Obstructive sleep apnea syndrome and cognition in Down syndrome
Obstructive sleep apnea syndrome and cognition in Down syndrome
复制标题
DOI：
10.1111/dmcn.12376
复制
发表时间：
2014-07-01
影响因子：
3.8
通讯作者：
Edgin, Jamie
中科院分区：
文献类型：
--
作者：
Breslin, Jennifer;Spano, Goffredina;Edgin, Jamie
目的良好的睡眠对正常的学习和记忆至关重要。睡眠碎片和睡眠结构紊乱在唐氏综合症患者的整个一生中都很常见，这种疾病的特点是在生命的头几个月出现认知缺陷。虽然阻塞性睡眠呼吸暂停综合征(OSAS)被认为是唐氏综合症患者睡眠质量下降的原因，但其与认知和行为障碍的关系仍未被了解。方法采用动态多导睡眠图，我们测量了38名唐氏综合症患者(男性15名，女性23名；平均年龄9岁7个月(SD 1岁9个月)，范围7-12岁)的睡眠。结果在患有唐氏综合症的儿童中，患有睡眠呼吸暂停低通气综合征的儿童的平均言语智商得分(p=0.006)比没有睡眠呼吸暂停低通气指数的儿童低9分，在认知灵活性测量上的表现也更差(p=0.03)。此外，睡眠呼吸暂停综合征患者的浅期睡眠增加(p=0.009)，慢波睡眠减少(p=0.04)。要完全理解睡眠不良和认知功能受损之间联系的潜在机制，还需要更多的工作。总体而言，这些发现突显了充足睡眠在典型和非典型发育人群中的重要性。
AIM Good-quality sleep is essential for normal learning and memory. Sleep fragmentation and disrupted sleep architecture are commonly observed throughout the lifespan of individuals with Down syndrome, a condition marked by cognitive deficits emerging within the first few months of life. While obstructive sleep apnea syndrome (OSAS) is known to contribute to the loss of sleep quality in Down syndrome, its relation to cognitive and behavioral impairment remains poorly understood.METHOD Using ambulatory polysomnography, we measured sleep in an unreferred community-based sample of 38 individuals with Down syndrome (15 males, 23 females; mean age 9y 7mo (SD 1y 9mo), range 7-12y). Cognitive outcomes were assessed with the Arizona Cognitive Test Battery, a set of psychometric measures designed and validated for this population.RESULTS Among children with Down syndrome, mean Verbal IQ score (p= 0.006) was 9 points lower in those with comorbid OSAS (apnea-hypopnea index > 1.5) than in those without OSAS, and performance on measures of cognitive flexibility was poorer (p= 0.03). In addition, those with OSAS showed increased light-stage sleep (p= 0.009) at the expense of slow-wave sleep (p= 0.04).INTERPRETATION These findings demonstrate a relation between OSAS and cognitive outcomes in Down syndrome. More work is required to fully understand the mechanisms underlying the links between poor sleep and impaired cognitive function. Overall, these findings highlight the importance of adequate sleep in typically and atypically developing populations.