Sleep Medicine in Children Flashcards
What kind of breathing is normal before 36 weeks?
Periodic/apneic breathing
Increased regular resp rate after 36 weeks
What is the sleeping pattern of neonates?
Sleep for 16-18h a day
Sleep wake states in 2-4h cycles then start to adapt to light/social cues
What kind of breathing is normal in infants?
Periodic breathing - periods of not breathing and then rapid breathing
By 6 months, what are most infants sleep patterns like?
14-15 hours of sleep
2 longer sleep periods at night
1-2 day time naps
How do most 2 year olds sleep?
12 hours of sleep and 1 day time nap
As age increases how does the ratio of REM to NREM sleep change?
Have less REM sleep and more NREM
What investigations may be used to study sleep in children?
Polysomnography
Direct behavioural observation (time lapse video)
Movement sensors in cot mattress
Oxygen/CO2 monitoring
After which age is napping/enuresis abnormal?
After 3-5 years
What are normal sleep phenomena that occur in children?
Sleep walking
Sleep terror
Hypnic jerk
What things may cause sleeplessness in kids?
Behavioural problems
Medications
Neurological disorders (melatonin)
What kids may cause excessive sleepiness in kids?
Insufficient sleep
OSAS
Nacrolepsy
What is primary snoring?
Snoring without apnoea, hypoventilation, hypoxia, hypercapnia, daytime symptoms
How can primary snoring sometimes be managed?
Adenotonsillectomy
What are some key differences between OSA in kids and in adults?
Adults - daytime sleepiness main symptom but kids experience this less
Obesity more common in adults
Mouth breathing common in kids
Enlarged tonsils common in kids
In adults obstructive pattern tends to be apnoea, in kids it tends to be hypoventilation
How is OSA managed in children?
Adenotonsillectomy, CPAP, weight loss, avoid environmental tobacco smoke
What respiratory disorders may lead to sleep issues in children?
Chronic lung disease –> hypoxaemia in REM sleep + cardiac complications
CF - reduced FEV1, leads to less REM sleep and more awakenings
What neurological disorders lead to sleeping problems in children?
Cerebral palsy - fragmented sleep/delayed onset
Down’s - OSAS
Prader-Willi syndrome - excessive daytime sleepiness
Duchenne’s MD - death due to respiratory failure
How is survival prolonged in Duchenne’s MD?
BiPAP
