• Hiroyuki Sawatari, Akiko Chishaki, Mari Nishizaka, Fumio Matsuoka, Chikara Yoshimura, Hiromi Kuroda, Anita Rahmawati, Nobuko Hashiguchi, Mami Miyazono, Junji Ono, Tomoko Ohkusa, and Shin-Ichi Ando.
• Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, 2) Research Fellow of the Japan Society for the Promotion of Science, Japan.
• Intern. Med. 2015 Jan 1; 54 (9): 100310081003-8.

ObjectiveIt 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.MethodsWe 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).ResultsOf 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).ConclusionSDB 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.

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