Sleep problems and associations with psychopathology and cognition in young people with 22q11.2 deletion syndrome (22q11.2DS)

• Published in: Psychological medicine 2020-05, Vol.50 (7), p.1191-1202
• Main Authors: Moulding, H A, Bartsch, U, Hall, J, Jones, M W, Linden, D E, Owen, M J, van den Bree, M B M
• Format: Article
• Language: English
• Subjects: 22q11 Deletion Syndrome - psychology; Adolescent; Age; Airway management; Anxiety; Anxiety disorders; Anxiety Disorders - epidemiology; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Autism; Autism Spectrum Disorder - epidemiology; Autistic children; Caregivers; Case-Control Studies; Child; Children & youth; Circadian rhythm; Cognition; Cognitive ability; Cognitive Dysfunction - complications; Cognitive functioning; Cognitive impairment; Conduct disorder; Conduct Disorder - epidemiology; Coordination; Developmental coordination disorder; Developmental delays; Executive function; Families & family life; Family income; Fear & phobias; Female; Genetics; Genomics; High risk; Humans; Insomnia; Laboratories; Male; Medical screening; Mental disorders; Neurodevelopmental disorders; Physiology; Prevalence; Psychopathology; Psychosis; Siblings; Sleep; Sleep disorders; Sleep Wake Disorders - epidemiology; Surveys and Questionnaires; Youth
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291719001119

Young people with 22q11.2 deletion syndrome (22q11.2DS) are at high risk for neurodevelopmental disorders. Sleep problems may play a role in this risk but their prevalence, nature and links to psychopathology and cognitive function remain undescribed in this population. Sleep problems, psychopathology, developmental coordination and cognitive function were assessed in 140 young people with 22q11.2DS (mean age = 10.1, s.d. = 2.46) and 65 unaffected sibling controls (mean age = 10.8, s.d.SD = 2.26). Primary carers completed questionnaires screening for the children's developmental coordination and autism spectrum disorder. Sleep problems were identified in 60% of young people with 22q11.2DS compared to 23% of sibling controls (OR 5.00, p < 0.001). Two patterns best-described sleep problems in 22q11.2DS: restless sleep and insomnia. Restless sleep was linked to increased ADHD symptoms (OR 1.16, p < 0.001) and impaired executive function (OR 0.975, p = 0.013). Both patterns were associated with elevated symptoms of anxiety disorder (restless sleep: OR 1.10, p = 0.006 and insomnia: OR 1.07, p = 0.045) and developmental coordination disorder (OR 0.968, p = 0.0023, and OR 0.955, p = 0.009). The insomnia pattern was also linked to elevated conduct disorder symptoms (OR 1.53, p = 0.020). Clinicians and carers should be aware that sleep problems are common in 22q11.2DS and index psychiatric risk, cognitive deficits and motor coordination problems. Future studies should explore the physiology of sleep and the links with the neurodevelopment in these young people.