Polysomnography - Physical Functional Performance

Palavras-chave

Síndrome de Down - Sono - Transtornos do Sono-Vigília - Polissonografia - Desempenho Físico Funcional

Authors' Contributions

MRC: conceptualization, methodology, investigation, data curation, writing - original draft, writing - review & editing; KBS, BVO, ARAA: investigation; RC: formal analysis and data curation; SMBA: conceptualization, methodology, investigation, data curation, writing - review & editing, project administration, and funding acquisition.

Support

The present study was funded by the Mackenzie Research and Innovation Fund (Mackpesquisa) – Mackenzie Presbyterian Institute (MPI). The MPI had no influence on study design, data acquisition, analyses, interpretation, and reporting.

Publication History

Received: 31 October 2022

Accepted: 23 January 2023

Article published online:
28 June 2023

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