0425 Severity of Insomnia Symptoms Differ by Cognitive Status in Adults with Down Syndrome

Abstract

Abstract Introduction Sleep is disturbed in Down syndrome (DS), with sleep apnea and insomnia prevalent throughout life. Sleep disturbance increases dementia risk and is more prevalent in dementia in non-DS populations. However, relationships between sleep and clinical status in DS remains unclear. We examined informant-reported sleep in adults with DS, with or without a consensus diagnosis of dementia, and related the severity of sleep disturbances to measures of adaptive behavior. Methods Insomnia (selected from Children’s Sleep Habits Questionnaire), daytime sleepiness (modified ESS), sleep apnea risk (modified STOP-BANG), and adaptive behavior (Vineland Adaptive Behavior Scales; VABS-3) questionnaires were collected from informants for 47 DS adults (52.1±6.6 years) enrolled in a Alzheimer’s disease biomarker study. Participants’ clinical statuses were categorized as cognitively unaffected (clinically significant impairment absent; n=38, 51.0±6.2 years), or as having definite dementia (clinically significant decline present; n=9, 56.6±6.4 years) using a standard consensus diagnosis procedure. Age was compared between groups using an independent samples t-test. ANCOVA was used to compare insomnia, daytime sleepiness, sleep apnea risk, and adaptive behavior measures across groups, while controlling for age. Partial correlation analyses examined associations between sleep measures and VABS-3 measures while controlling for clinical status. Results Participants categorized as definite dementia were older (t=-2.381, p=0.022). ANCOVA determined that insomnia symptoms, but not daytime sleepiness or apnea risk, were more severe in definite dementia participants (F=5.567, p=0.023), even when controlling for age. VABS-3 subscale scores differed by clinical status (all save play and leisure scores p<0.017). Partial correlation analyses adjusting for clinical status indicated that insomnia symptom severity worsened with lower adaptive functioning (e.g., daily living skills—coping r=-0.41, p=0.007; socialization r=-0.33, p=0.024) regardless of clinical status. Conclusion These findings indicate that insomnia may be related to functional impairment and dementia in DS adults, and raises the possibility that insomnia treatments may influence dementia course and clinical symptomatology in DS. Support NIH U01AG051412