Sleep Disordered Breathing in Neurodevelopmental Disorders

Sleep problems are common in children with neurodevelopmental disorders (NDD). In addition to insomnia, sleep disordered breathing (SDB) is ubiquitous and an important therapeutic target within this population. In this review, we discuss the evaluation and management of SDB in children with NDDs, with a particular emphasis on syndrome-specific considerations. Common NDDs that have increased risk of SDB include autism spectrum disorder, Down syndrome, myelomeningocele and Chiari malformation, attention deficit hyperactivity disorder, Prader–Willi syndrome, epilepsy, and 22q deletion syndrome. We discuss a variety of treatment options and advocate the need for a personalized treatment plan contingent on the underlying disease characteristics of the child and family preferences. Advancements in drug-induced sleep endoscopy and hypoglossal nerve stimulation represent exciting new surgical options for those children who cannot tolerate positive airway pressure. Children with a myriad of NDDs are at increased risk for SDB, for which treatment may result in clinically important changes in quality of life. Clinicians need to consider syndrome-specific features of SDB in both the evaluation and treatment phases of management.