Obstructive Sleep Apnea in Children with Cerebral Palsy

Abstract

Obstructive sleep apnea (OSA) is not uncommon in children with cerebral palsy. Children with cerebral palsy are at increased risk for OSA secondary to anatomic upper airway factors, craniofacial abnormalities, abnormal muscle tone, and underlying pulmonary and neurologic disease. Medications used in children with cerebral palsy can also increase risk of OSA. Consequences of untreated OSA include daytime sleepiness, behavioral changes including irritability, hyperactivity, or poor academic performance, and cardiopulmonary disease. Untreated sleep apnea can also affect the ability to adequately control other medical conditions, such as epilepsy, and cause difficulty with ability to recover from anesthesia. The gold standard for diagnosis of OSA is an overnight polysomnogram. Treatment options include positional therapy, adenotonsillectomy and other upper airway surgical procedures, noninvasive positive pressure therapy, and in severe cases, tracheostomy may be required. Screening children with cerebral palsy for obstructive sleep apnea is important for both improving quality of life and mitigating health consequences of untreated sleep apnea.