Polysomnographic Characteristics and Sleep Disorders in Pediatric Moyamoya Arteriopathy.

Purpose: 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.