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Sleep-disordered breathing in children and adults with intellectual disability: mind the gap!
  1. Renata L Riha1,
  2. Ankur Singh1,
  3. Elizabeth A Hill2,
  4. Hazel Evans3,
  5. David O'Regan4
  1. 1Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2School of Applied Sciences, College of Health, Science and Society, University of the West of England, Bristol, UK
  3. 3University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4Sleep Disorders Centre, Guy’s and St Thomas’ Hospital NHS Foundation Trust; Faculty of Life and Sciences Medicine, King’s College London, London, UK
  1. Correspondence to Dr Renata L Riha, Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK; rriha1{at}


Background In adults and children with intellectual disability (ID), sleep -disordered breathing (SDB) is thought to be common. However, large epidemiological studies are lacking, and there are few studies on optimal methods of investigation and even fewer randomised, controlled intervention trials of treatment.

Method Peer-reviewed publications from various databases were examined in line with search terms relevant to ID and SDB spanning the years 200-2024.

Results Findings suggest that, due to comorbid conditions, children and adults with ID may experience both an increased risk of SDB, as well as lower frequency of diagnosis. SDB can compromise the emotional, physical and mental health of individuals with ID. Appropriate treatment when tolerated leads to an improvement in health and well-being and several studies emphasized the importance of consistent follow-up of people with ID - something that is not universally occurring during childhood, in the transition to adulthood and during adulthood itself. As the most frequently occurring form of ID worldwide, we use Down syndrome as a specific example of how diagnosing and treating SDB can lead to improved outcomes.

Conclusions This review highlights the importance of identifying SDB in this heterogenous population, recognising the multi-faceted, deleterious consequences of untreated SDB in people with ID, and presents some strategies that can be harnessed to improve diagnosis and management. Until further ID-specific research is available, we urge flexibility in the approach to people with ID and SDB based in guidelines and standard practice developed for the typically developing population.

  • Sleep apnoea

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  • X @sleepresearcher, @DrLizzieHill

  • Contributors All authors contributed to the manuscript. RR: conception, writing, literature search editing and tables. AS: literature search and tables. HE: writing. EAH: writing. DO: writing, figure.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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