title: High prevalence of sleep disorders and associated comorbidities in a community sample of children with Down syndrome.
abstract: OBJECTIVE
  Down syndrome (DS) is a neurodevelopmental disorder characterized by multiple comorbidities. Sleep disorders are common among children with DS and can cause significant distress for families. However, research is limited describing sleep problems and correlates in large population-based samples. Accordingly, we aimed to describe sleep behavior among children with DS and its relationship with medical conditions in this population.
  
  
  METHODS
  We conducted a population-based, cross-sectional study (2009-2011) of sleep disturbances in children and adolescents with DS 7 to 17 years of age (N = 107). We assessed sleep problems using caregiver report on two validated screening tools: the Childhood Sleep Habits Questionnaire (CSHQ) and the Pediatric Sleep Questionnaire (PSQ). The prevalence of sleep problems was compared in children with and without important comorbidities using modified Poisson regression with robust standard errors.
  
  
  RESULTS
  65% of children screened positive on the CSHQ for significant sleep problems in the past month, but their parents often did not report sleeping difficulties in their children. On the PSQ, 46% screened positive for sleep related breathing problems and 21% screened positive for sleep related movement disorders. Children with asthma, autism, and a history of enlarged adenoids and tonsils had more current sleep problems than children without these comorbidities.
  
  
  CONCLUSIONS
  Our findings suggest that sleep problems may be an important but under-recognized problem in children with DS. Sleep problems appear to be correlated with prevalent comorbidities, which may provide guidance to augment current practice guidelines to evaluate sleep problems in this population.
authors.affiliation: Department of Veteran Affairs, Canandaigua, NY.
authors.forename: Claire A
authors.initials: CA
authors.lastname: Hoffmire
authors.affiliation: University of Rochester School of Medicine and Dentistry, Department of Pediatrics, Rochester, NY.
authors.forename: Caroline I
authors.initials: CI
authors.lastname: Magyar
authors.affiliation: University of Rochester School of Medicine and Dentistry, Department of Pediatrics, Rochester, NY.
authors.forename: Heidi V
authors.initials: HV
authors.lastname: Connolly
authors.affiliation: University of Rochester School of Medicine and Dentistry, Department Public Health Sciences, Rochester, NY.
authors.forename: I Diana
authors.initials: ID
authors.lastname: Fernandez
authors.affiliation: University of Rochester School of Medicine and Dentistry, Department Public Health Sciences, Rochester, NY.
authors.forename: Edwin
authors.initials: E
authors.lastname: van Wijngaarden
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009518:New York / Q000453:epidemiology; D016012:Poisson Distribution; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Down syndrome; pediatrics; sleep apnea syndromes; sleep disorders
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