A Cross-Sectional Comparison of the Prevalence of Obstructive Sleep Apnea Symptoms in Adults With Down Syndrome in Scotland and Japan

Hill, Elizabeth A.; Sawatari, Hiroyuki; Nishizaka, Mari K.; Fairley, Donna M.; Chishaki, Akiko; Funakoshi, Kouta; Riha, Renata L.; Ando, Shin-ichi

doi:10.1352/1944-7558-125.4.260

Cited by 4 publications

(5 citation statements)

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“…Five of the studies used questionnaires and requested the information from parents and carers. All five studies that utilised parent and carer report requested different information, for example frequent snoring and daytime sleepiness, caregiver report of medical diagnosis, and sleep disturbance several times per week (Brylewski & Wiggs, 1999; Esbensen, 2016; Hill et al, 2020). One study used a health questionnaire developed by an MDT (Wong, 2011).…”

Section: Resultsmentioning

confidence: 99%

“…However, it is worth noting that the sample sizes in these studies was small with one study having a sample of 16 participants (Trois et al, 2009), and the second having a sample of 12 participants (Andreou et al, 2002). While rated as poor quality, the study that sampled the largest number of people with Down Syndrome ( n = 725) found that 16.6% of the sample were identified as having symptoms of a sleep related breathing disorder as identified through a questionnaire (Hill et al, 2020). The remaining studies were all rated as poor quality (see Table 5).…”

Section: Resultsmentioning

confidence: 99%

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The prevalence of sleep disorders in adults with learning disabilities: A systematic review

Shanahan

Ahmad²,

Smith

et al. 2022

Brit J Learn Disabil

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Background Previous research indicated a high prevalence of disordered sleep among adults with learning disabilities, however issues with design impacted findings. The current systematic review aims to: (a) present how disordered sleep and sleep disorders amongst adults with learning disabilities are described in the literature, and (b) report on the prevalence of disordered sleep and sleep disorders among adults with learning disabilities. Methods Five databases (EMBASE, MEDLINE, PsycARTICLES, PsycINFO and PubMed) were searched for articles published from 1900 to October 2021 that examined the prevalence of disordered sleep and/or sleep disorders in adults aged 18 or older with learning disabilities. The Joanna Briggs Institute critical appraisal checklist for prevalence studies was used to assess study quality and prevalence is described and reported as ranges. The study was registered on PROSPERO (ID: CRD42019134550). Findings A total of 27 studies were selected. Twenty studies (n = 8043 participants) examined the prevalence of disordered sleep and identified prevalence ranging from 6.1% to 74.2% across a range of sleep parameters. Twelve studies examined sleep‐related breathing disorders (n = 2558 participants) and identified prevalence which ranged from 0.5% to 100%. There was notable heterogeneity between studies in terms of quality, definition of disordered sleep, measurement of sleep, and study design. Conclusion There was a variable prevalence of disordered sleep among people living with learning disabilities. There were problems in meaningfully synthesising results due to heterogeneity in measurement, diagnosis, study design and study quality. Based on these limitations, we suggest that future studies should seek to utilise objective, replicable and consistent measures of sleep in this population and control for physical health factors which could influence prevalence such as epilepsy and iatrogenic effects.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The prevalence of sleep disorders in adults with learning disabilities: A systematic review

Shanahan

Ahmad²,

Smith

et al. 2022

Brit J Learn Disabil

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“…Information on ethnicity was not collected, and our prevalence data may not be transferable to other countries with divergent ethnicity. However, work comparing the prevalence of OSAHS in adults with Down syndrome in Scotland with that in Japan showed similar prevalence of symptoms, despite the ethnic and anthropometric differences between these two populations [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Objective and Subjective Prevalence of Obstructive Sleep Apnoea/Hypopnoea Syndrome in UK Adults with Down Syndrome: A Strong Marker for Diurnal Behavioural Disturbances

