Circadian Sleep-Activity Rhythm across Ages in Down Syndrome

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.

Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review

“…However, contrary to these findings performance on word recall was not found to be related to long-term retention (Sakhon et al, 2018) and consistency in day-to-day sleep patterns has been negatively correlated with verbal and scene recall (Lovos et al, 2021). Therefore, the relationship between sleep and cognitive ability is likely to be more complex with multiple factors impacting the outcome.…”

“…People with Down's syndrome that have poor sleep have specific difficulties with expressive language, including word retention, recall and syntax (Ashworth et al, 2017; Edgin et al, 2015). However, contrary to these findings performance on word recall was not found to be related to long‐term retention (Sakhon et al, 2018) and consistency in day‐to‐day sleep patterns has been negatively correlated with verbal and scene recall (Lovos et al, 2021). Therefore, the relationship between sleep and cognitive ability is likely to be more complex with multiple factors impacting the outcome.…”

DYRK1A antagonists rescue degeneration and behavioural deficits of in vivo models based on amyloid-β, Tau and DYRK1A neurotoxicity

“…DS is caused by expression of three copies of chromosome 21 genes, including overexpression of APP and hence increased AD pathology 2 , 29 . DS is a syndrome involving complex developmental abnormalities leading to compromised motor control, learning difficulties and sleep disruption 30 – 32 . People with DS develop Alzheimer’s disease (AD)-like (AD-DS) pathology of Aβ plaques and accumulation of tangles of hyperphosphorylated Tau leading to neurodegeneration in people as young as 20 years old, causing progressive motor, cognitive and health decline in early middle age 33 , 34 and, finally, shortening of life by ~ 30 years 35 .…”

Estimating circadian rhythm across infancy: Development of intra- and interdaily stability, and relative amplitude

“…Moreover, it does not allow to observe sleep fragmentation, such as daytime sleep or night-time awakenings (Gonçalves et al, 2015). Non-parametric application is thus Variability (IV) and Relative Amplitude (RA) (Gonçalves et al, 2015;Lovos et al, 2021;Rock et al, 2014;Thomas et al, 2015;Van Someren et al, 1999). Witting et al (1990) first introduced these variables by degrading the circadian rest-activity rhythm in patients with Alzheimer's disease.…”

“…IS, IV and RA are thus promising indicators for sleep-wake rhythm development. They have been used considerably to assess the status of the circadian rhythmicity in various populations, i.e., patients with Alzheimer's disease, diabetes, Down Syndrome, bipolar disorder, and also infants (Lovos et al, 2021;Rock et al, 2014;Van Someren et al, 1999;Witting et al, 1990;Zornoza-Moreno et al, 2011 and was implemented in different populations (Bandín et al, 2014;Rodriguez-Morilla et al, 2019;Zornoza-Moreno et al, 2011.…”