Sleep development in children with congenital and acquired hypothyroidism.

To determine how thyroid hormone deficiency before birth influences early development of the human central nervous system, we examined sleep development in children with congenital hypothyroidism using all-night polysomnography. Although the sleep-wakefulness circadian rhythm was not disturbed, two patients under 1 year of age showed mild decreases of REM sleep. Rapid eye movements during REM sleep were significantly decreased in one patient in whom thyroxine replacement was delayed. Regarding phasic body movements during sleep, generalized gross movements were more frequently disturbed than localized muscle twitches, and even after L-thyroxine replacement, they were significantly reduced when compared with those in controls. Children with acquired hypothyroidism and neonatal transient hyperthyrotropinemia showed no severe abnormalities of the sleep parameters examined here. Sleep development in patients with congenital hypothyroidism is believed to be useful for regional evaluation of the brain impairment in congenital hypothyroidism.