O019 Sleep spindles are reduced in children with Down syndrome and sleep disordered breathing

M Shetty, B Tan, M Davey, G Nixon, L Walter, R Horne
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Abstract

Abstract Background Children with Down syndrome (DS) are at increased risk of sleep disordered breathing (SDB), which is associated with sleep disruption affecting daytime functioning. There is growing evidence that sleep spindles may serve as a sensitive marker of sleep quality. We investigated sleep spindle activity and its relationship with daytime functioning in children with DS compared to typically developing (TD) children matched for SDB severity. Methods Children with DS and SDB (n=44) and TD children matched for age, sex and SDB severity underwent overnight polysomnography. Fast or Slow sleep spindles were identified manually during N2 and N3 sleep. Spindle activity was characterised as spindle number, density (number of spindles/h) and intensity (density x average duration) on central (C) and frontal (F) electrodes. Parents completed the Child Behavior Checklist (CBCL) and OSA-18 questionnaires. Results Spindle number, density, and intensity were lower in the children with DS compared to TD children for F Slow and F Slow&Fast spindles combined (p<0.001 for all). In children with DS, there were no correlations between the density of any spindle type and subscales of the CBCL, however, spindle number, density and intensity for C Fast and C Slow&Fast were negatively correlated with OSA-18 emotional symptoms and caregiver concerns and C Fast number, density and intensity were also negatively correlated with daytime function and total problems. Conclusions The reduced spindle activity in the children with DS, indicates sleep micro-architecture is disrupted and this disruption may underpin the negative effects of SDB on quality of life and behaviour.
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[019]患有唐氏综合症和睡眠呼吸障碍的儿童睡眠纺锤波减少
唐氏综合症(DS)患儿发生睡眠呼吸障碍(SDB)的风险增加,这与影响白天功能的睡眠中断有关。越来越多的证据表明,睡眠纺锤波可以作为睡眠质量的敏感标志。我们研究了与SDB严重程度匹配的正常发育儿童(TD)相比,DS儿童的睡眠纺锤体活动及其与日间功能的关系。方法对44例DS合并SDB患儿和年龄、性别、SDB严重程度相匹配的TD患儿进行夜间多导睡眠描记。在N2和N3睡眠期间,人工识别快速或慢速睡眠纺锤体。在中央(C)和额叶(F)电极上,纺锤体活动的特征为纺锤体数、密度(纺锤体数/小时)和强度(密度x平均持续时间)。家长完成儿童行为检查表(CBCL)和OSA-18问卷。结果与TD儿童相比,DS儿童的纺锤体数量、密度和强度均低于慢速纺锤体和慢速纺锤体组合(p < 0.001)。在DS患儿中,任何纺锤体类型的密度与CBCL的亚量表均无相关性,但C Fast和C slow&fast的纺锤体数目、密度和强度与OSA-18情绪症状和照顾者关注呈负相关,C Fast数目、密度和强度与日间功能和总问题呈负相关。结论痴呆儿童的纺锤体活动减少,表明睡眠微结构被破坏,这种破坏可能是SDB对生活质量和行为的负面影响的基础。
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