A Nationwide Cross-sectional Study on Congenital Heart Diseases and Symptoms of Sleep-disordered Breathing among Japanese Down's Syndrome People

  • Sawatari Hiroyuki
    Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Japan Research Fellow of the Japan Society for the Promotion of Science, Japan
  • Chishaki Akiko
    Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Japan
  • Nishizaka Mari
    Sleep Apnea Center, Kyushu University Hospital, Japan Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Japan
  • Matsuoka Fumio
    Department of Medicine, Kyushu University School of Medicine, Japan
  • Yoshimura Chikara
    Sleep Apnea Center, Kyushu University Hospital, Japan
  • Kuroda Hiromi
    Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Japan
  • Rahmawati Anita
    Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Japan
  • Hashiguchi Nobuko
    Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Japan
  • Miyazono Mami
    School of Nursing, Fukuoka Prefectural University, Japan
  • Ono Junji
    Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Japan
  • Ohkusa Tomoko
    Kirameki Projects Career Support Center, Kyushu University Hospital, Japan
  • Ando Shin-ichi
    Sleep Apnea Center, Kyushu University Hospital, Japan

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Description

Objective It is well known that people with Down's syndrome (DS) frequently complicate with congenital heart diseases (CHDs). Patients with heart diseases often have sleep-disordered breathing as a co-morbidity (SDB) which worsens the heart diseases. However, the relationship between SDB and CHDs in DS people has not yet been fully elucidated. The aim of this study was to establish the association between SDB and CHDs in DS people using data from a large nationwide questionnaire survey in Japan.<br> Methods We conducted a cross-sectional questionnaire survey of a randomly selected sample of 2,000 DS people and their caregivers throughout Japan to examine the associations between observed signs of SDB and CHDs in DS people. The questionnaire included the presence of SDB symptoms (snoring, apnea, arousal, nocturia, and napping) and CHDs (the presence and types of CHDs).<br> Results Of the 1,222 replies received from the caregivers, 650 reported complications of some type of CHDs. The observed apnea tended to be higher among DS people with CHDs than those without CHDs (OR=1.28, 95% CI=0.97-1.70, p=0.09). DS people with tetralogy of Fallot reported significantly more frequent apnea than those without CHDs (OR=3.10, 95% CI=1.36-7.05, p<0.01).<br> Conclusion SDB prevailed among DS people with severe CHDs, such as tetralogy of Fallot. Careful attention to the signs of SDB in such patients may lead to earlier clinical intervention removing the vicious cycle between SDB and CHDs.<br>

Journal

  • Internal Medicine

    Internal Medicine 54 (9), 1003-1008, 2015

    The Japanese Society of Internal Medicine

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