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Polysomnographic profile in children diagnosed with celiac disease before starting on a gluten free diet
Stanislava Suroviaková1, Anna Ďurdíková1, Peter Ďurdík1
1Department of Pediatrics, Comenius University Bratislava, Jessenius Faculty of Medicine and University Hospital, 036 01, Martin, Slovakia.
Insights
Children with newly diagnosed celiac disease (CD) exhibit prolonged sleep latency and increased central sleep apnea (CSA) compared to healthy peers. Further research is needed to confirm these sleep abnormalities in untreated celiac disease.
Area of Science:
- Pediatric Gastroenterology
- Sleep Medicine
- Pediatric Neurology
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- Sleep disturbances are common in various chronic conditions, but their prevalence in newly diagnosed pediatric CD is not well-established.
- Understanding sleep abnormalities in untreated CD is crucial for comprehensive patient management.
Purpose of the Study:
- To assess sleep abnormalities in children recently diagnosed with celiac disease (CD) before starting a gluten-free diet (GFD).
- To characterize the polysomnographic profiles of these children.
- To compare their sleep patterns with those of age-matched healthy children.
Main Methods:
- A prospective cross-sectional study involving 46 pediatric CD patients (aged 1-19) and 32 healthy controls (aged 2-17).
- All participants underwent anthropometric measurements, laboratory tests, and overnight in-laboratory polysomnography (PSG).
- Subgroup analysis was performed based on median age (8.1 years) to compare younger and older children.
Main Results:
- Children with untreated CD showed significantly prolonged sleep latency (SOL) (21.89 ± 20.77 min vs. 10.99 ± 7.94 min, p=0.02).
- A 4.23-fold higher probability of prolonged SOL was observed in CD patients compared to controls.
- Significantly higher central apnea-hypopnea index (CAHI) was found in CD patients (0.54 ± 0.78 vs. 0.18 ± 0.24, p=0.03), indicating increased central sleep apnea (CSA), particularly in younger children.
Conclusions:
- Children with untreated celiac disease exhibit distinct sleep architecture differences, including prolonged sleep latency.
- There is an increased incidence of central sleep apnea (CSA) in pediatric patients with newly diagnosed, untreated CD.
- Further research is warranted to validate these findings and explore potential interventions.
Study Aims:
The study assessed the presence of sleep abnormalities in children who had recently been diagnosed with celiac disease (CD) and not started a gluten free diet (GFD). The children's polysomnographic profiles were also characterized and further compared with healthy children of the same age.
Methods:
This prospective cross-sectional study involved 46 pediatric subjects (aged 1-19 years) who had recently been diagnosed with CD and not started a GFD. The control group consisted of 32 healthy children (aged 2-17 years). All children underwent anthropometric measurement, laboratory testing and standard overnight observation with in-laboratory video-PSG. The study and control group were divided into subgroups according to the subjects' median ages (8.1 years): celiac children aged less than 8.1 years (n = 23) and more than 8.1 years (n = 23), healthy children less aged than 8.1 years (n = 16) and more than 8.1 years (n = 16).
Results:
No significant differences in the basic demographic and anthropometric parameters between the celiac and control group were observed. Significantly prolonged sleep latency (SOL) was evident in the celiac subjects (21.89 ± 20.77 min. vs. 10.99 ± 7.94 min, p = 0.02), with a probability of prolonged SOL of 4.23-fold greater (OR = 4.23; 95 % CI 1.1-16.22) than the healthy controls, especially in the subgroup of older celiac patients. No significant differences in the sleep period time (SPT), total sleep time (TST), wake during sleep (WASO), sleep efficiency (SE) and sleep stage distribution and cyclization were found. The respiratory rates during sleep indicated a significantly greater incidence of the central apnea-hypopnea index (CAHI) (0.54 ± 0.78 vs. 0.18 ± 0.24, p = 0.03) with a 3.16-fold greater probability of pathological CAHI (OR = 3.16; 95 % CI 1.02-9.77) than the control group. An increased incidence of CSA in the subgroup of younger celiac patients compared to younger healthy controls was especially evident.
Conclusions:
The findings of our study suggest a difference in sleep architecture and an increased incidence of CSA in children with untreated CD, but additional research is required to verify the results.
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