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Pediatric patients with Moyamoya arteriopathy frequently experience sleep fragmentation, daytime fatigue, and a trend toward shorter REM latency, without clinically significant sleep-disordered breathing. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 18, 2026Nature and Science of Sleep0 citationsOpen Access

Polysomnographic Characteristics and Sleep Disorders in Pediatric Moyamoya Arteriopathy

KSKantisa SirianansopaPrince of Songkla University RAReshma AminUniversity of Toronto JCJackie ChiangUniversity of Toronto

Key Points

This study aims to describe the polysomnographic characteristics and sleep-related symptoms in pediatric patients with Moyamoya arteriopathy.
Conducted a retrospective case series of pediatric patients with Moyamoya arteriopathy referred to a sleep clinic.
Included clinical, demographic, genetic, and polysomnographic data.
Performed level 1 polysomnography and multiple sleep latency tests.
Sleep fragmentation was observed in 90.9% of patients (n=10).
A trend toward shorter REM latency was noted compared to normative values.
Daytime fatigue was reported by 54.5% of patients (n=6).

Abstract

Kantisa Sirianansopa,1,2 Reshma Amin,2â 4 Jackie Chiang2,3 1Division of Pulmonary Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; 2Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; 3Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; 4Child Health and Evaluative Science, SickKids Research Institute, Toronto, Ontario, CanadaCorrespondence: Reshma Amin, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada, M5G 1X8, Tel +1 416-813-7654 ext. 415683, Email reshma.amin@sickkids.caPurpose: This study aimed to describe the polysomnographic characteristics and sleep-related symptoms in pediatric patients with Moyamoya arteriopathy (MMA) referred for sleep evaluation.Patients and Methods: We conducted a retrospective case series of pediatric patients with MMA who were referred to the sleep clinic at The Hospital for Sick Children, Toronto, Canada, and underwent level 1 polysomnography (PSG) between 2014 and 2024. Clinical, demographic, genetic, and sleep-related data, including PSG and multiple sleep latency test (MSLT) findings were reviewed.Results: Eleven pediatric patients were included, with a median (IQR) age of 15 (13, 17) years. Sleep fragmentation was commonly observed on PSG (n=10, 90.9%), while no patients demonstrated clinically significant sleep-disordered breathing. A trend toward shorter REM latency was noted compared with age-matched normative values. Daytime fatigue was the most frequently reported symptom (n=6, 54.5%). Two patients underwent MSLT due to persistent hypersomnolence; one met diagnostic criteria for narcolepsy.Conclusion: In this retrospective case series, sleep fragmentation and a trend toward shorter REM latency were commonly observed in pediatric patients with MMA. However, given the small sample size and absence of pre-revascularization baseline data, these findings should be interpreted with caution. These results are descriptive and hypothesis-generating, and further prospective studies are needed to better understand sleep disturbances in this population.Keywords: moyamoya arteriopathy, sleep fragmentation, REM latency, hypersomnolence, polysomnography, pediatric

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