Links between sleep and daytime behaviour problems in children with Down syndrome.
A J Esbensen, E K Hoffman, D W Beebe and 2 others
PMID 29282827WHAT IT FOUND
Parents reported more restless sleep and other night-time sleep problems in children with Down syndrome, and these reports were related to more conduct problems, anxiety, and hyperactivity at home and school.
Shorter sleep measured by a wrist watch was also related to inattention.
Key findings
01Parent-reported restless sleep and other night-time sleep problems were related to more parent-reported conduct problems, insecure or anxious behaviours, and hyperactivity or impulsivity.
02Shorter sleep period measured by the wrist monitor was related to higher parent ratings of inattention and hyperactivity or impulsivity, while sleep efficiency from the wrist monitor did not significantly predict parent-reported behaviour.
03Parent-reported night-time sleep problems were related to teacher-reported conduct problems and hyperactivity or impulsivity, but no sleep measure significantly predicted teacher-reported inattention.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was a pilot with only 30 children, which limited the power for additional statistical analyses. The children had a low rate of behavioural concerns, which further limited the study's power. The design measured sleep and behaviour at the same time, so it cannot show whether poor sleep caused behaviour problems or behaviour problems disrupted sleep. Parent-reported sleep and actigraphy-measured sleep correlated poorly, so the study could not clarify which sleep measure best relates to daytime behaviour. Medical conditions common in Down syndrome, such as obesity, obstructive sleep apnoea and ADHD, were not examined as factors in the sleep-behaviour link. Teacher reports were missing for several children because of school break or non-return, and one family did not complete the study battery.
Declared interests
The paper is labelled as supported by NIH extramural and non-U.S. government research support. No author conflict-of-interest statement is provided.
The easy way to misread this
Do not read these links as proof that sleep problems cause behaviour problems. The study was a small pilot and measured sleep and behaviour at the same time, so it cannot show which came first.