Sleep Medicine in Children Flashcards

1
Q

What are the respiratory patterns of foetuses?

A
  • Periodic/apneic before 36 weeks

- Increased regular resp after 36 weeks

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2
Q

What are the sleep patterns of new-borns?

A
  • 16-18hrs asleep
  • Sleep- wake states alternate in 3-4 hr cycles
  • Then start to adapt to light/dark/social cues
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3
Q

What are the sleep patterns of 6 month olds?

A
  • 14-15hr asleep
  • 2 longer sleep periods at night
  • 1-2 daytime naps
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4
Q

What are the sleep patterns of 2 year olds?

A
  • 12 hr asleep

- 1 daytime nap

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5
Q

How can the sleep of prepubertal children be described?

A

-Highly efficient

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6
Q

How can the sleep of adolescents be described?

A
  • Increased awakenings

- Need more/obtain less

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7
Q

How is sleep assessed in children?

A
  • Polysomnography
  • Direct behavioural observation
  • Time-lapse video
  • Movement sensors in cot mattress
  • Oxygen/CO2 monitoring
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8
Q

What are normal sleep presentation?

A
  • Sleep walking is normal in toddlers

- REM onset normal in first 3 months

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9
Q

What are abnormal sleep presentations?

A
  • Napping and enuresis become relatively abnormal after 3-5 yrs
  • 1 yr old abnormal if sleeps 8hr at night and does not nap
  • Abnormal if unmedicated adult is unarousable from sleep
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10
Q

Give examples of normal phenomena (3)

A
  • Sleep walking
  • Sleep terrors
  • Hypnic jerks
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11
Q

What can cause sleeplessness?

A

-Mainly behavioural problems
-Medication
Neurological disorders

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12
Q

What can cause excessive sleepiness?

A
  • Insufficient sleep
  • OSAS
  • Narcolepsy
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13
Q

Define primary snoring.

A

-Snoring without apnoea, hypoventilation, hypoxia, hypercarbia, daytime symptoms

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14
Q

What is the prevalence of primary snoring?

A

~10%

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15
Q

What can primary snoring progress to?

A

OSAS

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16
Q

What may cure some cases of primary snoring?

A

Adenotonsillectomy

17
Q

What is the prevalence of OSAS?

A

~2%

18
Q

What is the morbidity of OSAS?

A
  • Failure to thrive
  • Neurocognitive defects/ADHD
  • Systemic hypertension
  • Cor pulmonale
19
Q

What is the treatment?

A
  • Adenotonsillectomy
  • CPAP
  • Weight loss
  • Avoid environmental tobacco smoke
20
Q

What respiratory disorders can children have that affect sleep?

A
  • Chronic neonatal lung disease
  • Cystic fibrosis
  • Asthma
21
Q

How can chronic neonatal lung disease affect sleep ?

A
  • Hypoxaemia in REM sleep

- Cardiac complications

22
Q

How can cystic fibrosis affect sleep?

A
  • FEV1 30-60% associated with decreased SaO2

- Less REM/more awakenings

23
Q

What neurological disorders can children have that affect sleep?

A
  • Cerebral palsy
  • Down syndrome
  • Prader-Willi Syndrome
24
Q

How can cerebral palsy affect sleep?

A
  • Fragmented sleep/delayed onset

- Melatonin

25
Q

How can Down Syndrome affect sleep?

A

OSAS

26
Q

How can Prader-Willi Syndrome affect sleep?

A

-Excessive daytime sleepiness

27
Q

How do neuromuscular disorders such as Duchenne’s MD affect sleep?

A
  • Death due to respiratory failure
  • Nocturnal desaturation associated with FVC <1litre
  • Increasing quality of life/survival with BiPap