0867 SLEEP DISORDERED BREATHING IS HIGHLY PREVALENT AMONG NEWBORNS WITH MYELOMENINGOCELE

Abstract Introduction: Children with myelomeningocele are at risk for sleep-disordered breathing (SDB), possibly due to comorbid hydrocephalus and Chiari II malformations. Yet, objective assessments of their sleep in the newborn period have not been published. The goal of this study was to compare SDB in newborns with and without myelomeningocele, in the absence of obvious additional risk factors for SDB. Methods: Twenty newborns with myelomeningocele (12 male; mean gestational age 38 ± 2.6 weeks) who had undergone fetal (n=5) or postnatal (n=15) surgical repair were monitored with 12-hour attended polysomnography during the neonatal hospital admission at mean postnatal age of 8 ± 7.8 days. These newborns’ sleep measures were compared to those of (postmenstrual) age-matched subjects admitted to the newborn ICU for non-neurologic concerns. Results: Every newborn with myelomeningocele had SDB. The mean apnea hypopnea index (AHI) (32.4 ± 21.8) for these subjects was significantly higher than that of the comparison group (18.8+11.0) (conditional logistic regression, p=0.035, OR 1.11, 95% CI 1.01–1.23, per 1 point increase in AHI). AHI was highest during active sleep for both myelomeningocele (48.9 ± 26.8) and comparison (29.8 ± 18.9) newborns. The mean oxygen saturation of subjects with myelomeningocele (94.1 ± 3.1) was slightly lower than that of comparison subjects (96.4 ± 2.2) (p = 0.05, OR = 0.68, 95% CI 0.46–0.99). Time spent in specific sleep wake stages was not different between groups. Conclusion: SDB is ubiquitous among newborn infants with myelomeningocele. As treatment of SDB has long-term benefit for behavior and general health among older children, screening and treating sleep apnea in newborns with myelomeningocele may provide a new, worthwhile opportunity to optimize health at the very start of life. Support (If Any): This work was supported by a grant from the American Sleep Medicine Foundation and the University of Michigan Barwick Scholar Award.