Adults with MS and NMOSD are reported to have high rates of sleep disturbances and disorders, which result in daytime fatigue. In the pediatric onset MS (POMS) population, high rates of fatigue are also reported. It is unknown if these children are at higher risk for OSA as a potential contributor to daytime fatigue.  We therefore sought to evaluate for the presence of OSA in POMS patients.

This prospective observational study included consecutive children with demyelination disorders evaluated at the Pediatric MS and Neuroinflammatory Disorders clinic, Hospital for Sick Children, Canada from June 2017 to March 2018. Parents completed the Pediatric Sleep Questionnaire. Positive answers with >0.33 suggest a risk for a pediatric sleep-related breathing disorder. The total sleep-disordered breathing score is divided into breathing, daytime sleepiness, behavior and other symptoms subscores.

Participants included those with Mono-ADS (N=49, 24F, median(IQR) 13.1(6.72) y.o.), MS (N=29, 21F, 17.72(1.30) y.o.) and other recurrent disorders including NMOSD, MOG+ and recurrent optic neuritis (N=25, 16F, 13.35(3.97) y.o.).  Total sleep-disordered breathing score threshold was reached in 10.2%, 10.3% and 16.0%, respectively. Behavioral subscales were elevated in 50.0%, 37.0% and 54.2%, respectively suggesting a high prevalence of behavioral concerns. Significant differences were not noted within the subgroups nor when comparing mono-ADS to MS and other recurrent disorders.

Children with recurrent neuroinflammatory conditions and monophasic conditions have similar levels of OSA and sleep difficulties.  High levels of behavioral problems, including inattention and hyperactivity, are present in the cohort, but appear to be independent of the presence of OSA.