Nature and Science of Sleep (Nov 2023)
Impact of Spina Bifida on Sleep Quality: Current Insights
Abstract
Mohini Gunnett,1 Brandon G Rocque,2 Anis Nourani,1 Guillermo Beltran-Ale1 1Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA; 2Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Alabama at Birmingham (UAB), Birmingham, AL, USACorrespondence: Guillermo Beltran-Ale, University of Alabama at Birmingham, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, 620 Jarman F. Lowder Building, 1600 7th Avenue South, Birmingham, AL, 35233-1711, USA, Tel +1 205 638 9593, Fax +1 205 638 2850, Email [email protected]: Spina bifida (SB) is one of the most common birth defects in children. The care for patients with SB continues to evolve, and there has been notable improvement in survival outcomes, degree of disability and quality of life for these children. However, patients with SB continue to remain at higher risk for sleep-related breathing disorders (SRBD), unexplained sudden death, and potential alterations in their sleep chronotype. Previous studies report on abnormalities in the spinal cord, brainstem function, and dysfunction of upper airway maintenance as the likely mechanisms behind SRBD that is commonly seen in SB. Most studies looking at prevalence of SRBD in SB have been retrospective studies. A recent prospective study identified a prevalence as high as 42% when a polysomnography (PSG) was completed on all patients regardless of symptomatology. Treatment options vary depending on the type and severity of SRBD and can range widely. Despite advances in care for patients with SB and SRBD, a subset of these patients with myelomeningocele (MMC) continue to experience sudden unexplained death. Studies continue to evaluate ways to stratify which of these patients may be at higher risk of this devastating outcome. Given that SRBD is potentially treatable, early assessment and intervention could become an integral part of a multidisciplinary treatment strategy to optimize long-term medical and neurodevelopmental outcomes for this patient population. By understanding the impact that SB may have on a patient’s sleep quality, their biological chronotype and their potential of developing SRBD, a provider may help to optimize the care a patient with SB receives from birth into adulthood.Keywords: sleep apnea, sleep-disordered breathing, myelomeningocele, central sleep apnea, hydrocephalus, Chiari 2 malformation
