Sleep Disordered Breathing in Pediatric Patients with Tetralogy of Fallot

Abstract

Adverse effects on the pulmonary circulation in obstructive sleep disordered breathing (SDB) may place children with heart lesions affecting the right ventricle at increased risk for morbidity and mortality. We examined the distribution and effects of SDB in pediatric patients with tetralogy of Fallot (TOF). Families of 37 pediatric patients with TOF completed a survey of cardiac symptoms and school performance as well as a Pediatric Sleep Questionnaire (PSQ), a validated questionnaire for the screening of SDB in children 2-18 years of age. Medical records were reviewed for growth parameters, medical history, and most recent electrocardiogram (ECG) findings. Data from patients with SDB (PSQ score > or = 8, n = 14) were compared to data from patients without SDB (PSQ score < 8; n = 23). The prevalence of SDB in this population (38%) was significantly higher than the published prevalence of 5% in a healthy general pediatric population (p < 0.001). No significant difference was found in age, gender, or age and sex standardized body mass index between patients with or without SDB. No difference was seen in medication use or timing of surgical repair, whether primary or palliative. Patients with SDB had a significantly higher cardiac symptom score (p = 0.01) and increasing PSQ scores correlated with worsening cardiac symptom scores (p = 0.006). Increasing PSQ scores also correlated with worsening school performance (p = 0.001). No differences were seen in ECG data. The screened prevalence of SDB in the pediatric population with TOF is higher than in the general population; patients with TOF and SDB are more likely to have worse cardiac symptoms and poor school performance.

Associations of Overweight, Obesity and Related Factors with Sleep-Related Breathing Disorders and Snoring in Adolescents: A Cross-Sectional Survey

“…This result is consistent with the evaluated prevalence of 0%–5.7% in other studies on general children [21,22]. The snoring rate of 3.3% in this study agrees with the rates published in epidemiologic studies of 2.4% to 15.6% [14].…”

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

“…Each scale has been validated against polysomnography for the identification of OSA in children, and each has been used to define OSA in children in a variety of patient groups (e.g., Pijpers et al, 2004;Davis et al, 2006;Herold et al, 2006). Two additional questions determined whether the child had undergone a previous polysomnograph assessment.…”

Prevalence and risk factors of sleep apnoea in adult patients with CHD

“…A high prevalence of sleep apnoea in patients with adult CHD was observed in this study compared with a previously reported prevalence of sleep apnoea in a healthy community sample; that is 16.5 and 6.5% for apnoea-hypopnea index ≥5 and apnoeahypopnea index ≥15, respectively. 15 In a previous study that screened sleep apnoea using the Pediatric Sleep Questionnaire, which defined sleep apnoea as having Pediatric Sleep Questionnaire scores ≥8, the reported prevalence of sleep apnoea in the children with tetralogy of Fallot was 38% higher than that in the healthy general population (5%) 4 , and screening of sleep apnoea in CHD using type 3 polysomnography has not been reported yet. Several factors may contribute to this high prevalence of sleep apnoea in adult CHD.…”