Home Sleep Apnea Testing and Neurocognitive Testing for Obstructive Sleep Apnea in Young Adults with Down Syndrome

摘要 阻塞性睡眠呼吸暂停综合征（OSAS）在唐氏综合征（DS）患者中非常普遍，但很少 研究已经调查了它的出现、演变和对患者报告结果的贡献， 发病率，包括神经认知功能障碍和心脏代谢和心血管风险。这些知识 差距阻碍了DS医疗保健建议的发展，正如美国医学会所强调的那样， 儿科指南规定，所有DS儿童在4岁时都要接受睡眠研究，但没有说明 持续监视此外，与DS中OSAS相关的临床护理和研究的主要挑战是 需要在实验室过夜多导睡眠图（PSG），部分原因是缺乏专用的 睡眠实验室在照顾智障人士方面具有专业知识。该补充将 利用正在进行的家庭睡眠呼吸暂停测试（HSAT）与 在35名10-20岁DS青年中进行PSG，并增加n=15名16- 30岁的患者入组 1）通过一项新的合作，确保年轻DS患者的神经认知测试培训，2）估计 招募收益率时，空腹血液工作和神经认知测试包括在研究中，和3）获得 检查OSAS与a）神经认知功能和B） 在以下背景下确定的OSAS患者的心脏代谢风险标志物和OSAS治疗摄取 家长奖。这项工作将为针对成人合并症（DS相关 阿尔茨海默病和痴呆，心血管健康）和青少年OSAS纵向病史研究 年轻人与DS重要的是，从这一补充中获得的数据最终将解决知识问题， 围绕OSAS筛查的差距，以患者为中心的OSAS治疗和临床相关性，以及潜在的 可改变的痴呆风险因素。

ABSTRACT Obstructive sleep apnea syndrome (OSAS) is highly prevalent in people with Down syndrome (DS), but few studies have investigated its emergence, evolution, and contribution to patient-reported outcomes and co- morbidities, including neurocognitive dysfunction and cardiometabolic and cardiovascular risk. These knowledge gaps have stymied DS health care recommendation development as highlighted by the American Academy of Pediatrics guidelines that all children with DS undergo a sleep study by 4 years of age but that do not address ongoing surveillance. Moreover, major challenges to both clinical care and research related to OSAS in DS is the requirement of an in-laboratory overnight polysomnography (PSG) partly due to the scarcity of dedicated sleep laboratories with expertise in the care of individuals with intellectual disabilities. This supplement will leverage an ongoing study of feasibility, acceptability, and performance of home sleep apnea testing (HSAT) vs PSG in 35 youth aged 10-20 years with DS and expand enrollment by n=15 additional individuals aged 16-30y to 1) secure training in neurocognitive testing in young adults with DS through a new collaboration, 2) estimate recruitment yields when fasting blood work and neurocognitive testing are included in the study, and 3) obtain preliminary estimates examining the relationships of OSAS with a) neurocognitive function and b) cardiometabolic risk markers and OSAS treatment uptake in individuals with OSAS identified in the context of the parent award. This work will inform an OSAS intervention study aimed at adult comorbidities (DS-related Alzheimer disease and dementia, cardiovascular health) and a longitudinal history study of OSAS in adolescents and young adults with DS. Importantly, data derived from this supplement will ultimately address knowledge gaps surrounding OSAS screening, patient-focused and clinical relevance of OSAS treatment, and potentially modifiable risk factors for dementia.