Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.
Department of Pediatric Pulmonology, Critical Care and Sleep Medicine, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
J Clin Sleep Med. 2018 Apr 15;14(4):623-629. doi: 10.5664/jcsm.7058.
The nature of sleep disorders in children with Ehlers-Danlos syndrome (EDS) is unknown. We aimed to describe the type, the management, and the short-term outcome of sleep disorders in children with EDS referred to sleep clinics.
This is a retrospective review of medical records and polysomnography tests of children with EDS younger than 18 years who were referred to the sleep clinic. Demographic information and medical history were collected, and polysomnography tests were reviewed. Questionnaires completed during previous clinic visits, including the Pediatrics Sleep Questionnaire (PSQ), Epworth Sleepiness Scale (ESS), and Pediatric Quality of Life Inventory (PedsQL), were also evaluated.
Sixty-five patients with EDS-hypermobility type were included. The mean age was 13.15 ± 3.9 years. There were 68% of patients who were female, and 91% of patients were Caucasian. The mean follow-up period was 1.14 ± 1.55 years. Common sleep diagnoses included insomnia (n = 14, 22%), obstructive sleep apnea (OSA) (n = 17, 26%), periodic limb movement disorder (PLMD) (n = 11, 17%), and hypersomnia (n = 10, 15%). In addition, 65% required pharmacologic treatment and 29% were referred to behavioral sleep medicine. For OSA, two patients required continuous positive airway pressure. A significant improvement was observed in the PSQ, ESS, and PedsQL scores during follow-up visits after treatment (n = 34; = .0004, 0.03, and 0.01, respectively).
There is a high prevalence of sleep disorders, including OSA, insomnia, PLMD, and hypersomnia in children with EDS referred to sleep clinics. Specific management can improve quality of life and questionnaire scores of this patient population. Our study emphasizes the importance of screening for sleep disorders in children with EDS.
埃勒斯-当洛斯综合征(EDS)患儿的睡眠障碍性质尚不清楚。我们旨在描述睡眠障碍的类型、管理和 EDS 患儿转诊至睡眠诊所后的短期预后。
这是一项对转诊至睡眠诊所的年龄小于 18 岁 EDS 患儿的病历和多导睡眠图检查的回顾性研究。收集了人口统计学资料和病史,并对多导睡眠图检查进行了回顾。还评估了之前就诊时完成的问卷,包括儿科睡眠问卷(PSQ)、嗜睡量表(ESS)和儿科生活质量量表(PedsQL)。
共纳入 65 例 EDS-高运动性患儿,平均年龄为 13.15±3.9 岁,68%为女性,91%为白种人。平均随访时间为 1.14±1.55 年。常见的睡眠诊断包括失眠(n=14,22%)、阻塞性睡眠呼吸暂停(OSA)(n=17,26%)、周期性肢体运动障碍(PLMD)(n=11,17%)和嗜睡(n=10,15%)。此外,65%的患者需要药物治疗,29%的患者转至行为睡眠医学科。对于 OSA,有 2 例患者需要持续气道正压通气。治疗后随访时 PSQ、ESS 和 PedsQL 评分均显著改善(n=34;分别为 P<0.0004、0.03 和 0.01)。
EDS 患儿转诊至睡眠诊所时,睡眠障碍(包括 OSA、失眠、PLMD 和嗜睡)的发生率较高。针对性治疗可以改善该患者人群的生活质量和问卷评分。本研究强调了对 EDS 患儿进行睡眠障碍筛查的重要性。