et al. 2021

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Prior to this study, the prevalence of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) in adults with Down syndrome was unknown. We hypothesized that unrecognised OSAHS could have an additional deleterious impact on mood and behavioural disturbances in this group of people. Aims: To assess the prevalence of OSAHS in adults with Down syndrome in the United Kingdom, subjectively and objectively, and ascertain its association with diurnal behavioural disturbances. Method: Cross-sectional questionnaire study with home sleep apnoea testing (HSAT) during 2011–2015 across the four nations of the United Kingdom. Participants were adults aged ≥16 years with Down syndrome. Main outcome measures were: self- or caregiver-completed questionnaire data, including the Pictorial Epworth Sleepiness Scale (pESS), selected domains of the Developmental Behavioural Checklist for Adults (DBC-A), anthropometric measures, and symptoms of OSAHS. Objective prevalence was undertaken in a sample of responders using HSAT. Results: Responses were received from 1321/5270 participants (25%), with 1105 valid responses (21%). Eighty-one participants (7%) reported a prior diagnosis of OSA, of whom 38 were receiving therapy. Using validated algorithms, a diagnosis of OSAHS was probable in 366 participants (35%), who were younger, with higher BMI and higher mean total pESS (p < 0.0001). A total of 23% of participants had a pESS > 10. OSAHS was a strong marker for behavioural disturbances on the DBC-A depression, disruption and anti-social subscales (p < 0.001). Of 149 individuals who underwent HSAT, 42% were diagnosed with OSAHS. Conclusions: Untreated OSAHS in Down syndrome is common and associated with behavioural and mood disturbances. Improving awareness of OSAHS amongst adults with Down syndrome, their families and healthcare professionals is essential.

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“…We also surveyed the frequency of snoring as ‘frequently (5 to 7 nights/week)’, ‘sometimes (1 to 4 nights/week)’, or ‘rarely/never (less than 1 night/week)’ (Hill et al . 2020). We defined individuals as having frequent snoring when they were witnessed snoring >4 times per week.…”

Section: Methodsmentioning

confidence: 99%

“…When the participants with DS were witnessed snoring or having sleep apnoea, we regarded them as presenting with SDB-related signs. We also surveyed the frequency of snoring as 'frequently (5 to 7 nights/week)', 'sometimes (1 to 4 nights/week)', or 'rarely/never (less than 1 night/week)' (Hill et al 2020). We defined individuals as having frequent snoring when they were witnessed snoring >4 times per week.…”

Section: Questionnairesmentioning

confidence: 99%

Growth‐related changes in the influence of obesity on signs suggesting sleep‐disordered breathing and sleepiness in young individuals with Down syndrome

Sawatari,

Chishaki,

Rahmawati

et al. 2023

J intellect Disabil Res

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BackgroundSleep‐disordered breathing (SDB) is highly prevalent in individuals with Down syndrome (DS), who cease growing earlier than individuals without DS. These characteristics may be associated with increased obesity and subsequent SDB signs, such as snoring and apnoea or excessive daytime sleepiness (EDS). Thus, we assessed the influence of growth on the association between obesity and SDB signs or EDS; we used questionnaires sent to young individuals with DS and their caregivers, in a cross‐sectional study.MethodsWe sent out 2000 questionnaires to individuals with DS and their caregivers. The surveys included questions about SDB signs (witnessed snoring or apnoea), subjective sleeping time including witnessed midnight arousal, the Epworth sleepiness scale and witnessed napping as well as sex, age, body weight and body height.ResultsOf the 1222 questionnaires we received, 660 were from young individuals and were included in the analysis. SDB signs were highly prevalent (77.1%), and frequency of SDB signs increased with growth (P‐trend: P = 0.02) in individuals with DS. Multivariate analyses showed that EDS (Epworth sleepiness scale > 10 points) was associated with body mass index Z‐score (Z‐BMI) in the 6–9 years age group (odds ratio [OR] 95% confidence interval [95% CI]: 1.69 [1.09–2.62], P = 0.02). Conversely, SDB signs were associated with Z‐BMI in the 13–15 (OR [95% CI]: 1.99 [1.06–3.72], P = 0.03) and 16–18 years age groups (OR [95% CI]: 3.04 [1.22–7.59], P = 0.02). For the 19–21 years age group, SDB signs were associated with only male sex (OR [95% CI]: 7.28 [1.22–43.38], P = 0.03).ConclusionsThis study showed that the association between Z‐BMI and SDB or EDS was age dependent. In early school‐age children with DS, high Z‐BMI could not accurately predict the presence of SDB, but it was associated with EDS. In the pubescent period (i.e. 13–18 years), high Z‐BMI was associated with SDB signs but not with EDS. Overall, obesity affected SDB signs and EDS differently based on age in young individuals with DS.

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A Cross-Sectional Comparison of the Prevalence of Obstructive Sleep Apnea Symptoms in Adults With Down Syndrome in Scotland and Japan

Cited by 4 publications

References 40 publications

The prevalence of sleep disorders in adults with learning disabilities: A systematic review

The prevalence of sleep disorders in adults with learning disabilities: A systematic review

Objective and Subjective Prevalence of Obstructive Sleep Apnoea/Hypopnoea Syndrome in UK Adults with Down Syndrome: A Strong Marker for Diurnal Behavioural Disturbances

Growth‐related changes in the influence of obesity on signs suggesting sleep‐disordered breathing and sleepiness in young individuals with Down syndrome

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