Sleep apnea in children with Prader-Willi syndrome

Doctoral Dissertation uoadl:2875558 113 Read counter

Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences
Deposit date:
Polytarchou Anastasia
Dissertation committee:
Γεώργιος Χρούσος, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Χριστίνα Κανακά-Gantenbein, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Αθανάσιος Καδίτης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Αθανάσιος Μίχος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Μαρία-Ροζέ Πονς-Ροντρίγκεθ, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Παναγιώτα Περβανίδου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Φλώρα Μπακοπούλου, Επίκουρη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
Υπνική άπνοια σε παιδιά με σύνδρομο Prader-Willi
Translated title:
Sleep apnea in children with Prader-Willi syndrome
Objective: Children with Prader-Willi syndrome (PWS) have a high prevalence of obstructive sleep apnea syndrome (OSAS). In most typically developing children with OSAS, more obstructive apneas and hypopneas occur during rapid eye movement (REM) than during non-REM (NREM) sleep. It was hypothesized that patients with PWS are even more prone to obstructive events in REM sleep than otherwise healthy subjects with OSAS.
Methods: Polysomnographic data of patients with PWS and of typically developing children (controls) with OSAS (apnea-hypopnea index [AHI] > 1 episode/h) were analyzed. The two groups were compared regarding obstructive AHI (OAHI), OAHI during NREM sleep (OAHInrem), OAHI during REM sleep (OAHIrem), and the OAHIrem/OAHI ratio (outcome measures). The association between PWS diagnosis
and OAHIrem/OAHI was adjusted for confounders using a general linear model.
Results: Twelve children with PWS (median age 7.1 years [interquartile range 3.5, 12.4 years]) and 53 controls (6.5 years [3.9, 8.7 years]) were studied. Children with PWS and controls were similar regarding OAHI (p = 0.21) and OAHInrem (p =0.76). However, subjects with PWS had higher OAHIrem (17.6 episodes/h [5.8, 25.8 episodes/h]) and OAHIrem/OAHI (2.3 [1.5, 3.2]) than controls (5 episodes/h [1.5, 8.1
episodes/h]; p = 0.002 and 1 [0.5, 2]; p = 0.003, respectively). The association between PWS diagnosis and higher OAHIrem/OAHI persisted after adjustment for age, gender, and obesity (p = 0.009).
Conclusion: In children with PWS, OAHI calculated for total sleep time does not reflect OSAS severity during REM sleep, which on average can be twice as high. Mild OSAS in patients with PWS demonstrated by polygraphy without sleep staging may correspond to a moderately-to-severely increased OAHIrem.
Main subject category:
Health Sciences
Prader-Willi syndrome, Obstructive Sleep Apnea syndrome, REM sleep, Sleep Hypopnea
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