Sleep and Breathing

, Volume 19, Issue 1, pp 197–204 | Cite as

Relationship between sleep, sleep apnea, and neuropsychological function in children with Down syndrome

  • Lee J. BrooksEmail author
  • Molly N. Olsen
  • Ann Mary Bacevice
  • Andrea Beebe
  • Sofia Konstantinopoulou
  • H. Gerry Taylor
Original Article



To determine whether sleep and sleep disordered breathing (SDB) contribute to the neuropsychological deficits of patients with Down syndrome, and whether treatment of SDB results in improvement in cognitive function.


In this cohort study, 25 children with Down syndrome underwent overnight polysomnography (PSG), Multiple Sleep Latency Testing (MSLT), and a battery of neuropsychological tests. Patients with SDB underwent a follow up PSG after treatment. All patients repeated the neuropsychological tests 13 months later.


At baseline, there was no relationship between SDB and performance on the neuropsychological tests. However, total sleep time and sleep latency were related to tests of cognitive ability (p < 0.05) and comprehension (p < 0.01). The amount of time in slow-wave sleep correlated with tests of achievement (p < 0.01), and adaptive behavior (p < 0.01). Ten patients had SDB confirmed on PSG. Five of these patients were treated successfully with adenotonsillectomy and/or continuous positive airway pressure. The five who did not tolerate treatment were deficient in tests of adaptive behavior (Vineland p < 0.05) visual–motor integration (Beery p < 0.01) and achievement (Woodcock–Johnson p < 0.05) compared to those successfully treated. After treatment the patients improved in ratings of attention (Conners p < 0.05).


Although SDB is common in children with Down syndrome, it is not a major contributor to their cognitive deficits. Cognitive function is related to the amount of sleep and particularly slow wave sleep. Successful treatment of SDB may improve their attention.


Children Sleep Apnea Down syndrome Cognitive function CPAP 



Continuous positive airway pressure










Multiple Sleep Latency Test


Obstructive sleep apnea




Rapid eye movement


Slow wave sleep


Sleep disordered breathing


Apnea hypopnea index


Down syndrome



This work was funded by a grant from the American Lung Association of Ohio.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lee J. Brooks
    • 1
    • 2
    Email author
  • Molly N. Olsen
    • 2
  • Ann Mary Bacevice
    • 3
  • Andrea Beebe
    • 3
  • Sofia Konstantinopoulou
    • 1
  • H. Gerry Taylor
    • 3
  1. 1.Division of Pulmonary Medicine, Sleep Center, Children’s Hospital of PhiladelphiaUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children’s HospitalUniversity Hospitals Case Medical CenterClevelandUSA

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