Obstructive sleep apnea syndrome and cognition in Down syndrome

Authors

  • Jennifer Breslin,

    1. Department of Psychology, University of Arizona, Tucson, AZ, USA
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    • These authors contributed equally to the paper.
  • Goffredina Spanò,

    1. Department of Psychology, University of Arizona, Tucson, AZ, USA
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    • These authors contributed equally to the paper.
  • Richard Bootzin,

    1. Department of Psychology, University of Arizona, Tucson, AZ, USA
    2. Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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  • Payal Anand,

    1. Department of Psychology, University of Arizona, Tucson, AZ, USA
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  • Lynn Nadel,

    1. Department of Psychology, University of Arizona, Tucson, AZ, USA
    2. Cognitive Science Program, University of Arizona, Tucson, AZ, USA
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  • Jamie Edgin

    Corresponding author
    1. Department of Psychology, University of Arizona, Tucson, AZ, USA
    2. Cognitive Science Program, University of Arizona, Tucson, AZ, USA
    3. Sonoran University Center for Excellence in Developmental Disabilities, Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA
    • Correspondence to Jamie Edgin, Department of Psychology, University of Arizona, 1503 East University Blvd., Tucson, AZ 85721, USA. E-mail: jedgin@email.arizona.edu

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Abstract

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.

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