Rest, Repair, and Resilience: Why Quality Sleep Matters for People with Down Syndrome

October is National Down Syndrome Awareness Month, a time to recognize the unique strengths and challenges faced by individuals with Down syndrome. Among the many areas that parents and caregivers navigate, sleep is often one of the most misunderstood.

Children with Down syndrome tend to experience more sleep disruptions than typically developing children. Issues such as obstructive sleep apnea, difficulty staying asleep, and irregular sleep-wake cycles can impact everything from mood to cognitive development and family stress levels. Hopefully, this blog not only sheds light on your frustrations, but it can also offer relief that you are not alone.

Infancy: Sleep Challenges & Tips

From the start, babies with Down syndrome may have a harder time establishing a sleep rhythm. Muscle hypotonia (low muscle tone), larger tongues, and smaller airways can contribute to breathing challenges during sleep. These physiological traits increase the risk of obstructive sleep apnea (OSA), even in very young infants.

Studies show that babies with Down syndrome often have more fragmented sleep and less time in deep, restorative sleep. This can affect feeding schedules, growth, and parental sleep as well. To help manage your infant’s sleep, here are some places to start alongside your pediatrician.

• Monitor breathing sounds during naps and overnight. If snoring or gasping is present, talk with your pediatrician about a sleep study.
• Use supportive sleep gear like inclined bassinets if recommended by a medical professional. When our son had colic, we found that elevating his mattress was a huge help. Our pediatrician helped us find a safe way to make this a reality.
• Prioritizing calm bedtime routines with a warm bath, dim lights, and a short lullaby can begin to build healthy sleep associations. For colic, we found no television, soft classical music, and a warm tummy towel helped significantly at bedtime.

Toddlers: Sleep Challenges & Tips

As toddlers gain mobility and curiosity, bedtime battles can begin. For children with Down syndrome, communication delays or sensory sensitivities can complicate sleep routines. They may resist bedtime, wake frequently during the night, or become overtired without showing typical signs of fatigue.

Sleep apnea often becomes more apparent in this age group, with some children needing an earlier diagnosis and treatment through surgery or the use of a CPAP machine. It is important to repeat the steps for infancy to monitor their breathing while napping and sleeping.

• Stick to a predictable bedtime schedule even on weekends. This is always a hard adjustment if you have older children who want to sleep in, but Down syndrome need to have consistency.
• Use visual cues, such as a picture chart with pajamas, toothbrushing, bubble bath, and a book with their bed, to guide the routine.
• Consider a white noise machine if your child is sensitive to background noise. With our sleep-deprived toddler, we found a sound machine with stars and planets on his ceiling, which helped him find a focal point to focus.

School-Aged Children: Sleep Challenges

By the time children with Down syndrome enter elementary school, they may still face lingering sleep issues, often tied to untreated sleep apnea or behavioral sleep challenges. Some children may take longer to settle down or experience night wakings. These disruptions can affect school performance, attention span, and emotional regulation. If school is a stressful transition after the weekend, there are ways to help your child.

A comprehensive sleep study, often recommended by age 4 or earlier, can help uncover medical concerns. According to the American Academy of Sleep Medicine, many children in this age range are still undiagnosed. The Alaska Sleep Clinic will partner with you every step to ensure your child is not only diagnosed promptly but parents are given a comprehensive action plan.

• Advocate for a sleep evaluation if your child snores, gasps, or appears tired during the day despite getting enough hours of sleep.
• Create a relaxing wind-down routine with screen-free time and gentle activities like reading or coloring.
• Work with your child’s school if daytime fatigue is affecting focus. Teachers may be able to support with quiet breaks or flexible learning. Of course not every school district will have someone specialized in your child’s Down syndrome needs, so consider your options and meet with school leadership, including the teacher.

Teenagers: Sleep Challenges

Teens with Down syndrome may want to stay up later, especially if they see siblings or friends doing the same. Many teens continue to struggle with fragmented sleep, often due to lingering apnea, irregular schedules, or anxiety. While CPAP machines can dramatically improve sleep quality, some teens resist using them regularly.

• Involve your teen in their bedtime routine planning. Empower them to pick calming music, pajamas, or the order of steps.
• Encourage consistent wake and sleep times, even on weekends. This will be easiest if you implement it early in their childhood. Inconsistent sleep will hinder their progress.
• If your teen uses a CPAP, create a positive reinforcement system for nightly use, and troubleshoot discomfort with a sleep specialist if needed.

While sleep may always require extra attention for families navigating Down syndrome, the right tools and support can make a big difference. From infancy through adolescence, the goal is progress, not perfection. The Alaska Sleep Clinic is here to partner with your journey. Connect today for a free consultation.