Sleeping Disorders in Children Flashcards
Respiratory pattern in infants
Periodic/apnoeic before 36 weeks
REM onset rapid and spend more time in it
New born respiratory pattern (3)
16-18h asleep
Sleep-wake states alternate in 3-4h cycles
Slowly start to adapt to light-dark/social cues
6 months
14-15 hour asleep
2 longer sleep periods at night
1-2 daytime naps
2nd year
12 hours asleep
1 day time nap
Prepurbetal children
High efficient sleep
Adolescence
Increased awakening
Need more/Obtain less
Assessment (5)
Polysomnography Direct behavioural observation Time-lapse video Movement sensors in cot mattress Oxygen/CO2 monitoring
Abnormal (3)
Napping and enuresis after 3-5 years
Sleeping for 8 hours with no nap- 1 years old
Unmedicated adult is unrousable from sleep
Normal (4)
Sleep walking in toddlers
REM onset in first 3 months
Sleep terrors
Hypnic Jerks
Causes of Sleeplessness (3)
Mainly behavioral problems
Medication
Neurological disorders- Melatonin
Cause of excessive sleepiness (5)
Insufficient sleep OSAS Narcolepsy -Often not diagnosed in childhood -Cataplexy -Orexin deficiency
Primary Snoring
Snoring without apnoea, hypoventilation, hypoxia, hypercarbia, daytime symptoms
OSAS prevalence andreason why
Commonest in pre-school child
Adenoids are larger in children
Morbidity of OSAS
- Failure to thrive
- Neurocognitive defects/adhd
- Systemic hypertension
- Cor pulmonale
Differences between OSAS in Adults and Children
Day time sleepiness is main symptom in adults
Obesity is in the majority of adult cases
Mouth breathing is common in children
Enlarged tonsils are common in children
The obstructive pattern in adults is Apnoea whereas in children it is hypoventilation
