The impact of sleep problems on functional and cognitive outcomes in children with Down syndrome: a review of the literature

Abstract

The aim of this review was to summarize the existing literature on the association between sleep problems and cognition, function, and behavior in children with Down syndrome. Methods: Embase, PubMed, CINAHL, and PsychINFO databases were searched to retrieve all studies published between 1990 and 2018 that evaluated the relationship between sleep and cognition, function, or behavior in children with Down syndrome. Results: Fifteen articles were included, which were mostly of a cohort or case-controlled design. Five articles addressed sleep and cognition only, 6 reported on sleep and behavior, and only 1 reported on sleep and functional ability. Three papers evaluated sleep and both cognition and behavior. Findings varied across studies with methodological differences, making it difficult to directly compare results. The association between sleep and behavior or cognition in children with Down syndrome remains uncertain, but a large study in 110 children provides strong evidence of a negative impact of sleep disorders on the accomplishment of daily life habits. Conclusions: The impact of coexisting sleep disorders in children with Down syndrome has not been widely studied, with only 15 relevant studies found through an extensive literature review. Large well-designed studies are required to fully understand this relationship further. This is important as sleep-disordered breathing and difficulties with sleep patterns and routines are highly prevalent in children with Down syndrome. Sleep may be one of the few treatable factors that can assist in improving long-term outcomes in this population.

Characterization of Sleep Disturbances in Children and Adolescents with Down Syndrome and Their Relation with Cognitive and Behavioral Features

“…Because of the prevalence among people with DS, sleep breathing disorders and associated neuropsychological and psychopathological features have been largely investigated; however, less is known about the neuropsychological and psychopathological correlates of other sleep disturbances. As highlighted by a recent review on this topic, the impact of different kinds of sleep disorders in children with DS still requires widely researched and well-designed studies to better characterize such relationships [ 35 ].…”

DYRK1a Inhibitor Mediated Rescue of Drosophila Models of Alzheimer’s Disease-Down Syndrome Phenotypes

“…Our work also demonstrates the potential of DYRK1A inhibitors as sleep correctors for DS and AD-DS which may slow pathology and boost cognition, the high throughput capability of flies will allow further characterisation and screening of DS and AD circadian and sleep drugs ( Dissel et al, 2017 ; Wang et al, 2020 ). People with DS also display disrupted sleep including sleep apnoea which can negatively impact their cognition and motor control ( Chawla et al, 2020 ). Likewise, many people with AD in addition to the disrupted sleep at night mentioned previously also display sun-downing, where upon the patient experiences more anxiety and confusion in the evening ( Vitiello et al, 1992 ; McCurry et al, 1999 ; Volicer et al, 2001 ).…”

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

“…This work also validates the use of Drosophila as a high throughput system to screen for novel DS and AD circadian and sleep drugs 61 , 66 . Therefore, DYRK1A inhibitors have potential to be tested as sleep correctors for DS that would likely also have beneficial effects on cognition and motor skills 6 . Likewise, the drugs may also be effective for sleep disruption in AD with the additional potential benefit of correcting sun-downing, when the patients’ symptoms, anxiety and confusion are greater in the evening.…”