Overview

Overview

Sleep Problems commonly occur in people with Down Syndrome. Many of the common disorders of sleep such as difficulty settling, frequent night waking and parasomnias are reported at higher rates than in typically developing children and adults.  It is important to consider medical problems that may contribute to sleep disturbance, in particular sleep disordered breathing which is particularly common in this population. Sleep disorders can have a significant impact on behaviour, cognition and wellbeing and not only affect the individual but also their carers, so treating a sleep disorder may improve sleep for the whole family.

We know that around 50% of children who have Down Syndrome experience sleep issues, and sleep issues in adults who have Down Syndrome are common and varied in nature.  Sleep issues may also be associated with behavioural issues such as   Bedtime routines, consistent bedtime and waking times, going to bed when tired, falling asleep without parents and avoiding excitement near bedtime are some of the things that can help.

There are six categories of Sleep Disorders:

• Breathing disorders e.g. obstructive sleep apnoea. (Sleep disordered breathing)

See Topic Page on Sleep disordered breathing

• Insomnia –This is difficulty getting to sleep or staying asleep, or waking too early causing daytime distress for person.  This should be a diagnosis of exclusion i.e. you have ruled out physical disorders .  Management should be based on behavioural techniques. Melatonin may be prescribed in some instances.

• Movement Disorders e.g. restless leg syndrome (RLS), periodic limb movements

RLS  manifests as an uncomfortable sensation often hard to explain – it can be anywhere in the body, but usually the legs, worse at night and at rest and temporarily relieved by movement, often manifesting as sleep onset insomnia. Iron deficiency is a common cause and treatment is to aim for a ferritin above  50 micrograms/L  (children) or 75 micrograms/L (adults).

• Circadian rhythm disorders – the body clock is out of sync with the outside world e.g. delayed sleep wake phase syndrome (DSWPS), common in teenagers

• Hypersomnolence e.g. narcolepsy, idiopathic hypersomnia – note that  excessive sleepiness in Down syndrome may be due to sleep disordered breathing or hypothyroidism .

• Parasomnias – unwanted experiences and behaviours in the night such as sleepwalking and night terrors, which occur in non REM sleep , and behavioural  sleep disorders and nightmares occurring in REM sleep

Updated Dr E Rachamin/Dr L  Marder 2023

Presentations at DSMIG Meetings

Additional Resources

Managing sleep problems in Children- DSA Health Series

Sleep issues in adults – for parents and supporters – DSA Health Series 

Sleep problems in a Down syndrome population. Carter, M., McCaughey, E., Annaz, D. & Hill, C.M. (2009) Archives of Disease in Childhood.

SCOPE – Sleep Right A free online, and telephone support service that helps parents and carers of disabled children to improve their child’s sleep.

Cerebra  An organisation offering a wide range of services and support helping the families of children with brain conditions. There is a dedicated Sleep Advice Service, alongside a sleep guide for parents and an offer of one-to-one telephone support.