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Chiari malformation and sleep related breathing disorders.
J Neurol Neurosurg Psychiatry. 2007 Dec; 78(12):1344-8.JN

Abstract

OBJECTIVE

To estimate the frequency, mechanisms and predictive factors of sleep apnoea syndrome (SAS) in a large group of children and adults with type I (CMI) and II (CMII) Chiari malformation (CM).

BACKGROUND

The anatomical and functional integrity of both respiratory circuits and lower cranial nerves controlling the upper airway is necessary for breathing control during sleep. These latter structures may be altered in CM, and a few investigations have reported CM related sleep disordered breathing.

METHODS

Forty-six consecutive unrelated patients with CM (40 CMI, six CMII), of which 20 were children (eight males) and 26 were adults (12 males), underwent physical, neurological and oto-rhino-laryngoscopic examination, MRI and polysomnography.

RESULTS

SAS was present in 31 (67.4%) of the patients with CM (70% of CMI, 50% of CMII, including mainly children). Sixty per cent of children with CM exhibited SAS, including 35% with obstructive (OSAS) and 25% with central (CSAS) sleep apnoea syndrome. SAS was observed in 73% of CM adults (57.7% OSAS, 15.4% CSAS). Severe SAS was found in 23% of CM adults. Multiple regression analysis revealed that age, type II Chiari and vocal cord paralysis predicted the central apnoea index.

CONCLUSION

SAS is highly prevalent in all age groups of patients suffering from CM. CSAS, a rare condition in the general population, was common among the patients with CM in our study. Sleep disordered breathing associated with CM may explain the high frequency of respiratory failures observed during curative surgery of CM. Our results suggest that SAS should be systematically screened for in patients with CM, especially before surgery.

Authors+Show Affiliations

Service de Neurologie, Hôpital Gui-de-Chauliac, INSERM U888 Montpellier, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17400590

Citation

Dauvilliers, Y, et al. "Chiari Malformation and Sleep Related Breathing Disorders." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 78, no. 12, 2007, pp. 1344-8.
Dauvilliers Y, Stal V, Abril B, et al. Chiari malformation and sleep related breathing disorders. J Neurol Neurosurg Psychiatry. 2007;78(12):1344-8.
Dauvilliers, Y., Stal, V., Abril, B., Coubes, P., Bobin, S., Touchon, J., Escourrou, P., Parker, F., & Bourgin, P. (2007). Chiari malformation and sleep related breathing disorders. Journal of Neurology, Neurosurgery, and Psychiatry, 78(12), 1344-8.
Dauvilliers Y, et al. Chiari Malformation and Sleep Related Breathing Disorders. J Neurol Neurosurg Psychiatry. 2007;78(12):1344-8. PubMed PMID: 17400590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chiari malformation and sleep related breathing disorders. AU - Dauvilliers,Y, AU - Stal,V, AU - Abril,B, AU - Coubes,P, AU - Bobin,S, AU - Touchon,J, AU - Escourrou,P, AU - Parker,F, AU - Bourgin,P, Y1 - 2007/03/30/ PY - 2007/4/3/pubmed PY - 2007/12/11/medline PY - 2007/4/3/entrez SP - 1344 EP - 8 JF - Journal of neurology, neurosurgery, and psychiatry JO - J Neurol Neurosurg Psychiatry VL - 78 IS - 12 N2 - OBJECTIVE: To estimate the frequency, mechanisms and predictive factors of sleep apnoea syndrome (SAS) in a large group of children and adults with type I (CMI) and II (CMII) Chiari malformation (CM). BACKGROUND: The anatomical and functional integrity of both respiratory circuits and lower cranial nerves controlling the upper airway is necessary for breathing control during sleep. These latter structures may be altered in CM, and a few investigations have reported CM related sleep disordered breathing. METHODS: Forty-six consecutive unrelated patients with CM (40 CMI, six CMII), of which 20 were children (eight males) and 26 were adults (12 males), underwent physical, neurological and oto-rhino-laryngoscopic examination, MRI and polysomnography. RESULTS: SAS was present in 31 (67.4%) of the patients with CM (70% of CMI, 50% of CMII, including mainly children). Sixty per cent of children with CM exhibited SAS, including 35% with obstructive (OSAS) and 25% with central (CSAS) sleep apnoea syndrome. SAS was observed in 73% of CM adults (57.7% OSAS, 15.4% CSAS). Severe SAS was found in 23% of CM adults. Multiple regression analysis revealed that age, type II Chiari and vocal cord paralysis predicted the central apnoea index. CONCLUSION: SAS is highly prevalent in all age groups of patients suffering from CM. CSAS, a rare condition in the general population, was common among the patients with CM in our study. Sleep disordered breathing associated with CM may explain the high frequency of respiratory failures observed during curative surgery of CM. Our results suggest that SAS should be systematically screened for in patients with CM, especially before surgery. SN - 1468-330X UR - https://www.unboundmedicine.com/medline/citation/17400590/Chiari_malformation_and_sleep_related_breathing_disorders_ L2 - https://jnnp.bmj.com/lookup/pmidlookup?view=long&pmid=17400590 DB - PRIME DP - Unbound Medicine ER -