The pattern of sleep problems in children with Down's syndrome and other intellectual disabilities

This study investigates the occurrence and nature of sleep problems and behaviours in a group of children with Down's syndrome (n = 91) compared with their siblings (n = 54), children from the general population (n = 78) and children with an intellectual disability other than Down's syndrome (n = 71). A comprehensive questionnaire was sent to parents asking about the general sleeping habits and arrangements of the child and the frequency of occurrence of a range of sleep disorders and behaviours falling under the general headings of: disorders of initiating and maintaining sleep, features associated with obstructive sleep apnoea, other sleep disorders and behaviours occurring during sleep, and sleep related disorders and behaviours occurring during the day. Overall, children with Down's syndrome and children with other forms of intellectual disability showed a greater number of sleep problems than the siblings and children from the general population. However, whereas the sleep problems of the children with other intellectual disabilities, the siblings and children from the general population principally took the form of disorders of initiating and maintaining sleep, the children with Down's syndrome were characterised by features suggesting sleep related breathing problems, i.e. restlessness, snoring, sleeping with neck extended, apnoeic episodes, gagging or choking, and mouth breathing. A number of significant age differences were found in the occurrence of some sleep problems and behaviours. These were mainly in the group with Down's syndrome. The implications of the findings are discussed with reference to effective treatments and also the beneficial effects these might have on cognitive and behavioural problems in these children.