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、演变以及对患者报告的结果的贡献和共同 病态，包括神经认知功能障碍、心脏代谢和心血管风险。这些知识 正如美国科学院强调的那样，差距阻碍了DS医疗保健建议的发展 儿科指南，所有患有DS的儿童在4岁前都要进行睡眠研究，但没有解决 正在进行的监视。此外，DS中与OSAS相关的临床护理和研究面临的主要挑战是 实验室内夜间多导睡眠图(PSG)的需求部分是由于缺乏专门的 睡眠实验室，具有照顾智障人士的专业知识。这份副刊将 利用正在进行的关于家庭睡眠呼吸暂停测试(HSAT)与 在35名10-20岁患有DS的青年中进行PSG，并扩大招生人数，16-30岁增加15名 为了1)通过新的合作确保青少年DS患者的神经认知测试的培训，2)估计 当研究中包括空腹血液检查和神经认知测试时，招募会产生效果，以及3)获得 初步评估OSAS与a)神经认知功能和b)的关系 OSAS患者的心脏代谢危险标记和OSAS治疗摄取 家长奖。这项工作将为一项针对成人共病(DS相关)的OSAS干预研究提供信息 阿尔茨海默病和痴呆、心血管健康)和青少年阻塞性睡眠呼吸暂停综合征的纵向病史研究 以及患有DS的年轻人。重要的是，从本补充资料中得出的数据最终将涉及知识 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 痴呆症的可改变的危险因素。

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.