Background: Sleep disorders are being more prevalent among general population. Its poor sleep quality causes depression, accidents, mortality, and morbidity among general population. Aim: To know the prevalence of sleep disorder among general population. Methods: Data was collected from general population of Karachi in 6 days. Questionnaire for Sleep-Quality Developed by Colin Espie, Professor of Sleep Medicine, University of Oxford was used to assess the sleep problems and sleep quality of respondents. Results: Moreover, 6.2% reported had severe sleeping problems and need clinical attention. 5.9% had some sleeping problems. 38.2% of respondents have good sleep while 49.75 had great sleep quality. Majority of respondents belong to age 20 to 30 age groups, students, undergraduate, female, exercised once in a week and were vegetarian. Age 20 to 30 age groups, students, undergraduate, female, exercised once in a week and being vegetarian was associated with sleep problem (P<0.05). 20 to 30 age group, Health sector and inter education level, diabetes, obesity, difficult breathing, snoring while sleeping and smoking was associated with sleep problems (P30 age group, undergraduate education level, students, exercising once in a week and eating vegetarian food were associated with good sleep quality (P<0.05). Poor sleep quality causes depression, accidents, mortality, and morbidity among general population. Conclusion: This study will provide the important information to the higher authorities related to the most vulnerable groups related to sleep problems and factors associated with good sleep quality.

Background: COVID-19 has become a global concern. Many risk factors have been identified. Down syndrome, which is 21 trisomy, affects the mental and physical health of the patient. The syndrome has many neurological complications, which include structural changes, mental retardation, young-onset Alzheimer’s disease, strokes and basal ganglia damage. Much less data is available regarding the association of COVID with Down syndrome. Objective: The objective of this systemic review is to focus on the different evidence available related to the association of COVID-19 with Down syndrome. Method: PubMed/Medline, Science Direct, Web of Science, and Scopus databases were used to find the research undertaken related to the association of COVID with Down syndrome up to 2022. Results: this systemic review includes eight studies. All studies showed that Down syndrome is associated with severe COVID and can lead to hospitalization. Discussion: Down syndrome leads to severe immune dysregulation. Scientists are investigating the exact mechanism behind the dysregulation of the immune system caused by trisomy 21 or Down syndrome, but research on it is still ongoing. In DS, chromosome 21 activates multiple genes which cause hyperactivity of the immune system. Chromosome 21 encodes the following immune regulators: interferon (IFN) receptors, Interleukin (IL)-10, IL-22, and IL-26. Immune and non-immune cells are sensitive to Interferon(IFN) and many studies report that in the absence of any infection there is still hyperactivity in T cells due to Interferon(IFN) in DS patients. Interferon response, which is involved in the antiviral response, is vigorous in DS patients and leads to cytokine storm. Recent studies showed that COVID infections are driven by an exacerbated immune response to the virus, leading to cytokine storm, acute respiratory distress syndrome, thromboembolic processes, and multi-organ failure. Conclusion: Patients with COVID-19 and Down syndrome are more vulnerable and should be prioritized for vaccination.