Background

The prevalence of sleep-disordered breathing is high in children with Down syndrome. Although the association between sleep-disordered breathing and developmental delay and behavioral abnormalities are proven among typically developing children, there are few such studies of children with Down syndrome. This study assesses the relationship between the severity of sleep apnea and development and behavioral abnormalities in individuals with Down syndrome.

Methods

In a cross-sectional prospective study, 53 children with Down syndrome were assessed for sleep-disordered breathing by overnight polysomnography. Behavior was assessed using Child Behavior Checklist (CBCL) and developmental quotient (DQ) using Developmental Profile 3. The association between various domains of behavior and development with the Apnea-Hypopnea Index (AHI) was assessed using Spearman rank correlation. Multiple linear regression assessed the independent effects of various factors on development and behavior.

Results

Of 53 subjects (three to 11.8 years), 51 (96%) were found to have obstructive sleep apnea (OSA). In both three to five year and six to 12 year age groups, there was a statistically significant positive correlation between the CBCL scores and the AHI (rho = 0.77 and 0.83, respectively). There was a statistically significant negative correlation between the DQ and the AHI (rho = −0.62). In multiple linear regression, AHI was the only independent variable that was associated with CBCL and DQ.

Conclusions

This study provides robust evidence that OSA can negatively influence the development and behavior in children with Down syndrome as in typically developing children. Moreover, with increasing severity of OSA, children with Down syndrome have more behavioral abnormalities, especially attention deficit and hyperactivity, and also have poorer development scores.

中文翻译：

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睡眠呼吸暂停与唐氏综合症的发展和行为的关联：一项前瞻性临床和多导睡眠图研究

背景

患有唐氏综合症的儿童睡眠呼吸障碍的患病率很高。尽管睡眠呼吸障碍与发育迟缓和行为异常之间的关联已在正常发育的儿童中得到证实，但对唐氏综合症儿童的此类研究却很少。本研究评估了唐氏综合症患者睡眠呼吸暂停的严重程度与发育和行为异常之间的关系。

方法

在一项横断面前瞻性研究中，通过夜间多导睡眠图评估了 53 名唐氏综合症儿童的睡眠呼吸障碍。使用儿童行为检查表 (CBCL) 和发育商 (DQ) 使用发育概况 3 评估行为。使用 Spearman 等级相关性评估行为和发育的各个领域与呼吸暂停-低通气指数 (AHI) 之间的关联。多元线性回归评估了各种因素对发育和行为的独立影响。

结果

在 53 名受试者（3 至 11.8 岁）中，发现 51 名（96%）患有阻塞性睡眠呼吸暂停（OSA）。在 3 至 5 岁和 6 至 12 岁年龄组中，CBCL 评分和 AHI 之间存在统计学上显着的正相关（rho = 0.77 和 0.83，分别）。DQ 和 AHI 之间存在统计学上显着的负相关（rho = -0.62）。在多元线性回归中，AHI 是唯一与 CBCL 和 DQ 相关的自变量。

结论

这项研究提供了强有力的证据，表明 OSA 可以对唐氏综合症儿童的发育和行为产生负面影响，就像正常发育的儿童一样。此外，随着 OSA 严重程度的增加，唐氏综合征患儿的行为异常也越来越多，尤其是注意力缺陷和多动，发育评分也越来越差。