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VOLUME 20 , ISSUE 12 ( December, 2019 ) > List of Articles


Sleep Quality in a Case-control Subset of Trisomy 21 and Typically Developing Children in Riyadh, Kingdom of Saudi Arabia

May W Al-Khudhairy, Farah Al Shami, Anfal AlOtebe, Ghadah Al Abdan, Hana Al Ghwery, Muntaha Al Zughaibi, Reem Al Abdan, Samaher Al Quhtani

Keywords : Children's sleep habits questionnaire, Obstructive sleep apnea, Parasomnia, Sleep anxiety, Sleep-disordered breathing, Trisomy 21

Citation Information : Al-Khudhairy MW, Al Shami F, AlOtebe A, Al Abdan G, Al Ghwery H, Al Zughaibi M, Al Abdan R, Al Quhtani S. Sleep Quality in a Case-control Subset of Trisomy 21 and Typically Developing Children in Riyadh, Kingdom of Saudi Arabia. J Contemp Dent Pract 2019; 20 (12):1424-1429.

DOI: 10.5005/jp-journals-10024-2718

License: CC BY-NC 4.0

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: To identify sleep-domains as well as clinical features in children with trisomy 21 that may shed light on a possible sleep disturbance as compared with typically developing (TD) age-matched-controls. Materials and methods: A convenient sample of 100 Saudi Arabian children between the ages of 3–12 were invited to participate from several schools and centers in Riyadh during February 2018 to April 2018. Fifty of these children had trisomy 21, and 50 were TD age-matched-controls. A clinical examination of participants’ oral characteristics as well as the Wisconsin's 22 item Children's Sleep Habit Questionnaire (CSHQ) were utilized to help identify the impact of these variables on sleep quality. Results: Sleep domains that harbored strong evidence in differences between the two groups were sleep anxiety, parasomnia, and sleep-disordered-breathing. The clinical features unique to trisomy 21 were Mallampati score, macroglossia, lip-incompetence, tongue-ridging, and wear-facets. Conclusion: Clinical features and sleep quality coexist, providing better insight into the degree of sleep disturbance a child with trisomy 21 may have. Clinical significance: Dental clinicians must consider such factors that preclude to poor sleep, which might place children with trisomy 21 at a further disadvantage despite the fact that their baseline is already at risk of being at such a stage.

