Obstructive sleep apnea in children with cerebral palsy and epilepsy

Dev Med Child Neurol. 2016 Oct;58(10):1057-62. doi: 10.1111/dmcn.13091. Epub 2016 Mar 16.

Abstract

Aim: To examine the risk of obstructive sleep apnea (OSA) in children with cerebral palsy (CP) and/or epilepsy.

Method: This cross-sectional study employs the Pediatric Sleep Questionnaire (PSQ), the Gross Motor Function Classification System (GMFCS), and chart review to identify symptoms of OSA in children presenting to a multi-specialty pediatric healthcare institution.

Results: Two-hundred and fifteen patients were grouped into those with epilepsy (n=54), CP (n=18), both (n=55), and neither (comparison group, n=88). The comparison group comprised children with developmental disabilities but not children with typical development. Significantly increased PSQ scores (indicating increased risk of OSA) were found among children with CP (58%) and CP with epilepsy (67%) than among the comparison group (27%; p<0.001 and p<0.0001 respectively). Children with both CP and epilepsy had a greater number of increased PSQ scores compared with CP alone (p<0.05). Increased PSQ scores were observed with increasing CP severity as measured using the GMFCS. The PSQ identified more children at risk of OSA (46%) than did the medical record review for symptoms of OSA (8.2%, p<0.001).

Interpretation: Children with CP of greater severity or comorbid epilepsy are at increased risk of OSA. This study supports the routine questionnaire-based assessment for OSA as a regular part of the care of all children with CP, especially in those with more severe CP and those with epilepsy.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Cerebral Palsy / epidemiology*
  • Child
  • Child, Preschool
  • Comorbidity
  • Cross-Sectional Studies
  • Developmental Disabilities / epidemiology*
  • Epilepsy / epidemiology*
  • Female
  • Humans
  • Male
  • Risk
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*