152 - Prevalence and Characteristics Associated with Sleep Disordered Breathing in Children with Spina Bifida

Poster Number: 152
Publication Number: 152.305

Olukemi Ogundiran, Case Western Reserve University, Katy, TX, United States; Jason Woodward, Cincinnati Childrens Hospital Medical Center, Cincinnati, OH, United States; Rachael E. Mahr, Cincinnati Children's Hospital Medical Center, Burbank, OH, United States; Brittany L. Spicer, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; John Pascoe, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Jareen Meinzen-Derr, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Narong Simakajornboon, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: The prevalence of sleep disordered breathing (SDB) in individuals with spina bifida (SB) has been reported as high as 40 to 80%. It is necessary to identify risk factors associated with SDB in individuals with SB to develop effective strategies for SDB screening and timely diagnosis in children with SB.

Objective: Describe the prevalence of sleep disordered breathing and the factors associated with increased risk for SDB amongst patients with SB attending a multidisciplinary Spina Bifida Clinic (SBC).

Design/Methods: A retrospective database analysis was conducted at tertiary care pediatric hospital. Demographic and clinical data, such as primary diagnosis, common comorbidities, and surgeries of patients with SB, are collected at annual multidisciplinary SBC visits and entered in the Center for Disease Control and Prevention’s (CDC) National Spina Bifida Patient Registry (NSBPR). The hospital’s Sleep Center Database includes data on sleep parameters, including AHI, OI, etc., and diagnosis of SDB for all the patients referred for polysomnography (PSG) at the institution. Data for all patients enrolled in the multidisciplinary SBC’s NSBPR database was linked through unique identifier with PSG data in sleep center database. Descriptive statistics and chi-square analysis described prevalence of SDB and differences between those with and without a PSG and those with and without diagnosis of SDB.

Results: 286 patients were identified in the SBC’s NSBPR database. Most patients had myelomeningocele (82.5%) and were 2 -12 years of age (46%). The majority were either non-ambulators (47%) or community ambulators (38%). 71 of 286 patients in the NSBPR had diagnostic sleep studies (80 (28%) total had PSGs). Patients completing a PSG were more likely to function at thoracic level and be non-ambulators (both p< .001) than those without a sleep study (Table 1). 50 of 71 (70%) patients completing a diagnostic PSG had a SDB diagnosis (OSA =35; CSA = 7). Those diagnosed with SDB were more likely to be male (p =0.007) and all 6 patients older than 13 with a diagnostic PSG had a SDB diagnosis (Table 2). Those with SDB were less likely to have had a shunt revision surgery (p=0.008).Conclusion(s): 70% of patients attending a multidisciplinary SBC who completed a diagnostic PSGs were diagnosed with SDB and 17% overall of participants enrolled in the SBC’s registry. Those with PSGs were more likely to have a higher functional level and non-ambulators. Male sex and no h/o shunt revisions were associated with increased risk for SDB. Further studies are needed on effective SDB screening strategies in children with SB.
Table 182380D70-FF1F-4B8B-8559-3880B7C88DBB.jpegComparing demographic and clinical characteristics of patients with and without a Polysomnogram (286 total patients).
Table 2AA1DA1F4-0793-4C8C-9EED-32E2774BCEAE.jpegThe demographic and clinical risk factors associated with a SDB Diagnosis. 80 of 286 patients in the NSBPR had at least one PSG on record, with 71 being diagnostic studies.