Global Pediatrics (Dec 2023)
Sleep-disordered breathing in children with Prader-Willi Syndrome cannot be attributed solely to increased body weight
Abstract
Background: Sleep disordered breathing is common in obese people. One of the main characteristics of patients with PWS is excess body weight. In this population study we aimed to investigate the differences in sleep disordered breathing (SDB) in overweight and obese children with Prader-Willi syndrome (PWS) and obese children. Methods: 27 children previously diagnosed with PWS and 24 obese peers, matched by age and gender were recruited and underwent a 12-channel overnight polysomnography (PSG) with oxygen saturation, snoring and body position recorded. Patient (caregiver) reported data on sleep abnormalities and data on other chronic, perinatal and bihevioural conditions were also collected. Results: Mean apnea-hypopnoea index (AHI) was higher in the PWS group than in the control obese children (5.37±7.47 and 1.97±5.35, respectively, p<0.001). REM latency was lower in the PWS group compared to obese controls (89.22 ± 49.92 vs 164.62 ± 91.05, p = 0.001). Both the duration of longest apnoeic episodes and the average duration of apnoeic episodes were higher in the PWS group compared to obese controls (21.04 ± 14.78 vs 8.79 ± 5.6, p = 0.002 and 12.15 ± 3.13 vs 8.79 ± 5.5, p = 0.003, respectively). Total awakeness time and the microarousal index were also higher in the PWS group compared to control obese children (56.59 ± 4.14 vs 29.54 ± 30.67, p = 0.002 and 3.45 ± 3.55 vs 2.36 ± 1.49, p = 0.046, respectively). Both average and lowest oxygen saturation rates were lower in children with PWS compared to obese controls (96.16 ± 1.55 vs 97.87 ± 2.11, p = 0.002 and 84.74 ± 5.67 vs 88.87 ± 4.63, p = 0.007). Slow wave sleep time was also significantly lower in the PWS group compared to obese controls (24.20 ± 7.75 vs 30.07 ± 6.93, p = 0.003). Parent/caregiver reported. Conclusions: SDB was more common in children with PWS, suggesting that the etiology of SDB in patients with PWS is multifactorial, likely related to the clinical manifestations of the syndrome and cannot be attributed solely to obesity.
