0897 Sleep Disordered Breathing In Pediatric Patients With Turner Syndrome

Abstract

Introduction Turner syndrome (TS) is a common genetic disorder that affects phenotypic females with partial or complete absence of one X chromosome. It typically presents with characteristic facial appearance, neck webbing, lymphedema, linear growth failure, and ovarian insufficiency. TS is also associated with other disorders, though sleep related disorders are not commonly reported. We present a case series of pediatric patients diagnosed with TS and assess their risk for sleep disordered breathing. Methods This study utilized retrospective chart review of the electronic medical record at the University of North Carolina at Chapel Hill from April 2014 to January 2019. Only pediatric patients under the age of 18 years who had previously undergone polysomnography and carrying the diagnosis of Turner syndrome were included in this study. Polysomnography results were reviewed. Results Retrospective chart analysis yielded ten (10) patients who qualified for inclusion. The mean age was 8.3 years (age range 1-15 years). Nine (9) patients were found to have sleep disordered breathing ranging from upper airway resistance syndrome to moderate sleep apnea (AHI range 1.2 to 6.2). Six (6) patients were found to have elevated periodic limb movement indices (PLM index range 5.1 to 30). Parasomnias and hypoventilation were not seen. Conclusion Our case series illustrates that sleep disordered breathing may be more common in TS than previously realized. Eklund et al. found that females with TS had more retrognathic mandibles and maxillas, shorter mandibles, and larger cranial base angles. These findings may indicate elevated risk of sleep apnea. Further studies are needed to define the overall risk of sleep disordered breathing in TS. Support None.

High Prevalence of Obstructive Sleep‐Disordered Breathing in Pediatric Patients With Turner Syndrome

“…The first case report describing an association between OSA and TS discusses a 32‐year‐old nonobese woman with TS, a narrow upper airway and brachycephaly, whose OSA resolved after maxillomandibular advancement osteotomy 6 . Subsequently, small case series have described an association between OSA and TS 7,8 . A large retrospective review of patients aged 2 to 26 years reported a 9% prevalence of sleep apnea in TS 9 ; however, this study did not provide diagnostic criteria for sleep apnea, polysomnogram (PSG) data, age of diagnosis, or risk factors.…”

“…6 Subsequently, small case series have described an association between OSA and TS. 7,8 A large retrospective review of patients aged 2 to 26 years reported a 9% prevalence of sleep apnea in TS 9 ; however, this study did not provide diagnostic criteria for sleep apnea, polysomnogram (PSG) data, age of diagnosis, or risk factors.…”