{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:34:25Z","timestamp":1793864065400,"version":"4.6.1"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007353","name":"Jerome LeJeune Foundation project","doi-asserted-by":"publisher","award":["1804"],"award-info":[{"award-number":["1804"]}],"id":[{"id":"10.13039\/100007353","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Children with Down syndrome (DS) are at increased risk of obstructive sleep disordered breathing (SDB), which is associated with intermittent hypoxia and sleep disruption affecting daytime functioning. We aimed to examine the effects of treatment of SDB on sleep quality and daytime functioning in children with DS. Methods: Children with DS and SDB (n = 24) completed a baseline and follow-up overnight polysomnographic (PSG) study 22 \u00b1 7 months (mean \u00b1 SD) later. Sleep micro-architecture was assessed using EEG spectral analysis, and parents completed a number of questionnaires assessing sleep, behavior, daytime functioning, and quality of life (QOL). Results: A total of nine children (38%) were treated. At baseline, the treated group had more severe SDB compared to the untreated group. SDB severity was significantly improved from 40.3 \u00b1 46.9 events\/h to 17.9 \u00b1 26.9 events\/h (p &lt; 0.01) at follow up in children who were treated. There were no significant differences in sleep macro-architecture parameters from baseline to follow up in either the treated or untreated group. Sleep micro-architecture was not different between studies in the treated group, however this tended to improve in the untreated group, particularly in REM sleep. Daytime functioning and behavior were not different between the studies in either group, however, QOL improved after treatment. Conclusions: Our study identified that treatment of SDB improves severity of the disease as defined by PSG, and this was associated with parental reports of improved QOL, despite treatment having no demonstrable impacts on sleep quality, behavior, or daytime functioning.<\/jats:p>","DOI":"10.3390\/children9070984","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T20:53:02Z","timestamp":1656622382000},"page":"984","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of Treatment of Sleep Disordered Breathing on Sleep Macro- and Micro-Architecture in Children with Down Syndrome"],"prefix":"10.3390","volume":"9","author":[{"given":"Viecky M. P.","family":"Betavani","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot J.","family":"Davey","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"},{"name":"Melbourne Children\u2019s Sleep Centre, Monash Children\u2019s Hospital, Melbourne, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian M.","family":"Nixon","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"},{"name":"Melbourne Children\u2019s Sleep Centre, Monash Children\u2019s Hospital, Melbourne, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary S. C.","family":"Horne","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"},{"name":"Department of Paediatrics, Level 5, Monash Children\u2019s Hospital, 246 Clayton Road, Clayton, Melbourne, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.smrv.2018.11.002","article-title":"Sleep and sleep disordered breathing in children with down syndrome: Effects on behaviour, neurocognition and the cardiovascular system","volume":"44","author":"Horne","year":"2018","journal-title":"Sleep Med. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e714","DOI":"10.1542\/peds.2012-1672","article-title":"Diagnosis and management of childhood obstructive sleep apnea syndrome","volume":"130","author":"Marcus","year":"2012","journal-title":"Pediatrics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1001\/archotol.132.4.432","article-title":"Obstructive sleep apnea: Should all children with Down syndrome be tested?","volume":"132","author":"Shott","year":"2006","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.bjan.2015.10.007","article-title":"Upper airway morphology in Down Syndrome patients under dexmedetomidine sedation","volume":"66","author":"Subramanyam","year":"2016","journal-title":"Braz. J. Anesthesiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.smrv.2014.06.009","article-title":"The conundrum of primary snoring in children: What are we missing in regards to cognitive and behavioural morbidity?","volume":"18","author":"Biggs","year":"2014","journal-title":"Sleep Med. