sleep medicine in children Flashcards
before 36 weeks is it normal for children to periodically stop breathing while sleeping?
yes
what are the abnormal if infants <36 weeks stop breathing periodically while sleeping?
colour change
HR change
how long do 6 month old children typically sleep?
14-15hrs made up of 2 long sleep period at night and 1-2 naps during the day
how long do 2 year olds typically sleep?
12 hrs, one day time nap
what sort of sleep do prepubescent children have?
highly efficient
what sort of sleep do adolescents have?
more awakenings then prepubuscent children. require more sleep but dont get it
what are the assessments to monitor sleep?
polysomnopgraphy direct behavioural observation time-lapse video movement sensors on matress O2 or CO2 monitoring
after what age is enuresis and napping abnormal?
3-5y
if a one year old sleeps 8 hours at night and doesnt nap is it abnormal?
yes
is sleep walking abnormal in toddlers?
no
if an unmedicated adult is unarousable from sleep is this normal?
no
are sleep terrors normal?
yes
are hypnic jerks abnormal?
yes
what are the six main causes of sleepiness?
- behavioural problems- infants usually wake up during the night
- medication
- neurological disorders
- insufficient sleep
- OSAS
- narcolepsy
what is primary snoring?
snoring withous apnoea, hypoventilation, hypercarbia, daytime symptoms
what can primary snoring progress to?
OSAS
what are the associated morbidities with OSAS?
failure to thrive
neurocognitive defects/ ADHD
(systemic hypertension and cor pulminale, both rare)
what causes OSAS in children?
inflammation of the tonsils and adenoids
what is common in child OSAS but not adult?
mouth breathing, enlarged tonsils, hypoventilation
what is common in adult OSAS but not child?
daytime sleepiness, obesity, apnoea
what is the treatment for OSAS in children?
adenotonsillectomy
CPAP
weight loss
avoid tobacco smoke
how can chronic neonatal lung disease affect sleep?
it can cause the hypoxaemia in REM sleep
also causes cardiac complicatios
hoe can CF affect sleep
FEV1 is 30-60% which causes decrease in oxygen saturation which can cause less REM and more awakenings
can asthma disturb sleep?
yes
how does cerebral palsy affect sleep?
fragmented sleep/delayed onset and issues with melatonin
how does down syndrome affect sleep?
it can cause OSAS
how does Prader-Willi syndrome affect sleep?
can cause excessive daytime sleepiness
how can duchenne muscular dystrophy affect sleep?
there is nocturnal desaturation if FVC < 1litre
