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Sleep Architecture Linked to Airway Obstruction and Intracranial Hypertension in Children with Syndromic

Bart Spruijt1,2, Irene M J Mathijssen1,2, Hansje H Bredero-Boelhouwer1,2

  • 1Rotterdam, The Netherlands; London, United Kingdom; and Boston, Mass.

Plastic and Reconstructive Surgery
|November 24, 2016
PubMed

Insights

Children with syndromic craniosynostosis generally have normal sleep architecture. However, moderate to severe obstructive sleep apnea significantly disrupts sleep patterns, impacting sleep efficiency and REM sleep.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Craniofacial Surgery

Background:

  • Syndromic craniosynostosis is associated with obstructive sleep apnea (OSA) and intracranial hypertension (ICH).
  • Understanding the impact of OSA and ICH on sleep architecture in these children is crucial.
  • Evaluating the effectiveness of surgical treatment on sleep patterns is important.

Purpose of the Study:

  • To assess sleep architecture in children with syndromic craniosynostosis.
  • To determine if OSA and/or ICH influence sleep architecture.
  • To evaluate the impact of treatment on sleep architecture.

Main Methods:

  • Included 39 patients with syndromic craniosynostosis.
  • Assessed obstructive sleep apnea via polysomnography (categorized as none, mild, moderate, or severe).
  • Identified intracranial hypertension using funduscopy, OCT, and ICP monitoring; analyzed sleep architecture (REM/NREM sleep, arousal index, sleep efficiency).

Main Results:

  • Patients without moderate/severe OSA or ICH had normal sleep architecture compared to controls.
  • Moderate/severe OSA was linked to increased respiratory effort-related arousals, reduced sleep efficiency, and less REM sleep.
  • Monobloc surgery improved sleep architecture in a small subset of patients.

Conclusions:

  • Children with syndromic craniosynostosis typically exhibit normal sleep architecture.
  • Moderate to severe obstructive sleep apnea significantly disturbs sleep architecture.
  • Findings support a unifying theory linking OSA, ICH, and sleep disturbances.
Abstract

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