Role of sleep study in children with Chiari malformation and sleep disordered breathing

Childs Nerv Syst. 2019 Oct;35(10):1763-1768. doi: 10.1007/s00381-019-04302-0. Epub 2019 Aug 1.

Abstract

Purpose: Chiari malformation incorporate numerous forms of congenital or acquired cerebellar herniation through the foramen magnum. This may lead to brain stem, high spinal cord and cranial nerve compression resulting in obstructive and central apneas. This review highlights he high prevalence of sleep-disordered breathing in this population and the importance of refering these patients for sleep studies as part of their workup.

Methods: A review of the literature was performed through a PubMed and EMBASE search of original articles and reviews using the key words "chiari" "chiari malformation" "hindbrain herniation" "sleep disordered breathing" "obstructive sleep apnea" "central sleep apnea" "sleep study" and "foramen magnum decompression".

Discussion: We highlight the pathophysiology of sleep disordered breathing in patients with Chiari malformation, how it can be diagnosed and what the treatment options are.

Conclusions: Sleep-disordered breathing is highly prevalent in patients with CM1. Clinicians caring for these patients should be aware of this and prioritise sleep diagnostic testing to allow for early diagnosis and management particularly in the presence of neurological symptoms and specific brain MRI pointers.

Keywords: Chiari malformation; Foramen magnum decompression; Hindbrain herniation; Sleep disordered breathing (obstructive/central sleep apnea); Sleep studies.

Publication types

  • Review

MeSH terms

  • Arnold-Chiari Malformation / complications
  • Arnold-Chiari Malformation / diagnosis*
  • Arnold-Chiari Malformation / physiopathology*
  • Child
  • Humans
  • Polysomnography / methods
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / diagnosis*
  • Sleep Apnea Syndromes / physiopathology*