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Sleep development in children with congenital and acquired hypothyroidism
M Hayashi1, S Araki, J Kohyama
1Department of Pediatrics, Tokyo Medical and Dental University, Japan.
Insights
Congenital hypothyroidism, or thyroid hormone deficiency before birth, can impact early central nervous system development, specifically affecting REM sleep and body movements during sleep in infants.
Area of Science:
- Neuroscience
- Endocrinology
- Developmental Pediatrics
Background:
- Thyroid hormones are crucial for normal central nervous system (CNS) development.
- Congenital hypothyroidism (CH) is a condition of insufficient thyroid hormone production from birth.
- The impact of prenatal thyroid hormone deficiency on early sleep development is not fully understood.
Purpose of the Study:
- To investigate the influence of congenital hypothyroidism on the sleep development of the human central nervous system.
- To assess specific sleep parameters in infants and children diagnosed with CH.
Main Methods:
- Utilized all-night polysomnography to examine sleep development in children with CH.
- Compared sleep patterns, including REM sleep and body movements, between CH patients and controls.
- Analyzed data from patients with varying durations of thyroxine replacement therapy.
Main Results:
- While the sleep-wakefulness circadian rhythm was generally unaffected, mild decreases in REM sleep were observed in younger CH patients.
- One patient with delayed thyroxine replacement showed significantly reduced rapid eye movements during REM sleep.
- Generalized gross body movements during sleep were more frequently disturbed in CH patients and remained reduced even after L-thyroxine treatment.
Conclusions:
- Congenital hypothyroidism can lead to specific abnormalities in sleep development, particularly affecting REM sleep and gross motor activity.
- Sleep development patterns in CH patients may serve as an indicator for evaluating regional brain impairment.
- Acquired hypothyroidism and transient hyperthyrotropinemia did not present with similar severe sleep abnormalities.
Abstract:
To determine how thyroid hormone deficiency before birth influences early development of the human central nervous system, we examined sleep development in children with congenital hypothyroidism using all-night polysomnography. Although the sleep-wakefulness circadian rhythm was not disturbed, two patients under 1 year of age showed mild decreases of REM sleep. Rapid eye movements during REM sleep were significantly decreased in one patient in whom thyroxine replacement was delayed. Regarding phasic body movements during sleep, generalized gross movements were more frequently disturbed than localized muscle twitches, and even after L-thyroxine replacement, they were significantly reduced when compared with those in controls. Children with acquired hypothyroidism and neonatal transient hyperthyrotropinemia showed no severe abnormalities of the sleep parameters examined here. Sleep development in patients with congenital hypothyroidism is believed to be useful for regional evaluation of the brain impairment in congenital hypothyroidism.