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The prevalence of Joint Hypermobility Syndrome (JHS) worldwide is estimated to be 5-17% 1. Hypermobility syndromes have been associated with a variety of comorbidities, and can be an important risk factor for Sleep Disordered Breathing (SDB). The usual risk factors for SDB, such as obesity, male gender, or post-menopausal status, are frequently absent in hypermobile populations, yet the impact of SDB on the quality of these patients' lives can be profound. Methods: Charts of 49 consecutive patients with a Beighton hypermobility score ≥ 5 from a Neurology Institute were retrospectively reviewed. The review included 33 MRI's and 36 weight-bearing flexion and extension radiographs of the neck, obtained to evaluate cervical spine complaints. The presence of Fatigue or Sleep Complaints, SDB, Headache or Migraine, Disorders of the Cervical Spine, and Symptoms of Dysautonomia (DYS) was evaluated. All ± values reflect the standard error of the mean. Results: 41 patients (84%) had sleep or fatigue complaints. 30 underwent attended Polysomnography (PSG), and 5 completed Home Sleep Testing (HST), though PSG was requested for all. SDB was diagnosed in 31 patients (63%). 21 had Obstructive Sleep Apnea (OSA) (G47.33) and 10 had Sleep Apnea-Upper Airway Resistance Syndrome (OSA-UARS) (G47.30). For Patients with SDB the average age was 34.36±2.3 years, and the average BMI was 27.14±1.1. See figures 1-3 for prevalence of SDB, Headache or Migraine, Disorders of the Cervical Spine, and Symptoms of Dysautonomia. On a T1-weighted MRI in mid-sagittal section, the following airway measurements were obtained and reflect the largest dimensions in centimeters: Retropalatal (0.47±0.06), Retro-lingual (0.86±0.05), and Retro-epiglottal (0.47±0.04), and Epiglottal length (2.22±0.06). MRI measurements for patients with SDB did not differ from those patients without sleep complaints. There was no difference in cervical spine mobility in patients with or without sleep complaints. However, there was a correlation in patients with Headache Disorders: see figure 4.

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