Preserved Sleep for the Same Level of Respiratory Disturbance in Children with Prader-Willi Syndrome

Debate remains as to how to balance the use of recombinant human growth hormone (rhGH) as an important treatment in Prader-Willi syndrome (PWS) with its potential role in obstructive sleep apnea. This single-center, retrospective study assessed differences in overnight polysomnography results between children with and without PWS and changes in respiratory parameters before and after the initiation of rhGH treatment in those with PWS. Compared with age-, sex-, and body-mass-index-matched controls (n = 87), children with PWS (n = 29) had longer total sleep time (434 +/- 72 vs. 365 +/- 116 min; p < 0.01), higher sleep efficiency (86 +/- 7 vs. 78 +/- 15%; p < 0.05), and lower arousal events (8.1 +/- 4.5 vs. 13.0 +/- 8.9 events/h; p < 0.05). Mean oxygen saturation was lower in PWS children (94.3 +/- 6.0 vs. 96.0 +/- 2.0%; p < 0.05), with no other differences in respiratory parameters between groups. Eleven children with PWS (38%) met the criteria for further analyses of the impact of rhGH; polysomnography parameters did not change with treatment. Compared with other children undergoing polysomnography, children with PWS had more favorable markers of sleep continuity and lower oxygen saturation for the same level of respiratory disturbance. rhGH administration was not associated with changes in respiratory parameters in PWS.