Obstructive sleep apnea in children with cerebral palsy and epilepsy

Aim To examine the risk of obstructive sleep apnea ( OSA ) in children with cerebral palsy ( CP ) and/or epilepsy. Method This cross‐sectional study employs the Pediatric Sleep Questionnaire ( PSQ ), the Gross Motor Function Classification System ( GMFCS ), and chart review to identify symptoms of OSA in children presenting to a multi‐specialty pediatric healthcare institution. Results Two‐hundred and fifteen patients were grouped into those with epilepsy ( n =54), CP ( n =18), both ( n =55), and neither (comparison group, n =88). The comparison group comprised children with developmental disabilities but not children with typical development. Significantly increased PSQ scores (indicating increased risk of OSA ) were found among children with CP (58%) and CP with epilepsy (67%) than among the comparison group (27%; p <0.001 and p <0.0001 respectively). Children with both CP and epilepsy had a greater number of increased PSQ scores compared with CP alone ( p <0.05). Increased PSQ scores were observed with increasing CP severity as measured using the GMFCS . The PSQ identified more children at risk of OSA (46%) than did the medical record review for symptoms of OSA (8.2%, p <0.001). Interpretation Children with CP of greater severity or comorbid epilepsy are at increased risk of OSA . This study supports the routine questionnaire‐based assessment for OSA as a regular part of the care of all children with CP , especially in those with more severe CP and those with epilepsy.