O009 Predictors of sleep disordered breathing in children with neuromuscular disorders

Abstract Introduction Children with neuromuscular disorders (NMD) can develop sleep disordered breathing (SDB). Screening for SDB (obstructive sleep apnoea (OSA) and hypoventilation) could inform when resource limited polysomnography is warranted. Factors associated with SDB are not well described. Methods Children with NMD from three sites had laboratory polysomnogram and collection of demographics, anthropometrics, motor function, pulmonary function, patient self-reported/parent-reported outcome measures. Associations with OSA and hypoventilation were determined. Significant factors were examined with Binary Logistic Regression to construct predictive models. Model power was assessed by Receiver Operator Characteristic curves and area under the curve (AUC). Regression coefficients were used to construct predictive equations. Results There were 64 participants (72% male), median age 11.5 years, 20% used non-invasive ventilation (NIV). SDB was present in 48%, OSA 31%, hypoventilation 16%. Factors associated with OSA were loss of ambulation, higher age, lower slow vital capacity (SVC) z-score, higher lung clearance index (LCI2.5%) and abnormal self-reported hypoventilation symptom score. Factors associated with hypoventilation were BMI z-score, congenital myopathy/congenital muscular dystrophy, higher parent and self-reported hypoventilation symptom score, higher self-reported hyperactivity/externalising behaviour score and lower self-reported health-related and total quality-of-life score. The predictive model with the highest AUC for OSA combined SVC z-score and LCI2.5% and for hypoventilation combined self-reported hypoventilation symptom score, hyperactivity score and health-related quality-of-life score. Discussion SDB prevalence was high, likely under-estimated by current use of NIV. The predictive models performed well as screening tools, including novel factors such as patient-reported outcome measures and non-volitional pulmonary function tests.