title: A nationwide cross-sectional study on congenital heart diseases and symptoms of sleep-disordered breathing among Japanese Down's syndrome people.
abstract: OBJECTIVE
  It is well known that people with Down's syndrome (DS) frequently complicate with congenital heart diseases (CHDs). Patients with heart diseases often have sleep-disordered breathing as a co-morbidity (SDB) which worsens the heart diseases. However, the relationship between SDB and CHDs in DS people has not yet been fully elucidated. The aim of this study was to establish the association between SDB and CHDs in DS people using data from a large nationwide questionnaire survey in Japan.
  
  
  METHODS
  We conducted a cross-sectional questionnaire survey of a randomly selected sample of 2,000 DS people and their caregivers throughout Japan to examine the associations between observed signs of SDB and CHDs in DS people. The questionnaire included the presence of SDB symptoms (snoring, apnea, arousal, nocturia, and napping) and CHDs (the presence and types of CHDs).
  
  
  RESULTS
  Of the 1,222 replies received from the caregivers, 650 reported complications of some type of CHDs. The observed apnea tended to be higher among DS people with CHDs than those without CHDs (OR=1.28, 95% CI=0.97-1.70, p=0.09). DS people with tetralogy of Fallot reported significantly more frequent apnea than those without CHDs (OR=3.10, 95% CI=1.36-7.05, p<0.01).
  
  
  CONCLUSIONS
  SDB prevailed among DS people with severe CHDs, such as tetralogy of Fallot. Careful attention to the signs of SDB in such patients may lead to earlier clinical intervention removing the vicious cycle between SDB and CHDs.
authors.affiliation: Department of Health Sciences, Kyushu University Graduate School of Medical Sciences,  2) Research Fellow of the Japan Society for the Promotion of Science, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sawatari
authors.forename: Akiko
authors.initials: A
authors.lastname: Chishaki
authors.forename: Mari
authors.initials: M
authors.lastname: Nishizaka
authors.forename: Fumio
authors.initials: F
authors.lastname: Matsuoka
authors.forename: Chikara
authors.initials: C
authors.lastname: Yoshimura
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kuroda
authors.forename: Anita
authors.initials: A
authors.lastname: Rahmawati
authors.forename: Nobuko
authors.initials: N
authors.lastname: Hashiguchi
authors.forename: Mami
authors.initials: M
authors.lastname: Miyazono
authors.forename: Junji
authors.initials: J
authors.lastname: Ono
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ohkusa
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Ando
mesh_terms: D000328:Adult; D044466:Asian People; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D011795:Surveys and Questionnaires