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Sleep-disordered breathing in children with Chiari malformation type II and myelomeningocele

Muslim M Alsaadi1, Shaikh M Iqbal, Essam A Elgamal

  • 1Division of Pediatric Respiratory Medicine, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Pediatrics International : Official Journal of the Japan Pediatric Society
|May 9, 2012
PubMed

Insights

Sleep-disordered breathing (SDB) is common in children with Chiari malformation type II (CM-II) and neural tube defects (NTD). This underreported condition requires greater attention for timely diagnosis and treatment in affected children.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Medical Genetics

Background:

  • Chiari malformation type II (CM-II) is associated with neural tube defects (NTD).
  • The prevalence of sleep-disordered breathing (SDB) in children with CM-II is not well-documented.
  • Potential brainstem compression in CM-II may lead to respiratory dysfunction during sleep.

Purpose of the Study:

  • To assess the prevalence of SDB in pediatric patients with CM-II.
  • To identify potential predictive factors for SDB in this population.

Main Methods:

  • Retrospective review of pediatric patients with documented CM-II.
  • Referral from Neurosurgery to a University Sleep Disorders Centre.
  • Full overnight polysomnography (PSG) performed on all included patients.
  • Descriptive statistical analysis of polysomnographic data.

Main Results:

  • Sixteen children (mean age 4.7 years) with CM-II were studied.
  • The mean apnea-hypopnea index (AHI) was 6.3/h, with 31.3% of patients having AHI >5/h.
  • A significant prevalence of central SDB was observed (mean central AHI 5.9/h), while obstructive SDB was minimal (mean obstructive AHI 0.4/h).

Conclusions:

  • The study confirms the link between CM-II, NTD, and sleep-disordered breathing.
  • SDB is highly prevalent in children with CM-II associated with NTD.
  • SDB in these patients is likely underreported and undertreated, necessitating increased clinical awareness.
Abstract

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