Pathophysiology, evaluation, and management of sleep disorders in the mucopolysaccharidoses

Mol Genet Metab. 2017 Dec:122S:49-54. doi: 10.1016/j.ymgme.2017.08.008. Epub 2017 Aug 25.

Abstract

The mucopolysaccharidoses (MPS) represent a heterogeneous group of lysosomal storage disorders, each one associated with a deficiency in one of the enzymes involved in glycosaminoglycan degradation. Sleep disorders are a frequent manifestation of all types of MPS. Underlying causes are diverse and comprised of both respiratory and central nervous system (CNS) abnormalities. Sleep disordered breathing such as obstructive sleep apnea and nocturnal hypoventilation can arise in patients with upper airway obstruction and/or with alterations in respiratory mechanics, causing restrictive pulmonary disease. MPS patients with CNS disease can also develop sleep disturbances unrelated to ventilatory impairments, often associated with severe behavioral problems or night-time epileptic seizures. The present review discusses the pathophysiology, evaluation, and management of sleep disorders in MPS based on information from a meeting on the brain in MPS, attended by an international group of experts (April 28-30, 2016, Stockholm, Sweden), and additional literature searches.

Keywords: Behavioral problems; Lysosomal storage diseases; Mucopolysaccharidoses; Obstructive sleep apnea; Restrictive pulmonary disease; Sleep disorders.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / drug effects*
  • Brain / enzymology
  • Brain / metabolism
  • Central Nervous System Depressants / therapeutic use*
  • Child
  • Child Behavior / drug effects*
  • Child, Preschool
  • Congresses as Topic
  • Enzyme Replacement Therapy
  • Glycosaminoglycans / metabolism
  • Glycosaminoglycans / toxicity
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Mucopolysaccharidoses / complications*
  • Mucopolysaccharidoses / genetics
  • Mucopolysaccharidoses / pathology
  • Mucopolysaccharidoses / therapy
  • Polysomnography / methods
  • Respiratory System Abnormalities / diagnosis
  • Respiratory System Abnormalities / etiology
  • Respiratory System Abnormalities / therapy
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / etiology*
  • Sleep Wake Disorders / therapy
  • Treatment Outcome

Substances

  • Central Nervous System Depressants
  • Glycosaminoglycans