Obstructive Sleep Apnea in Children With Lennox‐Gastaut Syndrome: A Case Series
Gita Gupta, Louise M. O'Brien, Fauziya Hassan, Stephanie M. D. Rau, Arushi Gupta, Renée A ShellhaasABSTRACT
Background
Lennox–Gastaut syndrome (LGS) is a highly refractory epilepsy syndrome associated with poor sleep. Abnormal sleep can lower seizure threshold, yet a treatable cause of disordered sleep, obstructive sleep apnea (OSA), is understudied in children with LGS. We assessed the frequency of objectively diagnosed OSA and concordance of screening questionnaires with polysomnography results.
Methods
Caregivers of children (< 18 years) with LGS completed the Pediatric Sleep Questionnaire Sleep‐Related Breathing Disorders (PSQ‐SRBD) subscale and could opt to undergo overnight polysomnography. A positive polysomnogram was defined as an obstructive apnea–hypopnea index (OAHI) ≥ 1. PSQ‐SRBD scores were compared between children who did and did not undergo polysomnography.
Results
Caregivers of 31 children with LGS completed the PSQ‐SRBD; however, only 26 responses were valid based on the scoring criteria. Twenty out of twenty six (77%) screened positive. Among completed polysomnograms, 6/10 (60%) were positive for OSA. PSQ‐SRBD scores did not differ between participants who opted in versus out of polysomnography. In the subset completing both the questionnaire and polysomnogram ( n = 9), results were concordant in 5/9; two children with negative PSQ‐SRBD had OSA on polysomnography.
Conclusions
OSA appears highly prevalent in children with LGS, but a standard questionnaire missed OSA in a substantial minority. These findings support a low threshold for polysomnogram‐based OSA screening in children with LGS.