Sleep disordered breathing in Bardet-Biedl Syndrome

Int J Pediatr Otorhinolaryngol. 2017 Nov:102:127-132. doi: 10.1016/j.ijporl.2017.09.004. Epub 2017 Sep 12.

Abstract

Introduction: Bardet-Biedl Syndrome (BBS) is an autosomal recessive ciliopathy, and obesity is among its defining characteristics. Consequently, the incidence of sleep disordered breathing (SDB) in this population is expected to be high. Due to its relative rarity, the nature of SDB in this population is poorly described. The objective of this study was to review a single institutional experience in the assessment and management of SDB in patients with BBS.

Methods: Retrospective chart review of tertiary care, academic pediatric hospital.

Results: 20 patients with BBS were evaluated over a 25-year period. Median age at initial consultation was 69 months; half of these patients were referred before the diagnosis of BBS was made. Eighteen of twenty patients had symptoms of sleep-disordered breathing. Median follow-up duration was 17.5 months. A wide range of polysomnographic outcomes was observed, including obstructive apnea-hypopnea indexes of 0-195 events/hour. Patients were managed with adenotonsillectomy and/or non-invasive positive pressure ventilation.

Conclusions: SDB is commonly seen in BBS. These patients should be routinely screened for OSA and if present, a polysomnogram should be obtained. Based on patient characteristics, the failure rate of primary surgical intervention, namely adenotonsillectomy, is expected to be high. Further investigation into the role of ancillary diagnostic testing is still needed.

Keywords: Apnea-hypopnea index; Bardet-Biedl Syndrome; Obesity; Obstructive sleep apnea; Polysomnography; Sleep disordered breathing.

MeSH terms

  • Adenoidectomy / adverse effects
  • Adenoidectomy / methods
  • Adolescent
  • Bardet-Biedl Syndrome / complications*
  • Body Mass Index
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Male
  • Noninvasive Ventilation / methods
  • Obesity / complications*
  • Polysomnography / methods
  • Retrospective Studies
  • Sleep Apnea Syndromes / complications*
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / surgery
  • Tonsillectomy / adverse effects
  • Tonsillectomy / methods