Sleep‐disordered breathing in children with pycnodysostosis

• Published in: American journal of medical genetics. Part A 2020-01, Vol.182 (1), p.122-129
• Main Authors: Khirani, Sonia, Amaddeo, Alessandro, Baujat, Geneviève, Michot, Caroline, Couloigner, Vincent, Pinto, Graziella, Arnaud, Eric, Picard, Arnaud, Cormier‐Daire, Valérie, Fauroux, Brigitte
• Format: Article
• Language: English
• Subjects: Airway management; Apnea; Child; Child, Preschool; Children; Continuous positive airway pressure; Continuous Positive Airway Pressure - methods; ENT surgery; Female; Humans; Hypoventilation; Infant; Male; Patients; Polysomnography; Pycnodysostosis; Pycnodysostosis - complications; Pycnodysostosis - physiopathology; Pycnodysostosis - surgery; Respiration; Respiratory tract; Sleep; Sleep apnea; Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - physiopathology; Sleep Apnea Syndromes - surgery; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - surgery; Sleep disorders; sleep‐disordered breathing; Surgery; upper airway
• ISSN: 1552-4825; 1552-4833
• DOI: 10.1002/ajmg.a.61393

Upper airway obstruction is a common feature in pycnodysostosis and may cause obstructive sleep apnea (OSA). The aim of our study was to analyze sleep‐disordered breathing and respiratory management in children with pycnodysostosis. A retrospective review of the clinical charts and sleep studies of 10 consecutive children (three girls and seven boys) with pycnodysostosis seen over a time period of 10 years was performed. Six patients had severe OSA and/or nocturnal hypoventilation and were started on continuous positive airway pressure (CPAP) as a first treatment at a median age of 3.4 ± 2.6 years, because of the lack of indication of any surgical treatment. Three patients could be weaned after several years from CPAP after spontaneous improvement (two patients) or multiple upper airway surgeries (one patient). Three patients had upper airway surgery prior to their first sleep study with two patients still needing CPAP during their follow‐up. Only one patient never developed OSA. Patients with pycnodysostosis are at a high risk of severe OSA, underlying the importance of a systematic screening for sleep‐disordered breathing. Multidisciplinary care is mandatory because of the multilevel airway obstruction. CPAP is very effective and well accepted for treating OSA.