Sleep disturbances in children

Question 1

Normal sleeping trends in infants -adolescence

Answer 1

<6months
-REM onset
-sleeps 16-18 hours: wakes up every 3/4 hours
-apneic breathing
6 months
-14-15 hours sleep: 2 long sleeps at night and 1/2 nap
2 years:
-12 hours sleep at night
-1 nap
Preadolescence: very good sleeping pattern
Adolescence: sleep disturbances- need more sleep/get less

Question 2

Investigations for sleep patterns in children

Answer 2

• polysomnography
• 02/co2 saturation levels
• cot monitors
• observational study
• time-lapse videos

Question 3

Signs of abnormal behaviour?

Answer 3

• past the ages of 3-5 years awakenings during the night and enuresis
• inability to awaken unmedicated patients
• in infants: 8 hours sleep during the night with no naps during the day

Question 4

Normal behaviour which is thought to be abnormal?

Answer 4

• night terrors
• hypnic awakening
• sleep walking in toddlers
• REM patterns

Question 5

causes of sleepiness

Answer 5

• medication
• behavioural problems
• neurological disorders

Question 6

Cause of XS sleepiness

Answer 6

• Narcolepsy
• OSAS
• insufficient sleep

Question 7

Disorders which lead to abnormal sleep patterns

Answer 7

• Asthma
• Down syndrome : OSAS
• Cystic Fibrosis: less REM and more awakenings due to reduced FEV1 and so sats reduced
• Praeder-Willi syndrome:XS daytime sleeping
• Cerebral palsy : disrupted sleeping
• Chronic neonatal lung disorder: hypoxemia in REM sleep

Question 8

Primary snoring

Answer 8

• can lead to OSAS
• Symptoms include: hypercapnia,hyperventilation, hypoxia, daytime syndromes
• treatment: adenotonsillectomy