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1016\/j.ridd.2013.03.009","article-title":"The impact of sleep disruption on executive function in Down syndrome","volume":"34","author":"Chen","year":"2013","journal-title":"Res. Dev. Disabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"61","DOI":"10.5665\/sleep.4326","article-title":"Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome","volume":"38","author":"Churchill","year":"2015","journal-title":"Sleep"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/dmcn.12376","article-title":"Obstructive sleep apnea syndrome and cognition in Down syndrome","volume":"56","author":"Breslin","year":"2014","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_9","first-page":"197","article-title":"Relationship between sleep, sleep apnea, and neuropsychological function in children with Down syndrome","volume":"19","author":"Brooks","year":"2015","journal-title":"Int. J. Sci. Pract. Sleep Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.jfma.2019.07.015","article-title":"REM sleep and sleep apnea are associated with language function in Down syndrome children: An analysis of a community sample","volume":"119","author":"Lee","year":"2020","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/jir.12387","article-title":"Sleep-Disordered Breathing and Cognitive Functioning in Preschool Children with and without Down Syndrome","volume":"61","author":"Joyce","year":"2017","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1080\/15402002.2019.1641501","article-title":"Obstructive Sleep Apnoea Contributes to Executive Function Impairment in Young Children with Down Syndrome","volume":"18","author":"Joyce","year":"2020","journal-title":"Behav. Sleep Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1046\/j.1365-2869.2002.00289.x","article-title":"Obstructive sleep apnea and the prefrontal cortex: Towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits","volume":"11","author":"Beebe","year":"2002","journal-title":"J. Sleep Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1093\/sleep\/33.9.1165","article-title":"Determining sleep quality in children with sleep disordered breathing: EEG spectral analysis compared with conventional polysomnography","volume":"33","author":"Yang","year":"2010","journal-title":"Sleep"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"zsz118","DOI":"10.1093\/sleep\/zsz118","article-title":"Age and autonomic control, but not cerebral oxygenation, are significant determinants of EEG spectral power in children","volume":"42","author":"Walter","year":"2019","journal-title":"Sleep"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1152\/physiol.00062.2015","article-title":"Sleep Neurophysiological Dynamics Through the Lens of Multitaper Spectral Analysis","volume":"32","author":"Prerau","year":"2017","journal-title":"Physiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1038\/s41390-021-01642-z","article-title":"Sleep-disordered breathing and sleep macro- and micro-architecture in children with Down syndrome","volume":"91","author":"Sibarani","year":"2021","journal-title":"Pediatr. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5664\/jcsm.8150","article-title":"Adenotonsillectomy for pediatric obstructive sleep apnea: How to predict those at risk for postoperative complications","volume":"16","author":"Connolly","year":"2020","journal-title":"J. Clin. Sleep Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2366","DOI":"10.1056\/NEJMoa1215881","article-title":"A randomized trial of adenotonsillectomy for childhood sleep apnea","volume":"368","author":"Marcus","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"975","DOI":"10.5664\/jcsm.6698","article-title":"Success of Tonsillectomy for Obstructive Sleep Apnea in Children with Down Syndrome","volume":"13","author":"Ingram","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2214\/ajr.183.1.1830175","article-title":"Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI","volume":"183","author":"Donnelly","year":"2004","journal-title":"Am. J. Roentgenol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"597","DOI":"10.5664\/jcsm.2172","article-title":"Rules for scoring respiratory events in sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine","volume":"8","author":"Berry","year":"2012","journal-title":"J. Clin. Sleep Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1542\/peds.109.1.45","article-title":"Centers for Disease Control and Prevention 2000 growth charts for the United States: Improvements to the 1977 National Center for Health Statistics version","volume":"109","author":"Ogden","year":"2002","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1067\/mhn.2000.105254","article-title":"Quality of life for children with obstructive sleep apnea","volume":"123","author":"Franco","year":"2000","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1001\/archotol.128.7.770","article-title":"Child behavior and quality of life before and after tonsillectomy and adenoidectomy","volume":"128","author":"Goldstein","year":"2002","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_26","unstructured":"Mahwah, N.J. (1999). The child behavior checklist and related instruments. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, Lawrence Erlbaum Associates Publishers. [2nd ed.]."