Sleep Breathing Disruptions in Newborns with Severe Spina Bifida
Children born with spina bifida, a birth defect affecting the spinal cord, face lifelong challenges, including an increased risk of cognitive difficulties. Recent research reveals a previously underestimated threat to their development: widespread, undetected breathing problems during sleep. A multi-center study is shedding light on this issue and suggesting a path toward improved outcomes for these vulnerable infants.
A Hidden Risk: Sleep-Disordered Breathing in Newborns
What the Study Found
Researchers at Washington University School of Medicine in St. Louis and Michigan Medicine discovered that more than half of newborns who underwent surgery for myelomeningocele – the most severe form of spina bifida – exhibited some form of sleep-disordered breathing. This finding is significant because it demonstrates these issues begin much earlier than previously understood. The study involved detailed analysis of 173 newborns, measuring breathing patterns, brain activity, muscle activity, and heart rhythms.
These breathing problems can manifest as obstructive sleep apnea, where the airway is blocked, or central sleep apnea, where the brain fails to send proper signals to breathe. Left untreated, these disruptions and resulting low oxygen levels can negatively impact attention and cognitive function.
Why Early Detection Matters
The research suggests that identifying and treating sleep-disordered breathing in infancy could be a crucial step in protecting brain development and reducing long-term cognitive and behavioral difficulties. “What if early diagnosis and treatment of something as seemingly straightforward as sleep-disordered breathing could improve cognitive development for at-risk babies?” asked Renée Shellhaas, MD, lead author of the study and a neurologist at WashU Medicine.
The study team, comprised of experts from nine centers across the US, emphasizes that the vast majority of these breathing problems would have gone undetected without comprehensive sleep studies performed before hospital discharge. St. Louis Children’s Hospital, where some study patients were treated, is now considering routine screening for high-risk babies.
What’s Next?
Researchers are continuing to follow the study participants until they reach age two to assess the long-term effects of early intervention on sleep, cognitive development, and physical progress. It is possible that this ongoing research will provide further evidence supporting the benefits of early screening and treatment. A broader effort to diagnose and treat sleep-related breathing problems in other high-risk infant populations may also emerge. If successful, this approach could represent a significant advancement in neurodevelopmental care.
Frequently Asked Questions
What is myelomeningocele?
Myelomeningocele happens when the spinal column does not form properly during early fetal development, resulting in exposure of the spinal cord. Surgery can improve motor outcomes and reduce complications, but patients remain at risk of social and learning problems.
What types of sleep-disordered breathing were observed?
The study identified both obstructive sleep apnea, where the airway is blocked, and central sleep apnea, where the brain’s drive to breathe is abnormal.
Who was involved in this research?
The study was led by researchers at Washington University School of Medicine in St. Louis and Michigan Medicine, in collaboration with experts at nine centers across the US, representing multiple specialties including neonatology, sleep medicine, and neurosurgery.
Could early intervention for sleep-disordered breathing significantly alter the developmental trajectory for children with spina bifida?