Polysomnographic diagnosis of obstructive sleep apnea in children with cerebral palsy – a 10-year retrospective review

Objective

To investigate the frequency and characteristics of OSA in children with cerebral palsy (CP) referred to a sleep laboratory.

Materials and methods

A retrospective review of pediatric patients (0–21 years) with CP who.

underwent PSG from January 2013 to December 2022 at a large tertiary medical center. Sleep staging and respiratory events were scored using standard criteria, with OSA defined as an apnea-hypopnea index (AHI) ≥1 event/hour. Clinical data and Gross Motor Function Classification System (GMFCS) scores were abstracted from medical records.

Results

Among 272 patients (56 % male, 44 % female; median age 7.7 years), 226 (83.5 %) met pediatric OSA criteria: 60.6 % were mild, 18.1 % were moderate, and 21.1 % were severe. While median AHI, Non-REM AHI, and REM AHI were 2.7, 2.3, and 4.9 events/hour, respectively, 13 children had an AHI >30 (IQR: 5.6). Furthermore, minimum SpO2 had a median of 89 % (range: 46 %–96 %, IQR: 7.9). More severe GMFCS levels (IV/V) were associated with higher AHI and lower SpO2.

Conclusion

Children with cerebral palsy have a high frequency of OSA. A substantial subset of children demonstrated profound desaturations associated with severe OSA. Notably, children with the greatest functional impairment (GMFCS scores of IV/V) exhibited the highest frequency of severe OSA indicating a pressing need for providers to identify and treat OSA in these complex patients.