Peer-reviewed article
Multidimensional Sleep Health of Toddlers With Down Syndrome: A Descriptive Study Guided by the Pediatric Sleep Health Framework.
Aljurayyad W, Caldwell AR, Hartman AG ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined sleep health in 24 toddlers with Down syndrome aged 12-36 months using a multidimensional framework covering behaviour, satisfaction, alertness, timing, efficiency, and duration. Half the children had difficulties across multiple sleep domains, with behavioural issues being most common (63%), though most maintained consistent bedtimes and routines. Children slept an average of 12.5 hours per day with early bedtimes around 8 p.m. and most woke without night awakenings. The findings show that a multidimensional approach reveals heterogeneous sleep profiles and can help identify specific intervention targets.
Key points
- 50% of toddlers with Down syndrome had multidomain sleep difficulties; 33% had single-domain difficulties; 17% had no sleep concerns
- Behavioural sleep problems were most common (63%), followed by satisfaction and efficiency (29% each)
- Most children (≥80%) had consistent bedtimes and routines, 70% fell asleep independently, and 67% had limited pre-bedtime screen exposure
- Mean 24-hour sleep duration was 12.5 hours with median lights-out at 8 p.m. and no night awakenings in 71% of children
- Multidimensional framework reveals heterogeneous sleep profiles and helps identify specific intervention targets
Limitations
This is a small descriptive study (n=24) with no comparison group, relying on parent-reported data without objective sleep measurement. The findings describe sleep patterns but do not establish causation or test interventions, limiting generalisability beyond this sample.
Abstract
Importance Sleep health supports child development and family well-being. Toddlers with Down syndrome experience elevated sleep difficulties, yet few studies have examined their sleep within a multidimensional framework. Objective To apply the Pediatric Sleep Health framework (Peds B-SATED) to characterize multidimensional sleep health and sleep-related practices of toddlers with Down syndrome (12-36 mo). Design Secondary analysis of cross-sectional descriptive data. Setting Clinics and organizations serving families of children with Down syndrome. Participants Twenty-four mothers of children with Down syndrome were recruited. Outcomes and measures Parent-reported Brief Infant Sleep Questionnaire items mapped onto the Peds B-SATED domains (Behavior, Satisfaction, Alertness, Timing, Efficiency, Duration). Descriptive statistics summarized sleep profiles and parental practices. Results Fifty percent of the sample demonstrated multidomain sleep difficulties; 33% had difficulties in a single domain, and 17% had none. Behavior was the most problematic domain (63%), followed by satisfaction and efficiency (29% each), timing (25%), and duration (13%). Most children had structured sleep behaviors (consistent bedtimes/routines ≥80%; falling asleep independently, 70%; limited prebedtime screen exposure, 67%) and high parental satisfaction. Most children woke up happy and took one daytime nap (>90%). Sleep timing and efficiency were characterized by early bedtimes (median lights-out 8 p.m.; median wake 7 a.m.), no night awakenings (71%), and mean sleep latency of 13.5 min. Mean 24-hr sleep duration was 12.5 hr. Conclusions and relevance A multidimensional approach to characterizing sleep health reveals heterogeneous sleep profiles across domains and offers clinicians and researchers an in-depth view of intervention targets for toddlers with Down syndrome. Plain-Language Summary: This study examined the sleep health of toddlers with Down syndrome ages 12-36 months by using the Pediatric Sleep Health framework, which looks at multiple aspects of sleep, including routines, quality, timing, and duration. Parents of 24 children completed a questionnaire about their child's sleep, and then we mapped their responses to this sleep health framework. We found that most children went to bed and woke up early, slept about 12.5 hr per day, and were described as good sleepers. However, many children had at least one area of difficulty, most often related to bedtime behaviors (63%). In general, about 17% had no sleep-related concerns, whereas the remainder experienced challenges in one or more areas. These findings show that even when overall sleep appears good, specific sleep behaviors may still benefit from attention. Using a multidimensional sleep health framework can help identify these patterns and better describe sleep health of young children with Down syndrome.