Session 8 - Sleep

Exploring Sleep Behaviors and Behavioral Intervention Acceptance in Down Syndrome: A Caregiver-Child Comparison

Kaylie Burns¹, Shannon Kirshy¹, Brianna Paquette¹, Wanqin Yu¹, Sylvie Mrug¹, & Caroline G. Richter¹

1. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294

1st Author Email: kmburns@uab.edu

Background:

Sleep disturbances are common in individuals with Down syndrome (DS), significantly impacting their quality of life and cognitive functioning (Breslin et al., 2014). Caregivers often report their child's sleep concerns, but discrepancies between caregiver- and self-reports may occur due to perception differences or communication barriers (Esbensen et al., 2019). While Mindfulness-Based Therapy for Insomnia (MBTI) (Ong, 2017) and Brief Behavioral Treatment for Insomnia (BBTI) (Gunn et al., 2019) are effective in other populations, their applicability to individuals with DS remains understudied.

Research question(s):

This study aims to (1) describe and compare caregiver- and self-reported sleep patterns in individuals with DS and (2) evaluate MBTI and BBTI participation willingness.

Method:

Twelve caregivers and 18 individuals with Down Syndrome (M age=26 years, SD=12.26, range=7–43) completed sleep surveys assessing sleep behaviors, nighttime disruptions, and acceptability of MBTI and BBTI. Surveys were administered in person at a local organization, using visual aids to facilitate responses.

Results:

Caregivers reported that individuals with DS receive 8 hours of sleep on weekdays and 9.5 on weekends, whereas individuals with DS reported sleeping 10.5 and 10.83 hours respectively. Correlations within dyads were varied: six were strong, one was moderate, and four were weak. Nighttime wakings were reported with 44% individuals with DS reported waking “almost every night”, and no parents reported waking “almost every night”. Acceptability of MBTI was reported by 44% of individuals with DS and 22% caregivers. For BBTI, 56% of individuals with DS and 11% caregivers reported acceptability.

Conclusion:

This study highlights the need for multi-informant approaches in assessing sleep behaviors in DS, as discrepancies may reflect awareness or interpretation differences. Tailored interventions should align with preferences of individuals with DS while addressing caregiver concerns.

Citations:

• Ong, J. C. (2017). Mindfulness-based therapy for insomnia. American Psychological Association. https://doi.org/10.1037/14952-000
• Gunn HE, Tutek J, Buysse DJ. Brief Behavioral Treatment of Insomnia. Sleep Med Clin. 2019 Jun;14(2):235-243. doi: 10.1016/j.jsmc.2019.02.003. Epub 2019 Apr 1. PMID: 31029189.
• Breslin, J. H., et al. (2014). Developmental Medicine & Child Neurology, 56(7), 657-664
• Esbensen, A. J., et al. (2019). Journal of Intellectual Disability Research, 63(2), 139-148.

Role of sleep in enhancing emotional memory in teens and young adults with Down syndrome

Jaclyn H. Ford (Jaclyn.ford@bc.edu), Ana Benitez, Emily Finn, Laryssa Gazda, Brianna Lenza, Sylvia Murray

Boston College

Background: Sleep plays an essential role in the long-term consolidation of new memories (i.e., sleep-dependent memory consolidation) in typically-developing (TD) young adults, and can selectively support consolidation of emotional content. However, there is evidence that this process is disrupted in individuals with Down syndrome (DS), with studies either showing no effect or impairments following sleep, and no research to date has examined the differential effects of sleep on emotional and neutral information in this population. The proposed research will be the first to systematically examine the effects of sleep on memory for emotional v. neutral information in individuals with DS. Research Questions: Is DS associated with global sleep-related impairments in memory consolidation, or is there preservation of sleep-related emotional memory enhancements in this population?

Method: In Experiment 1, 80 participants (20 each: TD-sleep, TD-wake, DS-sleep, DS-wake) complete an emotional memory task with a 12-hour delay between encoding and retrieval. Emotional and neutral memory will be compared across those with intervening sleep v. wake. In Experiment 2, 40 participants (20 each of: TD-sleep and DS-sleep) complete the same emotional memory task, with overnight sleep measured using PSG and coupling of sleep spindles and slow-wave oscillations computed.

(Interim) Results: Data from wake participants reveal significant emotional memory enhancements in both groups. Additional analyses revealed a significant group-by-valence interaction.

(Interim) Conclusion: The current data suggest that individuals with DS show similar emotional memory prioritization as TD peers, although there may be qualitative differences in the materials that lead to these enhancements. Sleep analyses will examine whether this prioritization will result in expected sleep-related emotional memory enhancements in DS.

Mindfulness-Based Treatment for Insomnia: Adaptations for use in Young People with Down Syndrome

Anna Pyle B.A.¹, Carolina Rodriguez M.S.¹, Shannon Kirshy B.S.¹, Sylvie Mrug PhD¹, S. Justin Thomas PhD¹, Caroline G. Richter PhD¹

1. The University of Alabama at Birmingham, Birmingham, AL

Email: amorga25@uab.edu

Background

Individuals with Down Syndrome (DS) have a higher prevalence of sleep problems, especially sleep-disordered breathing (SDB) and insomnia (Esbensen & Schwichtenberg, 2016). These issues arise from anatomical and physiological factors, health comorbidities, and behavioral and sensory challenges, as well as maladaptive sleep behaviors, dysfunctional thoughts, and physiological arousal (Giménez et al., 2021). Behavioral interventions for insomnia effectively address many of these root causes, avoid side effects associated with pharmacotherapy, improve adherence to sleep treatment devices, and offer lasting benefits (Ogundele & Yemula, 2022). However, research on behavioral interventions for DS-related sleep issues remains limited (Shanahan et al., 2019; Tsou et al., 2022). Mindfulness-Based Therapy for Insomnia (MBTI) is a well-established behavioral intervention with unique benefits for individuals experiencing insomnia (Ong, 2017; Ong & Kalmbach, 2023), but its efficacy for individuals with DS and their caregivers is unexplored.

Research Questions

This study aims to adapt a virtually delivered 8-session MBTI intervention for use in 12-30- year-olds with Down Syndrome and their caregivers.

Method

Collaboration with community advisory boards comprising DS stakeholders, including caregivers, self-advocates, non-profit organizations, and practitioners informs intervention adaptations.

Results

Adaptations to the intervention include visual aids and videos to clarify mindfulness concepts, shorter meditations, and direct caregiver involvement. With interventionist guidance, caregivers practice techniques before introducing them to the individual with DS. Homework materials, such as handouts and videos, reinforce concepts for home practice. Daily text or email reminders encourage consistency. Each session starts with a formal meditation and includes a review segment to discuss experiences and refine practices. Materials will be available in the project’s website for public use.

Conclusion

Adapting MBTI for young people with DS ensures mindfulness principles are effectively communicated, emphasizing gradual skill-building, consistent practice, and a supportive environment, addressing unique challenges while enhancing insomnia management and overall well-being.