Sleep-disordered breathing in children with neurodisabilities

The prominence of sleep-disordered breathing (SDB) in children with neurodisabilities is increasingly becoming apparent. Patients can manifest not only obstructive sleep apnoea but also central sleep apnoea, nocturnal hypoxaemia and hypoventilation or often a combination thereof. The impact of SDB on quality-of-life measures has been increasingly demonstrated. This in turn is powering a paradigm shift, where investigation of SDB and subsequent treatment with surgical procedures or respiratory interventions, such as noninvasive ventilation, are increasingly considered in this cohort of patients, whereas historically they may not have been, given perceived barriers to successful treatment. In this review, we aim to summarise the literature on SDB in children with neurodisabilities published in the past two decades. We have concentrated on three main groups of children with neurodisabilities, namely those with cerebral palsy, those with inborn errors of metabolism where disease-modifying therapies are available for selected conditions and those with other genetic conditions resulting in significant neurodisability, such as Rett syndrome.