Brief Report: Examining Sleep Challenges in Down Syndrome

BackgroundSleep disturbances, common in Down syndrome (DS), adversely affect daily functioning and quality of life across the lifespan. However, little is known about behavioral sleep problems in adolescents and young adults with DS, including age and sex differences, as well as agreement between caregiver- and self-reports of sleep. MethodsStudy 1 included 24 individuals with DS (37% female, Mage=18.33 years, SD=4.38) and their caregivers, who completed six dichotomous questions assessing bedtime resistance, prolonged sleep onset latency, inappropriate sleep location, nighttime awakenings, early morning awakenings, and daytime sleepiness. After estimating prevalence, binomial logistic regressions tested age and sex differences in each problem. Study 2 included 12 caregiver-participant dyads (25% female, Mage=29.17 years, SD=8.99) who completed parallel self- and caregiver-report forms of the Children's Report of Sleep Patterns (CRSP). Wilcoxon signed-rank tests, ICCs and Spearman rank-order correlations examined reporter differences, absolute agreement and associations.ResultsIn Study 1, daytime sleepiness was most prevalent (92%), followed by bedtime resistance (79%), nighttime awakenings (75%), prolonged sleep onset latency (58%), early morning awakenings (54%), and inappropriate sleep location (46%). Older age was associated with increased odds of prolonged sleep onset latency; no other age or sex-specific associations were significant. In Study 2, caregiver and self-reports differed significantly for sleep location, bedtime fears, restless legs, insomnia, and enuresis. Associations and absolute agreement were generally limited, although Weekend Bedtime showed the strongest correspondence between reporters.ConclusionsSleep problems are highly prevalent in adolescents and young adults with DS, with greater sleep onset difficulties at older ages. Caregiver- and self-reports provide complementary rather than interchangeable information, supporting the need for multi-informant sleep assessment.