A Reflection of Day and Night: Down Syndrome and Sleep

“But I’m not tired” is a common sentence heard by parents as they attempt to tuck their children into bed after a long day. As your child grows up, this phrase may be heard less and less throughout the years. However, for people with Down Syndrome (DS), there may be little change to no change when it comes to not being tired. Complications from DS can make it difficult to enjoy a quality night of sleep.

Sleep problems have been widely reported in children with DS, with over 85% of school-aged children experiencing clinical symptoms of sleep problems (Lukowski & Milojevich, 2017). In a study conducted by Nicole M. Phillips, MD, from the University of Michigan, children with Down Syndrome have more instances of fragmented sleep and frequent awakenings compared to children who do not possess DS. Children with DS also have lower sleep efficiency, fewer total hours of sleep, less REM sleep, and spend more time in a lighter sleep stage than those without DS. A decrease in the quality and amount of sleep can further impair cognitive, behavioral, and physical growth that is already present in DS children (American Academy of Sleep Medicine, 2017).

Children with Down Syndrome often suffer from sleep-disordered breathing such as snoring or sleep apnea because of hypotonia, upper airway restriction and the placement of the tongue. They are also more likely to suffer from sleepwalking, sleep anxiety, and insomnia. Sleep-disordered breathing results in multiple brief sleep disruptions or fragmentations that can reduce the restorative function of sleep and, as a result, increase daytime fatigue (Lukowski & Milojevich, 2017). This fatigue impacts a person’s attentiveness and cognitive abilities during the day. The Journal of Intellectual Disability Research reports that a lack of sleep can also lead to a decrease in physical activity which can lead to obesity, a prevalent feature in those with DS (Chen & Ringenbach, 2018).

Although children and infants have an occasional bout of sleeplessness, these issues decline over time. The same cannot be said for children with DS. Complications for those with down syndrome often create restless nights no matter how tired one is.


American Academy of Sleep Medicine. (2017, November 08). Children with Down syndrome sleep poorly, have more fragmented sleep. https://aasm.org/children-with-down-syndrome-sleep-poorly-and-have-more-fragmented-sleep/

Lukowski, A. F., & Milojevich, H. M. (2017). Sleep problems and temperament in young children with Down syndrome and typically developing controls. Journal Of Intellectual Disability Research, 61(3), 221-232. doi:10.1111/jir.12321

Chen, C. J., & Ringenbach, S. R. (2018). Walking performance in adolescents and young adults with Down syndrome: the role of obesity and sleep problems. Journal Of Intellectual Disability Research, 62(4), 339-348. doi:10.1111/jir.12474


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