A study was presented at ACVIM this year (2025) by Drs. Parker et al that evaluated sleep scores, neuropathic pain scores and perceived QOL by owners in a cohort of Cavalier King Charles Spaniels. The premise for this study was that poor sleep might exacerbate chronic pain in humans. They enrolled 68 CKCS, 37 of whom were diagnosed with caudal occipital malformation syndrome (COMs). Of these 37 dogs, 19 of them were considered to be clinical for the diagnosis and 18 were not clinically affected. Interestingly, dogs with clinical COMS also had greater difficulty falling asleep, ability to stay asleep for long periods of time, and overall poorer sleep quality. It was noted that more dogs slept with their heads propped up than not in the clinically affected group.
Why are they sleeping more poorly?
The authors propose that dogs with COMs may have chronic pain, which results in greater sleep disturbances. Additionally, part of the COMs complex is kinking of the brainstem which is where respiratory centers and the reticular activating system (RAS) are housed. The authors proposed that disrupted sleep could be due to alterations of these systems as well. Lastly, these dogs are brachycephalic which can result in snoring while sleeping, which is also linked to poorer sleep scores.
What do we do about it?
Owners can purchase a “fit bark” or other activity monitor that tracks their dog’s sleeping patterns. If frequent sleep disturbances are noted, initiation of pain management, investigation into brachycephalic airway surgery, or allowing for a “propped” head position might be indicated to improve sleep. The pain management medication I suggest in these cases is gabapentin or pregabalin, however excessive sedation should be monitored.
Although not exactly in line with our summer of cranial nerves, I thought this study was interesting and worth sharing. Stay tuned for more Tidbits gleaned from the national meeting this year!
Thanks for reading. I hope you have a wonderful week and enjoy these dog days of summer with those you love.