0848 Sleep Manifestations And Sleep Architecture In Children With Eosinophilic Esophagitis

Abstract

Introduction: Eosinophilic esophagitis (EoE) is one of the most common esophageal diseases characterized by a chronic immune-mediated process affecting esophageal tissue. The effects of EoE on sleep have been reported as a common concern and occurred at all ages. However, there is limited data on various sleep disorders and sleep architecture in children with EoE. The purpose of this study was to describe sleep problems and polysomnographic findings in this population. Methods: A retrospective review was performed in children with EoE who were referred to sleep clinics. Both clinical manifestation and polysomnographic variables were analyzed. Sleep architecture of patients with EoE (E) were compared with those of normal control group subjects from our previous studies (C). Results: Subjects included 83 children with EoE with the mean age 10.22 ± 4.49 years. Sleep complaints were common in children with EoE, including snoring (64, 77.1%), sleep-onset insomnia (51, 61.4%), frequent nighttime awakening (34, 41.5%), restless sleep (55, 66.3%), legs jerking or leg discomfort (36, 43.4%) and daytime sleepiness (48, 57.8%). Analysis of PSG revealed that 30 (36.1%) subjects had obstructive sleep apnea (OI>;1); 1 (1.2%) subjects had central sleep apnea; 5 (6.0%) subjects had hypoventilation; 18 (21.7%) had periodic limb movements in sleep. Compared to 83 controls, the percentage of NREM 2 sleep was significantly higher (P < .001), and NREM3 was significantly reduced in children with EoE (P < .001). In addition, arousal index (E, 10.82 ± 4.57 vs C, 9.53 ± 2.66; P < .001) in children with EoE. There were no significant differences in the sleep efficiency and sleep latency between the two groups. Conclusion: Children with EoE have significant complaints and several sleep disorders identified from the sleep study including sleep disordered breathing and periodic limb movements disorder. Analysis of sleep architecture demonstrates significant sleep fragmentation as evidenced by decreased slow wave sleep and increased arousal index. Further studies are needed to evaluate the effect of sleep disorders and sleep fragmentation on clinical outcomes in this population.