Obstructive sleep apnoea contributes to executive function impairment in young children with Down syndrome

Anna Joyce, Heather E Elphick, Michael Farquhar, Paul Gringras, Hazel Evans, Romola S Bucks, Jana Kreppner, Ruth Kingshott, Jane Martin, Janine Reynolds, Carla Rush, Johanna Gavlak, Catherine M. Hill

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    17 Citations (Scopus)
    11 Downloads (Pure)


    Objective/Background: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA.
    Participants and Methods: Children with DS were recruited to take part in a larger study of OSA (N=202). Parents of 80 children (50 male) aged 36 to 71 months (M = 56.90, SD = 10.19 months) completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P). Of these 80 children, 69 were also successfully studied overnight with domiciliary cardiorespiratory polygraphy to diagnose OSA.
    Results: Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β=.23, R2=.05, p=.025), emotional control (β=.20, R2=.04, p=.047) and shifting (β=.24, R2=.06, p=.023). Conclusions: Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.
    Original languageEnglish
    Pages (from-to)611-621
    Number of pages11
    JournalBehavioral Sleep Medicine
    Issue number5
    Early online date16 Jul 2019
    Publication statusPublished - 2 Sept 2020

    ASJC Scopus subject areas

    • Neuroscience (miscellaneous)
    • Medicine (miscellaneous)
    • Psychology (miscellaneous)
    • Clinical Neurology


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