Vanderbilt Kennedy Center (TN IDDRC, UCEDD, LEND) Member Works to Improve Sleep Assessment in Down Syndrome Research

May 17, 2023

 A toddler-aged white boy with Down syndrome looks to the camera. He has straight brown hair, green eyes, and a red T-shirt.
A toddler-aged white boy with Down syndrome looks to the camera. He has straight brown hair, green eyes, and a red T-shirt.

In 2022, Vanderbilt Kennedy Center (VKC) member Sarika Peters, Ph.D., received a VKC Director’s Strategic Priorities Grant to determine the feasibility of use of a wearable sensor to assess sleep in children (ages 4-10 years) with Down syndrome.

Down syndrome is estimated to occur in 1 out of 700 babies and is associated with many co-occurring conditions including obstructive sleep apnea (OSA). OSA impacts between 50-79 percent of individuals with Down syndrome and the American Academy of Pediatrics recommends screening for OSA in children with Down syndrome starting at age 4.

Peters on brown background

“Disrupted sleep has a large burden on the health and well-being of both the child with Down syndrome and their parents and caregivers,” said Peters. “Studies show that individuals who have Down syndrome and OSA are more likely to have obesity, behavior problems such as ADHD, lower verbal functioning, and problems with executive functioning. One issue in this work is that polysomnography is considered the gold standard in sleep research, but it requires many resources and requires that a child sleep in an unfamiliar environment. With our VKC grant, we wanted to test alternative, objective, and less costly methods of quantifying sleep, especially in younger children with Down syndrome.”       

           Sarika Peters, Ph.D.

Peters and her team explored the use of wearable sensors, which measure body movements (actigraphy), and are increasingly utilized in sleep research studies because of their sensitivity, ease of use, and ability to capture data for extended periods of time within the home environment.

“In our study, participants wear the device for seven nights, one of which includes concurrent polysomnography,” said Peters. “Participants also receive detailed clinical assessments, and parents complete behavioral rating scales, the Child Sleep Habits Questionnaire (CSHQ), and a digital sleep diary. Although the data demonstrates the feasibility of the wearable sensor for capturing sleep quality in children with Down syndrome, it slightly overestimates total sleep time, wake after sleep onset, and sleep efficiency, and underestimates latency. Because we were using ready-made algorithms that were developed on typically developing populations, we decided that our next step would be to work closely with the company that makes the wearable sensor to develop a ‘fit for purpose’ algorithm that better captures aspects of sleep quality in Down syndrome.”

Peters recently was awarded an ActiGraph Digital Endpoint Accelerator Research “DEAR” Grant to address the existing challenges by developing a specific algorithm for the wearable device.

“With the DEAR Grant, we will continue our work to develop a specific algorithm for measuring sleep-based outcomes in Down syndrome,” said Peters. “This will help to determine whether actigraphy can be used more broadly to diagnose and monitor sleep problems and whether it could be applied in future clinical trials. I am grateful for the pilot data we were able to collect thanks to the VKC award and am excited to partner with ActiGraph so that we may further our understanding of how to treat OSA in young children with Down syndrome and ultimately improve health outcomes.”

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