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Age Does Not Affect Respiratory Characteristics in Children With Prader-Willi Syndrome Before and After Growth

Michelle Ip1, Sze Lut Cheng1, Okkes R Patoglu1

  • 1Department of Paediatrics, Monash University, Melbourne, Australia.

Acta Paediatrica (Oslo, Norway : 1992)
|January 23, 2026
PubMed

Insights

Children with Prader-Willi syndrome (PWS) treated with growth hormone do not show increased risk for sleep apnea. Very young children (<2 years) and older children (≥2 years) had similar outcomes for obstructive sleep apnea (OSA) and central sleep apnea (CSA).

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Genetics

Background:

  • Prader-Willi syndrome (PWS) is associated with increased risks of central sleep apnea (CSA) and obstructive sleep apnea (OSA).
  • Growth hormone (GH) therapy is often initiated in young children with PWS before age 2.
  • Previous studies on GH effects on sleep apnea in PWS have focused on older children.

Purpose of the Study:

  • To evaluate the impact of age on the prevalence of OSA and CSA in children with PWS.
  • To analyze sleep and respiratory characteristics in relation to age.
  • To determine the effects of growth hormone therapy on OSA and CSA in different age groups.

Main Methods:

  • Retrospective review of polysomnography data from children with PWS.
  • Data collected pre- and post-growth hormone treatment between January 2011 and June 2024.
  • Comparison of sleep apnea metrics between children younger than 2 years and those 2 years or older.

Main Results:

  • Pre-GH therapy, children aged ≥2 years had more severe OSA than those <2 years (p<0.05); no age difference in CSA severity.
  • Post-GH therapy, OSA developed in 21% of children <2 years and 20% of children ≥2 years.
  • CSA resolved in 21% (<2 years) and 6% (≥2 years), while new-onset CSA occurred in 11% (<2 years) and 13% (≥2 years).

Conclusions:

  • Growth hormone therapy does not appear to increase the risk of developing OSA or CSA in very young children with PWS.
  • Age does not significantly influence the development or resolution of sleep apnea following growth hormone treatment in PWS.
  • These findings support the safety of initiating growth hormone therapy early in children with PWS regarding sleep apnea risks.
Abstract

Keywords:
Prader‐Willi syndromecentral sleep apnoeagrowth hormoneobstructive sleep apnoeasleep

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