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

Abstract

ObjectiveGirls with Turner syndrome (TS) often have features that have been associated with obstructive sleep‐disordered breathing (oSDB). However, little is known about oSDB in TS. Herein, we aimed to characterize oSDB in young patients with TS and identify associated risk factors.Study DesignRetrospective cross‐sectional study.SettingTertiary care pediatric hospital.MethodsWe reviewed medical records for patients diagnosed with TS seen at our institution between October 1, 2007 and December 31, 2019 with the first outpatient visit before age 6 years. The prevalence of oSDB was compared to the general pediatric population with 1‐sample binomial proportion tests. Clinical characteristics were compared between those diagnosed with oSDB and those without oSDB, and risk factors for oSDB were identified.ResultsOf 151 patients with TS, 73 (48%) were diagnosed with oSDB which is 4‐fold higher than the general pediatric population (12%, P < 0.0001). In the multivariable model, adenoid, tonsillar, and inferior turbinate hypertrophy, birthweight, failure to thrive, and older age at the last clinic visit were all associated with increased odds for oSDB.ConclusionYoung children with TS have a high prevalence of oSDB and thus should be screened for oSDB. Polysomnography should be performed in those with associated risk factors and symptoms oSDB. Treatment of oSDB is imperative as individuals with TS are already at increased risk of behavioral problems, neurocognitive deficits, and growth impairment that may be worsened with oSDB.

Anxiety in Turner syndrome: Engaging community to address barriers and facilitators to diagnosis and care

“…Sleep disturbance is highly prevalent in children with anxiety disorders (Brown et al, 2018), and insomnia was consistently among the top symptoms experienced in our study across all age and rater groups. Individuals with TS are also at a great risk for sleep disordered breathing and sleep apnea (Gravholt et al, 2017; Pham et al, 2023), which may contribute to poor sleep health in addition to or in the absence of anxiety. There is remarkably little in the literature about sleep health in TS, but insomnia could be an early observable sign that an individual with TS is experiencing anxiety, as there is a reciprocal relationship between sleep disturbance and anxiety in the general pediatric population (Brown et al, 2018).…”