SEX EFFECTS ON THE QUALITY OF SLEEP IN DOWN SYNDROME

Abstract

AbstractBackgroundSex differences in biological factors, such as sleep, might contribute to sex differences in dementia risk. Down’s syndrome (DS) is a genetically determined form of Alzheimer’s disease (AD), with disrupted sleep and a high prevalence of obstructive sleep apnea (OSA). However, sex differences in nocturnal sleep in adults with DS have not been yet investigated. Thus, we aimed to evaluate the sex effect on polysomnographic sleep measures in adults with DS.MethodCross‐sectional study of 187 adults with DS from the Down‐Alzheimer Barcelona Neuroimaging Initiative (DABNI) that underwent a nocturnal polysomnography study. Sleep macrostructure parameters of i)sleep continuity [Total sleep time(TST), Sleep efficiency(SE), Wake after sleep onset(WASO), Sleep latency and latency to REM sleep], ii) NREM (phase N1, N2, N3) and REM stages, in minutes and percentages, and iii) respiratory parameters to determine the presence of OSA were evaluated. Chi‐squared and Mann‐Whitney tests were used to test differences between categorical data, and continuous variables, respectively. To evaluate the sex effects on sleep parameters, we performed ANCOVAs using sleep measurements as dependent variables, the sex, presence of dementia, and OSA as fixed effects, and age as a covariate. Interactions between subjects effects were aso calculatedResultOur cohort includes 187 adults with DS (57,2% females and 42.8% males). OSA was present in 76,2% of the subjects, and 22% of the subjects had symptomatic AD (prodomal/demented) without significant differences in both prevalences between sexes(p = 0.23, p = 0.08 respectively) (table 1). Females presented significant longer TST, WASO, NREM (m), N2(m), N3(m), with higher SE and N3(%), and decreased N1(%) compare to males. These sex differences were maintained after age correction. Results remain essentially similar when including dementia and OSA in the statistical models. No significant interactions between sex and OSA and sex and dementia were observed(Table2).ConclusionAs in general euploid population, females with DS presented a better objective sleep quality with more deep sleep than men. Further work is needed to investigate how sex differences in sleep parameters can influence clinical and biomarker profiles of AD in adults with Down syndrome.