Abstract
Across all ages, individuals with Down syndrome (DS) experience high rates of sleep problems as well as cognitive impairments. This study sought to investigate whether circadian rhythm disruption was also experienced by people with DS and whether this kind of sleep disorder may be correlated with cognitive performance. A cross-sectional study of 101 participants (58 with DS, 43 with typical development) included individuals in middle childhood (6–10 years old), adolescence (11–18 years old), and young adulthood (19–26 years old). Sleep and markers of circadian timing and robustness were calculated using actigraphy. Cognitive and behavioral data were gathered via a novel touchscreen battery (A-MAPTM, Arizona Memory Assessment for Preschoolers and Special Populations) and parent questionnaire. Results indicated that children and adolescents with DS slept the same amount as peers with typical development, but significant group differences were seen in phase timing. The circadian robustness markers, interdaily stability and intradaily variability of sleep-wake rhythms, were healthiest for children regardless of diagnostic group and worst for adults with DS. Amplitude of the 24-h activity profile was elevated for all individuals with DS. In analyses of the correlations between sleep quality, rhythms, and cognition in people with DS, interdaily stability was positively correlated with reaction time and negatively correlated with verbal and scene recall, a finding that indicates increased stability may paradoxically correlate with poorer cognitive outcomes. Further, we found no relations with sleep efficiency previously found in preschool and adult samples. Therefore, the current findings suggest that a thorough examination of sleep disorders in DS must take into account age as well as circadian robustness to better understand sleep-cognitive correlations in this group.
Highlights
Very little is known about the rhythmicity of sleep-wake cycles in individuals withDown syndrome (DS), even though high rates of other sleep disorders are well documented in this population
The primary goals of the current study were to report on sleep, phase timing, and circadian robustness markers demonstrated by children, adolescents, and young adults with DS compared to peers with typical development (TD); and to assess for correlations with cognitive and executive function measures that have been noted previously in the TD literature
This indicates the presence of a trend toward insufficient childhood sleep, noted previously by Astill et al [61], that cannot be seen as a positive direction for their health and safety
Summary
Very little is known about the rhythmicity of sleep-wake cycles in individuals withDown syndrome (DS), even though high rates of other sleep disorders are well documented in this population. Obstructive sleep apnea, and low sleep efficiency have been the most frequently noted sleep disorders and are well documented for infants [1], children [2,3], and adults with DS [4] Occurrence rates in this population have been estimated to be as high as 31–66% for sleep-disordered breathing and 52–69%. Sleep-disordered breathing, in turn, is a primary cause of fragmented sleep and can be responsible for reduced total sleep time, poor sleep quality and daytime sleepiness, as well as behavioral problems and cognitive limitations [3,10].
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