title: Sleep-disordered breathing in Prader-Willi syndrome and its association with neurobehavioral abnormalities.
abstract: OBJECTIVE
  To determine the prevalence and type of sleep-disordered breathing among patients with Prader-Willi syndrome (PWS) and its relationship to such neurobehavioral abnormalities as mental retardation, obsessive-compulsive behavior, and conduct disorders.
  
  
  METHODS
  Polysomnography (PSG) studies were conducted in 13 unselected subjects with PWS (age 1.5 to 28 years). PSG results were compared with tests of behavior and cognition (Development Behavior Checklist [DBC], Auditory Continuous Performance Test [ACPT], and Wechsler Intelligence Scale appropriate for age).
  
  
  RESULTS
  Nine of 13 (69%) subjects had > 10 apneas and hypopneas per hour of sleep. Apart from a 2-year-old subject with normal body weight who demonstrated severe central hypopnea in rapid eye movement sleep, the sleep-breathing disturbance was due to upper airway obstruction. Age-adjusted body mass index was associated with more severe hypoxemia during sleep (min SaO2, r = -.87, P < .005) and more sleep disruption (arousals/hour of sleep, r = .62, P < .05; sleep efficiency, r = -.66, P < .05). Increasing severity of obstructive sleep apnea (OSA) or sleep disturbance was associated with daytime inactivity/sleepiness and autistic-relating behavior (DBC) and with impulsiveness (ACPT). Unexpectedly, sleep hypoxemia appeared to be predictive of increased performance IQ.
  
  
  CONCLUSIONS
  OSA is prevalent among subjects with PWS and is associated with increased body mass, daytime inactivity/ sleepiness, and some behavioral disturbances.
authors.affiliation: Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, South Australia, Australia.
authors.forename: F J
authors.initials: FJ
authors.lastname: O'Donoghue
authors.forename: D
authors.initials: D
authors.lastname: Camfferman
authors.forename: J D
authors.initials: JD
authors.lastname: Kennedy
authors.forename: A J
authors.initials: AJ
authors.lastname: Martin
authors.forename: T
authors.initials: T
authors.lastname: Couper
authors.forename: L D
authors.initials: LD
authors.lastname: Lack
authors.forename: K
authors.initials: K
authors.lastname: Lushington
authors.forename: R D
authors.initials: RD
authors.lastname: McEvoy
mesh_terms: D000293:Adolescent; D000328:Adult; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology; D015992:Body Mass Index; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D017286:Polysomnography; D011218:Prader-Willi Syndrome / Q000453:epidemiology*; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*