Pediatric Sleep Medicine Flashcards
What is behavioral insomnia of childhood, sleep onset association type?
- The child needs special conditions to fall asleep
- Requires conditions that are problematic or demanding
- Needs the parents intervention to fall back asleep
What is behavioral insomnia of childhood, sleep onset association type and limit setting type?
- Child stalls or delays at bedtime
- Child falls asleep in a setting other than his own bed
At what age are healthy babies able to fall and stay asleep for 11 to 12 hours without a feeding?
6 months
At what age can you address sleep onset association insomnia?
6 months
What is a technique called bedtime fading?
In a patient that takes longer to fall asleep than the desired bedtime, you put them to bed at that bedtime and then gradually move the bedtime earlier and earlier until the desired bedtime is reached.
In CCHS, in what stage of sleep will hypoventilation most commonly be seen?
NREM sleep (not REM)
What is primary central sleep apnea of infancy?
- Occurs in infants > 37 weeks conceptional age (primary central sleep apnea of prematurity is < 37 weeks)
- An observed apnea or cyanosis or oxygen desaturation detected by monitoring
- Prolonged (> 20 seconds) central apneas or periodic breathing for greater than or equal to 5% of the total sleep time
What is the treatment for primary central sleep apnea of infancy/prematurity?
Theophylline or O2
What is the treatment for periodic breathing if it occurs on a background of hypoxemia?
O2, theophylline and caffeine
If the pediatric patient does not have any apneas/hypopneas, what are the alternate criteria for making a diagnosis of sleep apnea?
- > 25% TST
- PaCO2 > 50 mm Hg and
- The child snores or
- Paradoxical thoracoabdominal movements or
- Flattened inspiratory nasal pressure waveform
What are the minimum PLM index to diagnose PLMD in peds
5 for peds
15 for adults
What is settling?
It’s the process in kids where daytime napping decreases and nighttime sleep increases
CCHS is a genetic disorder involving what gene and what abnormality of that gene?
Trinucleotide repeats within the PHOX2B gene