Sleep and neuromuscular disorders in children

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Sleep Med Rev. 2008 Jun 3.

Sleep and neuromuscular disorders in children.

Alves RS, Resende MB, Skomro RP, Souza FJ, UC.

Department of Neurology, University of São o Medical School, HC–

FMUSP, São o, SP, Brazil.

Children suffering from neuromuscular diseases are at an increased

risk of sleep-related breathing disorders (SRBD) such as obstructive

sleep apnea syndrome (OSAS) and hypoventilation as well as central

sleep apnea, which is frequent in these patients due to diaphragmatic

weakness. They are at higher risk for developing complications of

nocturnal hypoxemia, including pulmonary hypertension, cor pulmonale

and neurocognitive dysfunction.

Neuromuscular disorders and OSAS are both prevalent disorders and

frequently overlap. Sleep-related hypoventilation/hypoxemia due to

neuromuscular diseases may be exacerbated in the presence of OSAS;

these children are likely to experience greater severity and duration

of sleep-related hypoxemia than are children with either disorder

alone.

Additionally, some of these children have reduced central neural

chemoresponsiveness. The development of SRBD in these patients

further impairs their quality of life and worsens their respiratory

status. We review the literature on the diagnosis and treatment of

SRBD in children with a variety of neuromuscular disorders.