A multi-center study reveals that more than half of newborns with myelomeningocele experience sleep-disordered breathing, highlighting a critical need for early screening.
Key takeaways:
- A study found that 53% of newborns with severe spina bifida (myelomeningocele) have sleep-disordered breathing.
- Researchers assessed 173 newborns using polysomnography before hospital discharge, showing that sleep disruptions in this population occur much earlier than previously recognized.
- Routine screening and early intervention for sleep disorders could help protect neurodevelopment and improve long-term outcomes for infants with the condition.
Many infants with the most severe form of spina bifida, called myelomeningocele, experience breathing disruptions during sleep, increasing the risk of cognitive deficits later in life, according to a new study.
The research, led by Michigan Medicine and Washington University School of Medicine in St Louis, reveals that sleep problems in this population occur much earlier in life than previously known. Sleep disorders are common among adults and older children with myelomeningocele, a congenital defect that occurs when parts of the developing spinal cord and nerves break through an opening in the back.
The results are published in Pediatrics.
“Sleep-disordered breathing, such as sleep apnea, is a significant contributor to behavioral problems during wakefulness, and likely to cognitive deficits as well, but it has not been well studied or routinely screened for in newborns,” says co-senior author Ronald Chervin, MD, MS, at the University of Michigan Medical School, in a release. “This study addresses a critical gap in our understanding of the prevalence and onset of these sleep and breathing disturbances, and raises the possibility of high-impact interventions that could improve long-term outcomes for these children.”
Around three of every 10,000 babies in the US are born with myelomeningocele. The multi-center study focused on sleep in newborns with the condition who underwent either fetal repair before delivery or postnatal surgery.
Researchers assessed 173 newborns before they left the hospital using a polysomnogram to track multiple bodily functions during sleep, including brain waves and heart rhythms. They found that 53% of newborns had sleep-disordered breathing, of which sleep apnea is the most common. Babies born more prematurely than others had more breathing disturbances per hour during sleep.
The timing of fetal spina bifida surgery, which can improve mobility and quality of life, was not linked to worsening symptoms except through its influence on premature birth.
“While fetal spina bifida repair is greatly beneficial, effective treatments for sleep-disordered breathing also can be delivered—but the condition must first be identified,” says co-senior author John Barks, MD, professor of pediatrics at U-M Medical School, in a release. “Even at health systems with robust myelomeningocele programs, screening for sleep disorders is not routine. Intervention as early as the first weeks after delivery could make a tremendous difference in the lives of these children.”
Untreated sleep-disordered breathing, regardless of the child’s health in other respects, can potentially lead to long-term complications. These include attention deficits, hyperactive behavior, learning disabilities, and cardiovascular conditions. Researchers say the findings highlight a novel potential opportunity to find and address sleep disorders in high-risk infants, thereby protecting their neurodevelopment.
“For children who have a high risk of sleep problems and who also have a high risk of developmental disabilities, this study identifies a relatively accessible and potentially powerful intervention that could meaningfully improve long-term outcomes,” says lead author Renée Shellhaas, MD, professor of neurology at WashU Medicine, in a release.
