title: Longitudinal evaluation of sleep-disordered breathing in children with Prader-Willi Syndrome during 2 years of growth hormone therapy.
abstract: OBJECTIVE
  To review longitudinal polysomnography data to assess sleep-related disordered breathing (SRDB) before and up to 2 years after initiation of growth hormone (GH) therapy in children with Prader-Willi syndrome (PWS).
  
  
  METHODS
  This was a retrospective review of systematic polysomnography evaluations performed in children with PWS before and at 6 weeks, 6 months, 1 year, and 2 years after initiation of GH therapy.
  
  
  RESULTS
  A total of 15 children with PWS were reviewed. At baseline, the median age was 3.7 years (range, 0.8-15.4 years), and the median body mass index percentile was 82.4 (range, 0-100). GH was discontinued in 2 of these 15 children owing to the occurrence of severe obstructive sleep apnea after 6 weeks of GH therapy. The remaining 13 children who were followed for up to 2 years on GH therapy demonstrated no statistically significant trends over time for any adverse sleep-related outcomes, specifically obstructive or central sleep apnea.
  
  
  CONCLUSIONS
  In young children with PWS with known SRDB at baseline, the first few weeks after initiation of GH therapy may represent a vulnerable time for the development of significant SRDB. However, most children with PWS did not show significant changes in SRDB after 2 years of GH therapy. We conclude that long-term GH therapy appears to be safe after an initial period of increased risk in the context of SRDB in children with PWS.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Suhail
authors.initials: S
authors.lastname: Al-Saleh
authors.forename: Amal
authors.initials: A
authors.lastname: Al-Naimi
authors.forename: Jill
authors.initials: J
authors.lastname: Hamilton
authors.forename: Allison
authors.initials: A
authors.lastname: Zweerink
authors.forename: Andrea
authors.initials: A
authors.lastname: Iaboni
authors.forename: Indra
authors.initials: I
authors.lastname: Narang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D017286:Polysomnography; D011218:Prader-Willi Syndrome / Q000188:drug therapy*; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000139:chemically induced*; D013997:Time Factors
chemical_list: D019382:Human Growth Hormone