Dados do Trabalho

Título

The impact of Obstructive Sleep Apnea on cognitive decline in adults with Down Syndrome: Preliminary Findings

Introdução

Sleep-related breathing disorders are commonly reported in the Down Syndrome population, but data on its prevalence and severity are scarce, especially for the adult population. The increase in life expectancy and premature aging in patients with Down Syndrome reinforces the need for an assessment of sleep quality. This study evaluated sleep-disordered breathing in adults with Down Syndrome using sleep measures by Polysomnography.

Objetivo

The aim of this study is to define the association between the severity of obstructive sleep apnea (OSA) in adults with Down Syndrome and the clinical diagnoses of stable cognition versus prodromal dementia and dementia. Furthermore, it was possible to correlate sleep respiratory variables in these groups.

Métodos

All 48 participants underwent a sleep study Type 1 Polysomnography, analyzed according to the American Academy of Sleep Medicine (AASM). The diagnostic criteria for OSA and its severity were based on the description of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A multidisciplinary consensus including psychiatrists and geriatricians classified the participants into three diagnostic groups: stable cognition, prodromal demetia, and dementia. A neuropsychological assessment was carried out, according to the Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS).

Resultados

From our sample, 7 participants had dementia, 5 were classified as prodromal dementia and 36 were in the stable cognition group. It was not possible to determine statistically significant evidence between the AHI and the diagnoses, possibly due to the small sample of non-control cases. There was a strong correlation between AHI (events/h) and ODI (events/h), for all groups included. Sleep architecture by its metric variables was measured, and these numerical findings were compared among the groups, with a significant difference in REM Sleep ​​(%) between the control and prodromal groups (p=0.031).

Conclusões

Studies show that OSA is the main sleep disorder in the Down Syndrome population, demonstrating the importance of early diagnosis. In our analysis, it was not possible to define a correlation between OSA and clinical diagnoses, possibly because there are few non-control cases. Being preliminary data, clinical and polysomnographic follow-up will support our preliminary hypotheses.

Palavras -chave

Down Syndrome; Cognitive decline; Sleep-related breathing disorders; Polysomnography