BACKGROUND Retrospective studies have shown high rates of sleep disordered breathing in children with myelomeningocele. However, most patients included in those studies underwent polysomnography because of symptoms, so the prevalence of sleep disordered breathing in this population is unknown. OBJECTIVE To determine the prevalence of sleep disordered breathing in children with myelomeningocele using screening polysomnography. METHODS In this cross-sectional study, all children with myelomeningocele seen in a multi-disciplinary spina bifida clinic between 2016 and 2020 were referred for polysomnography regardless of clinical symptoms. Included children had not previously undergone polysomnography. The primary outcome for this study was presence of sleep disordered breathing, defined as Apnea-Hypopnea Index (AHI, number of apnea or hypopnea events per hour of sleep) greater than 2.5. Clinical and demographic variables relevant to myelomeningocele were also prospectively collected and tested for association with presence of sleep apnea. RESULTS A total of 117 participants underwent polysomnography (age 1 mo to 21 yr, 49% male). The majority were white, non-Hispanic. Median AHI was 1.9 (interquartile range 0.6-4.2). A total of 49 children had AHI 2.5 or greater, yielding a sleep disordered breathing prevalence of 42% (95% CI 33%-51%). In multivariable logistic regression analysis, children with more rostral neurological lesion levels had higher odds of sleep disordered breathing (OR for thoracic, mid-lumbar, and low-lumbar: 7.34, 3.70, 4.04, respectively, compared to sacral level, P = .043). CONCLUSION Over 40% of a sample of children with myelomeningocele, who underwent screening polysomnography, had significant sleep disordered breathing. Routine screening polysomnography may be indicated in this population.

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脊髓脊膜膨出儿童睡眠呼吸障碍的患病率

背景 回顾性研究表明，脊髓脊膜膨出儿童的睡眠呼吸障碍发生率很高。然而，这些研究中的大多数患者由于症状而接受了多导睡眠图检查，因此该人群中睡眠呼吸障碍的患病率尚不清楚。目的 使用筛查性多导睡眠图确定脊髓脊膜膨出儿童睡眠呼吸障碍的患病率。方法 在这项横断面研究中，无论临床症状如何，2016 年至 2020 年间在多学科脊柱裂诊所就诊的所有脊髓脊膜膨出儿童均被转诊进行多导睡眠图检查。纳入的儿童以前没有接受过多导睡眠图检查。本研究的主要结果是存在睡眠呼吸障碍，定义为呼吸暂停-低通气指数 (AHI, 每小时睡眠的呼吸暂停或呼吸不足事件数）大于 2.5。还前瞻性地收集了与脊髓脊膜膨出相关的临床和人口统计学变量，并测试了与睡眠呼吸暂停存在的关联。结果 共有 117 名参与者接受了多导睡眠图检查（年龄 1 个月至 21 岁，49% 为男性）。大多数是白人，非西班牙裔。AHI 中位数为 1.9（四分位距 0.6-4.2）。共有 49 名儿童的 AHI ≥ 2.5，睡眠呼吸障碍患病率为 42% (95% CI 33%-51%)。在多变量逻辑回归分析中，与骶骨水平相比，具有更多头端神经系统病变水平的儿童具有更高的睡眠呼吸障碍几率（胸椎、中腰椎和下腰椎的 OR：分别为 7.34、3.70、4.04，P = . 043). 结论 超过 40% 的脊髓脊膜膨出儿童样本，接受筛查多导睡眠图的人，有明显的睡眠呼吸障碍。在该人群中可能需要常规筛查多导睡眠图。