Sleep in infants with congenital myasthenic syndromes

Serena Caggiano, Sonia Khirani, Elisabetta Verrillo, Christine Barnerias, Alessandro Amaddeo, Cyril Gitiaux, Briac Thierry, Isabelle Desguerre, Renato Cutrera, Brigitte Fauroux

Research output: Contribution to journalArticle

Abstract

Background and objectives Infants with congenital myasthenic syndrome (CMS) are at risk of brief resolved unexplained event (BRUE) and sleep-disordered breathing. The aim of the study was to explore sleep in infants with CMS with a particular focus on heart rate (HR) variability. Methods Overnight polygraphy was performed and HR variations associated with respiratory events were analysed. Bradycardia and tachycardia were defined as a variation of HR of ±10 bpm from baseline and analysed as events/hour. Results The data of 5 infants with CMS were analysed. Two patients had known mutations (COLQ and RAPSN). One patient had a tracheostomy. The apnoea-hypopnoea index (AHI) was abnormal in all the patients (range 2.8–47.7 events/h), with the highest AHI being observed in the 3 youngest infants. Nocturnal transcutaneous gas exchange was normal in all patients except the tracheostomised patient. Mean HR was 114 ± 23 bpm with a mean HR index of 4.5 ± 4.3 events/h. The amplitudes of HR variations (bradycardia or tachycardia) were around 15–20 bpm, regardless of the type of respiratory event, and comparable between patients. No correlations were found between HR indexes or variations and the type and mean duration of respiratory events. Ventilatory support was initiated in 3 infants immediately after the sleep study because of a high AHI and/or nocturnal hypoventilation. Conclusions All 5 infants had an abnormal AHI with younger infants having the highest AHI. Three infants required ventilatory support after the polygraphy, underlining its clinical usefulness. No significant abnormalities of HR were observed during the sleep studies.

Original languageEnglish
Pages (from-to)842-851
Number of pages10
JournalEuropean Journal of Paediatric Neurology
Volume21
Issue number6
DOIs
Publication statusPublished - Nov 1 2017

Keywords

  • Brief resolved unexplained event
  • Congenital myasthenic syndrome
  • Heart rate
  • Poly(somno)graphy
  • Sleep
  • Ventilatory support

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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    Caggiano, S., Khirani, S., Verrillo, E., Barnerias, C., Amaddeo, A., Gitiaux, C., Thierry, B., Desguerre, I., Cutrera, R., & Fauroux, B. (2017). Sleep in infants with congenital myasthenic syndromes. European Journal of Paediatric Neurology, 21(6), 842-851. https://doi.org/10.1016/j.ejpn.2017.07.010