Sleep-disordered breathing in children with congenital muscular dystrophies

Eur J Paediatr Neurol. 2012 Nov;16(6):619-24. doi: 10.1016/j.ejpn.2012.02.009. Epub 2012 Mar 16.

Abstract

Objective: Most types of neuromuscular diseases are known to be associated with a high risk of sleep-disordered breathing. We performed a prospective study in a well individualized group of muscular disorders, congenital muscular dystrophies (CMD), to characterize the frequency of sleep-disordered breathing and thereby to determine the potential usefulness of sleep studies in such patients.

Methods: Twenty CMD children (12 F, 8 M, aged 4-17 years) were included. Using overnight polysomnography, we determined the following parameters: sleep stages, sleep latency, sleep efficiency index, wake time duration, total sleep time (TST), apnea/hypopnea index (AHI), arterial blood oxygen saturation, and nocturnal paroxysmal EEG activity.

Results: As compared to healthy controls, we detected in our study group frequent awakenings, a decreased TST (mean 448 ± 44.4 min) and a decreased REM duration (mean 11.5 ± 3.5% of TST). Significant increase in wake time duration (28-90 min) and decrease in REM duration were observed in 12 patients. An apnea/hypopnea syndrome was detected in 13 patients (65%) with central apneas in 8, obstructive apneas in 2 and 3 mixed apneas in 3 patients. AHI was >10 in 3 cases, <10> 5 in 4 cases and were concomitant with blood oxygen de-saturation in four cases. NPA were detected in 10 patients ranging from 10 to 40% of TST.

Interpretation: Our results confirm the high incidence of sleep disordered breathing in children with CMD, and thereby, the usefulness of overnight polysomnography recordings in such patients.

MeSH terms

  • Adolescent
  • Blood Gas Analysis
  • Child
  • Child, Preschool
  • Electrophysiological Phenomena
  • Female
  • Humans
  • Male
  • Muscular Dystrophies / complications
  • Muscular Dystrophies / congenital*
  • Muscular Dystrophies / physiopathology*
  • Neurologic Examination
  • Polysomnography
  • Prospective Studies
  • Respiratory Function Tests
  • Respiratory Mechanics / physiology
  • Sleep / physiology
  • Sleep Apnea Syndromes / etiology
  • Sleep Apnea Syndromes / physiopathology*
  • Sleep, REM / physiology
  • Wakefulness