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Sleep-Disordered Breathing in Children with Prader-Willi Syndrome in Relation to Growth Hormone Therapy Onset

Maja Zimmermann1, Constanze Laemmer2, Joachim Woelfle3

  • 1Pediatric Endocrinology and Diabetology, Children's Hospital, University of Bonn, Bonn, Germany.

Hormone Research in Paediatrics
|June 15, 2020
PubMed

Insights

Early growth hormone (GH) therapy is safe for Prader-Willi syndrome (PWS) children with sleep apnea. Sleep apnea development in PWS children is independent of GH treatment onset, but regular sleep monitoring is recommended.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Genetics

Background:

  • Prader-Willi syndrome (PWS) is a complex genetic disorder associated with various health issues, including sleep-related breathing disorders.
  • Obstructive sleep apnea (OSA) is a common comorbidity in children with PWS, impacting their growth and development.
  • The timing of growth hormone (GH) therapy initiation in relation to sleep apnea onset in PWS patients is not well-established.

Purpose of the Study:

  • To investigate the relationship between the age of initiating growth hormone (GH) therapy and the presence and severity of sleep apnea in children with Prader-Willi syndrome (PWS).
  • To assess the impact of early versus later GH therapy onset on key sleep apnea indices in PWS children.

Main Methods:

  • A longitudinal study analyzing cardiorespiratory polygraphy data from 62 PWS children, categorized into two groups based on GH therapy onset (before or after one year of age).
  • Sleep parameters including obstructive apnea hypopnea index (OAHI), central apnea index (CAI), oxygen desaturation index (ODI), and peripheral blood oxygen saturation (SpO2) were measured at baseline and at multiple time points post-GH therapy initiation.
  • Statistical analysis was performed to compare sleep apnea outcomes between the two treatment groups.

Main Results:

  • No significant differences in OAHI, CAI, ODI, or SpO2 were observed between PWS children who started GH therapy early versus later.
  • While pathological obstructive sleep apnea (OSA) increased in the early treatment group within the first three months, it normalized below baseline after one year in both groups.
  • The oxygen desaturation index (ODI) showed a significant decrease during GH therapy in both groups, indicating improvement in oxygenation.

Conclusions:

  • Obstructive sleep apnea in Prader-Willi syndrome children appears to develop independently of the timing of growth hormone therapy initiation.
  • Initiating GH therapy early in PWS children with sleep apnea is considered safe.
  • Regular sleep monitoring is crucial for PWS children undergoing GH therapy, regardless of treatment onset age.
Abstract

Keywords:
Growth hormone therapyInsulin-like growth factor-IObstructive sleep apneaPrader-Willi syndrome

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