sleep apnoea in children Flashcards
when do infants start to have a more regular respiratory pattern
after 36 weeks
describe an infant’s sleep pattern in the first 6 months
spend 14-15 hours asleep
2 longer sleep periods at night
1-2 daytime naps
describe an infant’s sleep pattern in their 2nd year of life
12 hours asleep
1 daytime nap
what gold standard test is used to assess sleep pattern?
polysomnography
describe what is involved in a polysomnography study (5)
O2 saturation (pulse oximetry) ECG EMG - electromyography - nerve and muscle cell function Abdominal wall movement oronasal flow
what is considered ‘abnormal’ sleep behaviour in a 1 year old?
if they sleep 8 hours at night and don’t nap throughout the day
what are some normal childhood sleep behaviours
sleep walking
sleep terrors
hypnic jerks
obstructive sleep apnoea in children
most common in pre- school children
can cause failure to thrive, neurocognitive defects/adhd, systemic hypertension or cor pulmonale - enlargement of the right side of the heart
treatment for sleep apnoea in children
Adenotonsillectomy
(CPAP)
Weight loss
Avoid environmental tobacco smoke
respiratory disorders in children
Chronic neonatal lung disease - hypoxaemia in REM sleep (similar COPD)
Cystic fibrosis
FEV1 30-60%
Asthma
neurological disorders related to sleep apnoea in children
cerebral palsy
down syndrome
prader-willi syndrome- excessive daytime sleepiness
duchenne’s MD - neuromuscular disease- death due to respiratory failure
Newborns sleep pattern?
16-18 hours asleep
sleep-wake states alternate in 3-4 hour cycles
then start to adapt to light-dark/social cues
what is REM rapid eye movement?
as you fall asleep you cycle between REM and non-REM sleep.
During REM sleep, your eyes move quickly in different directions
Dreams typically happen during REM sleep
which age group of children have highly efficient sleep?
prepubertal
other than polysomnography what other methods of sleep assessment are there for children? (4)
Direct behavioural observation
Time-lapse video
Movement sensors in cot mattress
Oxygen/CO2 monitoring
what normal phenomena are there in children?
sleep walking
sleep terrors
hypnic jerks
primary snoring?
snoring without apnea, hypoventilation, hypoxia, hypercarbia, daytime symptoms
10% prevalence
