Prospective trial of CPAP in community-dwelling adults with Down syndrome and obstructive sleep apnea syndrome

Hill, E. A., Fairley, D. M., Williams, L. J., Spanò, G., Cooper, S.-A. and Riha, R. L. (2020) Prospective trial of CPAP in community-dwelling adults with Down syndrome and obstructive sleep apnea syndrome. Brain Sciences, 10(11), 844. (doi: 10.3390/brainsci10110844) (PMID:33198148) (PMCID:PMC7696635)

Abstract

Adults with Down syndrome (DS) are predisposed to obstructive sleep apnoea (OSA), but the effectiveness and acceptability of continuous positive airway pressure treatment (CPAP) in this group has rarely been formally assessed. This study was designed as a pilot randomised, parallel controlled trial for one month, continuing as an uncontrolled cohort study whereby the control group also received the intervention. Symptomatic, community-dwelling DS individuals exhibiting ≥10 apnoeas/hypopneas per hour in bed on a Type 3 home sleep study were invited to participate in this study, with follow-up at 1, 3, 6, and 12 months from baseline. Measurements of sleepiness, behaviour, cognitive function and general health were undertaken; the primary outcome was a change in the pictorial Epworth Sleepiness Scale (pESS) score. Twenty-eight participants (19 male) were enrolled: age 28 ± 9 year; body mass index 31.5 ± 7.9 kg/m2; 39.6 ± 32.2 apnoeas/hypopneas per hour in bed; pESS 11 ± 6/24. The pilot randomised controlled trial at one month demonstrated no change between the groups. At 12 months, participant (p = 0.001) pESS and Disruptive (p 0.0001), Anxiety/Antisocial (p = 0.024), and Depressive (p = 0.008) behaviour scores were reduced compared to baseline. Improvement was noted in verbal (p = 0.001) and nonverbal intelligence scores (p = 0.011). General health scores also improved (p = 0.02). At the end of the trial, 19 participants continued on treatment. Use of CPAP in adults with DS and OSA led to a number of significant, sustained improvements in sleepiness and behavioural/emotional outcomes at 12 months.

• Item Type: Articles
• Additional Information: Funding: Chief Scientist Office, Scotland, Reference number CZH/4/549; Fondation Jerome Lejeune (grant); University of Edinburgh grant number R41361-195RSP; Baily Thomas Charitable Trust (grant); Reference number TRUST/RNA/AC/TM/2634-5178.
• Keywords: Obstructive sleep apnoea syndrome, developmental behaviour checklist-adults, Down syndrome, continuous positive airway pressure, cognition, cognitive testing in Down syndrome, adults, pilot randomised controlled trial.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cooper, Professor Sally-Ann

Creator Roles

Cooper, S.-A.: Conceptualization, Methodology, Writing – original draft, Writing – review and editing, Supervision, Funding acquisition

• Authors: Hill, E. A., Fairley, D. M., Williams, L. J., Spanò, G., Cooper, S.-A., and Riha, R. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Brain Sciences
• Publisher: MDPI
• ISSN: 2076-3425
• ISSN (Online): 2076-3425
• Published Online: 12 November 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Brain Sciences 10(11): 844
• Publisher Policy: Reproduced under a Creative Commons License