These results suggest that hot water bathing during cold seasons might induce more serious physiological changes in older people. Geriatr Gerontol Int 2017; 17: 2164-2170.

Our study shows that there is a close relationship between unusual sleep postures and SDB-RSs. We recommend that all people with DS with unusual sleep postures should be checked for the presence of SDB.

This study evaluated the prevalence of obstructive sleep apnea-related symptoms and assessed the relationship with obesity or unusual sleep postures in Down syndrome patients in Japan. We obtained the demographic characteristics, sleep postures, and obstructive sleep apnea-related symptoms experienced by 90 people as reported by their caregivers. Although 71% reported snoring and 59% arousals, obstructive sleep apnea-related symptoms were not significantly different between obese and non-obese participants. The youngest age group had the fewest obstructive sleep apnea-related symptoms, especially symptoms of snoring. The odds for arousal, nocturia, and apnea tended to be higher in the unusual sleep-postures group. Unusual sleep postures were most frequent in the group 6-15 years of age. People with Down syndrome might sleep in unusual postures to avoid upper airway obstruction caused by other anatomical factors. For nurses and other health professionals working in mainstream service, it is important to screen all persons with Down syndrome for symptoms suggestive of obstructive sleep apnea, particularly those six years of age and older, and to refer them for further evaluation for sleep disorders.

People with Down syndrome (DS) are prone to develop sleep-disordered breathing (SDB), especially obstructive sleep apnea (OSA) and they are reported to sleep in unusual sleep postures. The purpose of this study was to determine the relationship between sleep postures and SDB parameters, including the objective nocturnal oxygen desaturation in people with DS in Japan. Overnight pulse oximetry was measured in 32 people with DS (male 44%, mean age 18 ± 10 years) and a questionnaire was completed to obtain information on sleep postures and OSA-related symptoms. Subjects were divided by their dominant sleep postures into three groups: usual postures (supine and lateral), prone, and unusual postures (leaning forward and sitting). Subjects who slept mainly in unusual postures were younger (9.6 ± 5.0 years) than those who slept in prone (18.6 ± 12.4 years) and in usual postures (21.1 ± 8.9 years) (P < 0.05). Snoring was the most reported symptom (81.3%) and was the only symptom positively correlated with 4% oxygen desaturation index (ODI) (r = 0.386, P < 0.05). There was no significant association between 4% ODI and sleep postures among the three groups. DS children with prone and unusual sleep postures had significantly better 4% ODI and minimum SpO 2 level compared with those of usual postures (P < 0.05). Our results indicated that prone and unusual sleep postures in DS children might be compensation to alleviate against SDB. These postures could be related to alleviation of SDB resulting from the immaturity of people with DS.