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Volume 15 No. 01
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Accepted Papers

Scientific Investigations

Polysomnography Findings and Sleep Disorders in Children With Alternating Hemiplegia of Childhood

Sujay Kansagra, MD1; Ryan Ghusayni, MD1; Bassil Kherallah, MD1; Talha Gunduz, MD1; Melissa McLean, BS1; Lyndsey Prange, MSN, APRN, CPNP-PC1; Richard M. Kravitz, MD2; Mohamad A. Mikati, MD1
1Division of Pediatric Neurology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina; 2Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina

Study Objectives:

Patients with alternating hemiplegia of childhood (AHC) experience bouts of hemiplegia and other paroxysmal spells that resolve during sleep. Patients often have multiple comorbidities that could negatively affect sleep, yet sleep quality and sleep pathology in AHC are not well characterized. This study aimed to report sleep data from both polysomnography (PSG) and clinical evaluations in children with AHC.


We analyzed nocturnal PSG and clinical sleep evaluation results of a cohort of 22 consecutive pediatric patients with AHC who were seen in our AHC multidisciplinary clinic and who underwent evaluations according to our comprehensive AHC clinical pathway. This pathway includes, regardless of presenting symptoms, baseline PSG and evaluation by a board-certified pediatric sleep specialist.


Out of 22 patients, 20 had at least one type of sleep problem. Six had obstructive sleep apnea as documented on polysomnogram, of whom two had no prior report of sleep-disordered breathing symptoms. Patients had abnormal mean overall apnea-hypopnea index of 5.8 (range 0–38.7) events/h and an abnormal mean arousal index of 15.0 (range 4.8–46.6) events/h. Based on sleep history, 16 patients had difficulty falling asleep, staying asleep, or both; 9 had behavioral insomnia of childhood; and 2 had delayed sleep-wake phase syndrome.


Sleep dysfunction is common among children with AHC. Physicians should routinely screen for sleep pathology, with a low threshold to obtain a nocturnal PSG.


Kansagra S, Ghusayni R, Kherallah B, Gunduz T, McLean M, Prange L, Kravitz RM, Mikati MA. Polysomnography findings and sleep disorders in children with alternating hemiplegia of childhood. J Clin Sleep Med. 2019;15(1):65–70.

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