ABSTRACT In subjects with Down syndrome the obstructive sleep apnea is the cause of many disorders (cognitive and cardiovascular disorders, premature exhaustion, increase of daytime sleepiness). The standard treatment in the obstructive sleep apnea is continuous positive airway pressure, which eliminates the respiratory events, allows recovery of a satisfactory quality of sleep, and suppresses daytime sleepiness and cognitive dysfunction. The aim of this study was to verify the effects of continuous positive airway pressure on aerobic performance, as well as on hormonal and metabolic parameters during exercise, in two young adults with Down syndrome and with obstructive sleep apnea, treated or not, after an interval of 5 years. The main result observed is the beneficial effect on the ability to achieve a longer submaximal exercise with higher intensity in subject receiving the treatment. Obstructive sleep apnea syndrome treatment in people with Down syndrome could improve aerobic capacity and reduce daytime sleepiness.
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T. Leti, M. Guinot, A. Favre-Juvin, J. Pepin, P. Levy and V. A. Bricout, "Obstructive Sleep Apnea Syndrome in Two Subjects with Down Syndrome: Continuous Positive Airway Pressure Contribution on Exercise Tolerance," Neuroscience and Medicine, Vol. 3 No. 2, 2012, pp. 187-191. doi: 10.4236/nm.2012.32024.
 C. Finesilver, “A New Age for Childhood Diseases. Down Syndrome,” Registered Nurse, Vol. 65, No. 11, 2002, pp. 43-48.
J. de Miguel-Diez, J. R. Villa-Asensi and J. L. Alvarez-Sala, “Prevalence of Sleep-Disordered Breathing in Children with Down Syndrome: Polygraphic Findings in 108 Children,” Sleep, Vol. 26, No. 8, 2003, pp. 1006-1009.
J. D. Lattimore, D. S. Celermajer and I. Wilcox, “Obstructive Sleep Apnea and Cardiovascular Disease,” Journal of the American College of Cardiology, Vol. 41, No. 9, 2003, pp. 1429-1437. doi:10.1016/S0735-1097(03)00184-0
M. S. Trois, G. T. Capone, J. A. Lutz, M. C. Melendres, A. R. Schwartz, N. A. Collop and C. L. Marcus, “Obstructive Sleep Apnea in Adults with Down Syndrome,” Journal of Clinical Sleep Medicine, Vol. 5, No. 4, 2009, pp. 317-323.
L. J. Epstein, et al., “Clinical Guideline for the Evaluation, Management and Long-Term Care of Obstructive Sleep Apnea in Adults,” Journal of Clinical Sleep Medicine, Vol. 5, No. 3, 2009, pp. 263-276.
K. Narkiewicz, M. Kato, B. G. Phillips, C. A. Pesek, D. E. Davison and V. K. Somers, “Nocturnal Continuous Positive Airway Pressure Decreases Daytime Sympathetic Traffic in Obstructive Sleep Apnea,” Circulation, Vol. 100, No. 23, 1999, pp. 2332-2335.
M. T. Maeder, P. Ammann, T. Munzer, O. D. Schoch, W. Korte, C. Hurny, J. Myers and H. Rickli, “Continuous Positive Airway Pressure Improves Exercise Capacity and Heart Rate Recovery in Obstructive Sleep Apnea,” International Journal of Cardiology, Vol. 132, No. 1, 2009, pp. 75-83. doi:10.1016/j.ijcard.2007.10.040
O. Taguchi, W. Hida, S. Okabe, S. Ebihara, H. Ogawa, Y. Kikuchi and K. Shirato, “Improvement of Exercise Performance with Short-Term Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea,” The Tohoku Journal of Experimental Medicine, Vol. 183, No. 1, 1997, pp. 45-53. doi:10.1620/tjem.183.45
V. A. Bricout, M. Guinot, P. Faure, P. Flore, Y. Eberhard, P. Garnier and A. F. Juvin, “Are Hormonal Responses to Exercise in Young Men with Down’s Syndrome Related to Reduced Endurance Performance?” Journal of Neuroendocrinology, Vol. 20, No. 5, 2008, pp. 558-565. doi:10.1111/j.1365-2826.2008.01695.x
L. Q. Guillermo, T. J. Gal and E. A. Mair, “Does Obstructive Sleep Apnea Affect Aerobic Fitness?” The Annals of Otology, Rhinology and Laryngology, Vol. 115, No. 10, 2006, pp. 715-720.
A. Aron, D. Zedalis, J. M. Gregg, F. C. Gwazdauskas and W. G. Herbert, “Potential Clinical Use of Cardiopulmonary Exercise Testing in Obstructive Sleep Apnea Hypopnea Syndrome,” International Journal of Cardiology, Vol. 132, No. 2, 2009, pp. 176-186. doi:10.1016/j.ijcard.2008.11.014
J. T. Carlson, J. Hedner, M. Elam, H. Ejnell, J. Sellgren and B.G. Wallin, “Augmented Resting Sympathetic Activity in Awake Patients with Obstructive Sleep Apnea,” Chest, Vol. 103, No. 6, 1993, pp. 1763-1768. doi:10.1378/chest.103.6.1763
V. K. Somers, M. E. Dyken, M. P. Clary and F. M. Abboud, “Sympathetic Neural Mechanisms in Obstructive Sleep Apnea,” The Journal of Clinical Investigation, Vol. 96, No. 4, 1995, pp. 1897-1904. doi:10.1172/JCI118235
B. Fernhall, T. Baynard, S. R. Collier, A. Figueroa, S. Goulopoulou, G. H. Kamimori and K. H. Pitetti, “Catecholamine Response to Maximal Exercise in Persons with Down Syndrome,” The American Journal of Cardiology, Vol. 103, No. 5, 2009, pp. 724-726. doi:10.1016/j.amjcard.2008.10.036
A. Figueroa, S. R. Collier, T. Baynard, I. Giannopoulou, S. Goulopoulou and B. Fernhall, “Impaired Vagal Modulation of Heart Rate in Individuals with Down Syndrome,” Clinical Autonomic Research, Vol. 15, No. 1, 2005, pp. 45-50. doi:10.1007/s10286-005-0235-1