Neuromuscular Disorders

Is you child having a neuromuscular problem?

Are you aware that they can have breathing problems during sleep?

Children with neuromuscular problems like Duchenne’s muscular dystrophy, Spino-muscular atrophy, congenital myopathies and other muscular dystrophies can develop difficulty in breathing during sleep.

But why does this happen?

  • Children with neuromuscular problems have weakness in the body muscles. This also involves the muscles of breathing.
  • During sleeping the muscles of the body relax further called as hypotonia especially during dream sleep. During these stages the breathing can get difficult.

What are the problems that can happen during sleep?

  • Breathing problems in sleep can occur such as pauses in breathing (sleep apneas & hypopneas) and shallow breathing (hypoventilation) leading to accumulation of carbon dioxide (waste gas). Parents can sometimes witness the pauses in breathing. These might be missed since these can occur in some specific phases of sleep.
  • These factors lead to frequent awakenings during sleep (arousals) which deteriorate the quality of sleep or a disturbed sleep (sleep fragmentation).
  • Child can have morning headaches, might feel dull and tired during the day.
  • This shallow breathing would also lead to frequent chest infections

How do I suspect that my child is having sleep problems?

  • Children with neuromuscular who are now having difficulty in walking can start having breathing problems in sleep.
  • Lung function is also a good guide. If the values in the spirometry are low then also it indicates that sleep problems could be developing.
  • If the child is having recurrent chest infections requiring antibiotics, this can be another indication.
  • Also look for any nighttime problems such as pause in breathing, gasping and noisy breathing. Also look at daytimes symptoms such as headaches and tiredness.

How can we detect sleep problems during sleep?

  • If we suspect sleep problems then we should go ahead with a sleep study.
  • This will help understand child’s breathing pattern during sleep, any apneas (cessation in breathing), hypoventilation (shallow breathing), and retention of carbon dioxide (waste gas).
  • For more information on sleep study visit our page on Pediatric Sleep Studies