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/j.1365-2788.2005.00699.x","article-title":"Preschool children with intellectual disability: Syndrome specificity, behaviour problems, and maternal well-being","volume":"49","author":"Eisenhower","year":"2005","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s13052-019-0672-4","article-title":"Distribution and age of onset of psychopathological risk in a cohort of children with Down syndrome in developmental age","volume":"45","author":"Marino","year":"2019","journal-title":"Ital. J. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Oakland, T., and Harrison, P. (2008). Adaptive Behavior Assessment System-II, Western Psychological Services.","DOI":"10.1016\/B978-012373586-7.00001-1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.sleep.2011.12.005","article-title":"Psychometric properties of an omnibus sleep problems questionnaire for school-aged children","volume":"13","author":"Biggs","year":"2012","journal-title":"Sleep Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.sleep.2017.01.014","article-title":"Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis","volume":"33","author":"Janssen","year":"2017","journal-title":"Sleep Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"485","DOI":"10.5664\/jcsm.9632","article-title":"Establishing the content validity of the Epworth Sleepiness Scale for Children and Adolescents in Prader-Willi syndrome","volume":"18","author":"Patel","year":"2022","journal-title":"J. Clin. Sleep Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1177\/0194599817703921","article-title":"The Efficacy of Adenotonsillectomy for Obstructive Sleep Apnea in Children with Down Syndrome: A Systematic Review","volume":"157","author":"Nation","year":"2017","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1164\/rccm.200912-1930OC","article-title":"Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: A multicenter retrospective study","volume":"182","author":"Bhattacharjee","year":"2010","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ijporl.2009.11.006","article-title":"Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: A comparative study with children without Down syndrome","volume":"74","author":"Shete","year":"2010","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_36","first-page":"e983","article-title":"Characterization of Sleep Architecture in Down Syndrome Patients Pre and Post Airway Surgery","volume":"9","author":"Mims","year":"2017","journal-title":"Cureus"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"109968","DOI":"10.1016\/j.ijporl.2020.109968","article-title":"Obstructive sleep apnea in children with down syndrome\u2014Prevalence and evaluation of surgical treatment","volume":"133","author":"Nerfeldt","year":"2020","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1183\/09031936.98.11051135","article-title":"Spectral analysis of wakefulness and REM sleep EEG in patients with sleep apnoea syndrome","volume":"11","author":"Morisson","year":"1998","journal-title":"Eur. Respir. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1164\/rccm.201112-2167OC","article-title":"Effects of positive airway pressure therapy on neurobehavioral outcomes in children with obstructive sleep apnea","volume":"185","author":"Marcus","year":"2012","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/jir.12533","article-title":"Reliability of parent report measures of behaviour in children with Down syndrome","volume":"62","author":"Esbensen","year":"2018","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e477","DOI":"10.1542\/peds.2014-0620","article-title":"Quality of life and obstructive sleep apnea symptoms after pediatric adenotonsillectomy","volume":"135","author":"Garetz","year":"2015","journal-title":"Pediatrics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.sleep.2011.07.003","article-title":"Working memory in children with sleep-disordered breathing: Objective versus subjective measures","volume":"12","author":"Biggs","year":"2011","journal-title":"Sleep Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.ijporl.2014.06.027","article-title":"Comparison of treatment modalities in syndromic children with obstructive sleep apnea--a randomized cohort study","volume":"78","author":"Sudarsan","year":"2014","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1111\/cns.12605","article-title":"The Relationship Between Sleep-Disordered Breathing Severity and Daytime Adaptive Functioning in Children with Down Syndrome","volume":"22","author":"Nixon","year":"2016","journal-title":"CNS Neurosci. Ther."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/7\/984\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:41:05Z","timestamp":1760139665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/7\/984"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":44,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["children9070984"],"URL":"https:\/\/doi.org\/10.3390\/children9070984","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]}}}