  1. Prado IM, Abreu LG, Silveira KS, et al. Study of associated factors with probable sleep bruxism among adolescents. J Clin Sleep Med 2018;14(8):1369–1376. DOI: 10.5664/jcsm.7276.
  2. De Graaf G, Buckley F, Skotko BG. Estimates of Live Births, Natural Losses, and Elective Terminations with Down Syndrome in the United States. Am J Med Genet A 2015;167(4):756–767. DOI: 10.1002/ajmg.a.37001.
  3. Al Salloum A, El Mouzan MI, Al Herbish A, et al. Prevalence of selected congenital anomalies in Saudi Children: a community based study. Ann Saudi Med 2015;35(2):107–110. DOI: 10.5144/0256-4947.2015.107.
  4. Chamseddin BH, Johnson RF, Mitchell RB. Obstructive sleep apnea in children with down syndrome: demographic, clinical and polysomnographic features. Otolaryngol Head Neck Surg 2019;160(1):150–157. DOI: 10.1177/0194599818797308.
  5. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med 1976;27:465–484. DOI: 10.1146/
  6. Guilleminault C, Quo SD. Sleep disordered breathing. a view at the beginning of the Millennium. Dent Clin North Am 2001;45(4):643–656.
  7. Chung F, Yegneswaran B, Liao P, et al. Validation of the Berlin questionnaire and American Society of Anethesiolo-gists checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology 2008;108(5):822–830. DOI: 10.1097/ALN.0b013e31816d91b5.
  8. Meltzer LJ, Walsh CM, Traylor J, et al. Direct comparison of two new actigraphs and polysomnography in children and adolescents. Sleep 2012;35(1):159–166. DOI: 10.5665/sleep.1608.
  9. Chervin RD, Weatherly RA, Garetz SL, et al. Pediatric sleep questionnaire: prediction of sleep apnea and outcomes. Arch Otolaryngol Head Neck Surg 2007;133(3):216–222. DOI: 10.1001/archotol.133.3.216.
  10. Markovich AN, Gendron MA, Corkum PV. Validating the Childrens Sleep Habit Questionnaire against polysomnography and actigraphy in school aged children. Front. Psychiatry 2015;5(188):1–10. DOI: 10.3389/fpsyt.2014.00188.
  11. Owens JA, Spirito A, McGuinn M. The childrens sleep habit questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 2000;2(8):1–9. DOI: 10.1093/sleep/23.8.1d.
  12. Skotco BG, Macklin EA, Muselli M, et al. A predictive model for obstructive sleep apnea and Down syndrome. Am J Med Genet 2017;9999:1–8.
  13. Vriend JL, Davidson FD, Corkum PV, et al. Sleep quantity and quality in relation to daytime functioning in children. Child Health Care 2012;41(3):204–222. DOI: 10.1080/02739615.2012.6.
  14. Asaad T, Abu Ella I, Nasr YA, et al. Sleep Profile in a sample of Egyptian school aged children with depression. Middle East Curr Psychiatry 2014;21(2):63–71. DOI: 10.1097/01.XME.0000444268.42846.3f.
  15. Maris M, Verhulst S, Wojciechowski M, et al. Prevalence of obstructive sleep apnea in children with down syndrome. Sleep 2016;39(3): 699–704. DOI: 10.5665/sleep.5554.
  16. Whitney DG, Shapiro DN, Peterson MD, et al. Factors associated with depression and anxiety in children with intellectual disabilities. J Intellect Disabil Res 2019;63(5):408–417. DOI: 10.1111/jir.12583.
  17. Dekker AD, Sacco S, Carfi A, et al. The behavioral and psychological symptoms of dementia in down syndrome (BPSD-DS) scale: comprehensive assessment of psychopathology in down syndrome. J Alzheimers Dis 2018;63(2):797–820. DOI: 10.3233/JAD-170920.
  18. Esbensen AJ, Beebe DW, Byars KC, et al. Use of sleep evaluations and treatment in children with down syndrome. J Dev Behav Pediatr 2016;37(8):629–636. DOI: 10.1097/DBP.0000000000000333.
  19. Ella B, Ghorayeb I, Burbaud P, et al. Bruxism in movement disorders: a comprehensive review. J Prosthodont 2017;26(7):599–605. DOI: 10.1111/jopr.12479.
  20. Churchill SS, Kieckhefer GM, Bjornson KF, et al. Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome. Sleep 2015;38(1):61–71. DOI: 10.5665/sleep.4326.
  21. Alwhaibi RM, Aldugahishem HM. Factors affecting participation in physical activities in Saudi children with Down Syndrome: mothers’ perspective. Disabil Rehabil 2019;41(13):1524–1535. DOI: 10.1080/09638288.2018.1433241.
  22. Choi EK, Jung E, Van Riper M, et al. Sleep problems in Korean children with Down syndrome and parental quality of life. J Intellect Disabil Res 2019;63(11):1346–1358. DOI: 10.1111/jir.12675.
  23. Ono J, Chishaki A, Ohkusa T, et al. Obstructive sleep apnea-related symptoms in Japanese people with Down syndrome. Nurs Health Sci 2015;17(4):420–425. DOI: 10.1111/nhs.12206.
  24. Landry ML, Rompre PH, Manzini C, et al. Reduction of sleep Bruxism using a mandibular advancement device: an experimental controlled study. Int J Prosthodont 2006;19(6):549–556.
  25. Simpson R, Oyekan AA, Ehsan Z, et al. Obstructive sleep apnea in patients with Down syndrome: current perspectives. Nat Sci Sleep 2018;10:287–293. DOI: 10.2147/NSS.S154723.
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