Growth-related changes in the influence of obesity on signs suggesting sleep-disordered breathing and sleepiness in young individuals with Down syndrome

IF 2.1 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research Pub Date : 2023-09-06 DOI:10.1111/jir.13079

H. Sawatari, A. Chishaki, A. Rahmawati, S. Ando

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引用次数: 0

Abstract

Background

Sleep-disordered breathing (SDB) is highly prevalent in individuals with Down syndrome (DS), who cease growing earlier than individuals without DS. These characteristics may be associated with increased obesity and subsequent SDB signs, such as snoring and apnoea or excessive daytime sleepiness (EDS). Thus, we assessed the influence of growth on the association between obesity and SDB signs or EDS; we used questionnaires sent to young individuals with DS and their caregivers, in a cross-sectional study.

Methods

We sent out 2000 questionnaires to individuals with DS and their caregivers. The surveys included questions about SDB signs (witnessed snoring or apnoea), subjective sleeping time including witnessed midnight arousal, the Epworth sleepiness scale and witnessed napping as well as sex, age, body weight and body height.

Results

Of the 1222 questionnaires we received, 660 were from young individuals and were included in the analysis. SDB signs were highly prevalent (77.1%), and frequency of SDB signs increased with growth (P-trend: P = 0.02) in individuals with DS. Multivariate analyses showed that EDS (Epworth sleepiness scale > 10 points) was associated with body mass index Z-score (Z-BMI) in the 6–9 years age group (odds ratio [OR] 95% confidence interval [95% CI]: 1.69 [1.09–2.62], P = 0.02). Conversely, SDB signs were associated with Z-BMI in the 13–15 (OR [95% CI]: 1.99 [1.06–3.72], P = 0.03) and 16–18 years age groups (OR [95% CI]: 3.04 [1.22–7.59], P = 0.02). For the 19–21 years age group, SDB signs were associated with only male sex (OR [95% CI]: 7.28 [1.22–43.38], P = 0.03).

Conclusions

This study showed that the association between Z-BMI and SDB or EDS was age dependent. In early school-age children with DS, high Z-BMI could not accurately predict the presence of SDB, but it was associated with EDS. In the pubescent period (i.e. 13–18 years), high Z-BMI was associated with SDB signs but not with EDS. Overall, obesity affected SDB signs and EDS differently based on age in young individuals with DS.

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在患有唐氏综合症的年轻人中，肥胖对睡眠呼吸障碍和嗜睡迹象的影响的生长相关变化

睡眠呼吸障碍(SDB)在唐氏综合症(DS)患者中非常普遍，他们比没有唐氏综合症的人更早停止生长。这些特征可能与肥胖增加和随后的SDB症状有关，如打鼾和呼吸暂停或白天过度嗜睡(EDS)。因此，我们评估了生长对肥胖与SDB体征或EDS之间关系的影响;在一项横断面研究中，我们对患有退行性痴呆的年轻人及其照顾者进行了问卷调查。方法对退行性痴呆患者及其照顾者发放问卷2000份。调查的问题包括SDB体征(亲眼目睹打鼾或呼吸暂停)、主观睡眠时间(亲眼目睹午夜醒来)、爱普沃斯嗜睡量表和亲眼目睹午睡，以及性别、年龄、体重和身高。在我们收到的1222份问卷中，660份来自年轻人，并被纳入分析。在DS患者中，SDB的出现频率随年龄增长而增加(P-trend: P = 0.02)，发生率为77.1%。多变量分析显示，edds (Epworth嗜睡量表>10分)与6-9岁年龄组体重指数z -评分(Z-BMI)相关(优势比[OR] 95%可信区间[95% CI]: 1.69 [1.09-2.62]， P = 0.02)。相反，在13-15岁年龄组(OR [95% CI]: 1.99 [1.06-3.72]， P = 0.03)和16-18岁年龄组(OR [95% CI]: 3.04 [1.22-7.59]， P = 0.02)， SDB体征与Z-BMI相关。在19-21岁年龄组中，SDB体征仅与男性相关(OR [95% CI]: 7.28 [1.22-43.38]， P = 0.03)。结论Z-BMI与SDB或EDS的相关性具有年龄依赖性。在DS的早期学龄儿童中，高Z-BMI不能准确预测SDB的存在，但与EDS相关。在青春期(即13-18岁)，高Z-BMI与SDB体征相关，而与EDS无关。总体而言，肥胖对年轻DS患者SDB体征和EDS的影响因年龄而异。

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来源期刊

Journal of Intellectual Disability Research Multiple-

CiteScore

5.60

自引率

5.60%

发文量

期刊介绍： The Journal of Intellectual Disability Research is devoted exclusively to the scientific study of intellectual disability and publishes papers reporting original observations in this field. The subject matter is broad and includes, but is not restricted to, findings from biological, educational, genetic, medical, psychiatric, psychological and sociological studies, and ethical, philosophical, and legal contributions that increase knowledge on the treatment and prevention of intellectual disability and of associated impairments and disabilities, and/or inform public policy and practice. Expert reviews on themes in which recent research has produced notable advances will be included. Such reviews will normally be by invitation.