Treatment of Pediatric Obstructive Sleep Apnea and Periodic Limb Movement During Sleep

Information featured at SLEEP 2023 in Indianapolis, IN, showed powerful treatment of obstructive sleep apnea brought about higher frequency of periodic limb movement of sleep (PLMS) among a larger part of pediatric patients with the condition. Inconsistent results regarding changes in PLMS frequency following disease management have been found in previous research.

In this investigation, Daniel Ignatiuk, MD, pneumonic fellow, Division of Pulmonary and Sleep Medicine, Cincinnati Children’s Hospital Medical Center, led a team that planned to additionally look at the effect careful treatment of obstructive sleep apnea had on periodic limb movement index (PLMI) in pediatric patients.

“The relationship between obstructive sleep apnea and PLMS is not completely understood, especially among pediatric patients,” investigators wrote. “Previous research describes varied changes in PLMS following obstructive sleep apnea treatment, including increased, decreased, or unchanged PLMS frequency.”

Periodic limb movement during sleep in children.

Through a retrospective chart review, the study found that 198 children who had upper airway surgery for the condition had PLMI ≥ 5/hour. Pre- or post-treatment evidence of significant PLMS was required for inclusion.

Polysomnograms were performed between January and July 2022. Patients with an insufficient sleep time of < 2 hours were rejected.

The population’s average age at the pre-treatment polysomnogram was 5.3 years, with a range of 1.1 to 16.9 years. Adenotonsillectomy (n = 136) was the most common treatment for obstructive sleep apnea, and 129 (65.2%) of the patients were male.

Changes in PLMI and obstructive apnea-hypopnea index (OAHI) were observed between pre-and post-treatment polysomnograms in no less than a year of obstructive sleep apnea treatment. Mixed-effect linear models were used to analyze the data.