Obstructive sleep apnea in adults with Down syndrome: body composition, metabolic profile and cognitive status.

CONTEXT: Down Syndrome (DS) is the main genetic cause of Intellectual Disability (ID) and is characterized by the presence of several medical comorbidities. Among these, Obstructive Sleep Apnea (OSA) stands out, with a prevalence much higher than that of the general population. The clinical impact of OSA in subjects without DS described in the literature includes increased cardiovascular, metabolic and neurocognitive risk. However, among the adult population with DS, these associations are poorly described.

OBJECTIVES

To evaluate the presence and characterize OSA in adults with DS and its association with body composition, metabolic profile, functional and cognitive performance.

METHODS

This cross-sectional study included 34 persons with DS aged 18 years or over. The measurements were: anthropometry, complete Polysomnography in the Sleep laboratory (PSG), neuropsychological assessment using the Abbreviated Wechsler Intelligence Scale and NEUPSILIN Brief Assessment Instrument, biochemical assessments, and functionality scales (Barthel and Lawton). There were 30 representative PSG. Subjects with and without OSA were compared regarding clinical, anthropometric, functional (n = 30), and cognitive (n = 20) variables. Sleep changes were correlated with the variables under study.

RESULTS

The frequency of OSA (apnea-hypopnea index ≥ 5 events/h) was 63 %. As compared to no OSA, OSA was associated with male sex (p = 0.001), greater cervical circumference (34 vs. 40 cm, p < 0.001), greater deposition of abdominal fat (82 vs. 92 cm, p = 0.049), higher average levels systolic blood pressure (p = 0.03), higher frequency of altered fasting blood glucose or glycated hemoglobin equal to or greater than 5.7 % (p = 0.03) and low HDL cholesterol (p = 0.004). OSA was associated with worse performance in episodic and semantic verbal memory (p = 0.02).

CONCLUSION

Adults with DS have a high frequency of OSA, which may be related to metabolic profile and worse memory performance.