Sleep Apnoea in Children Flashcards
Describe the respiratory patterns in infants
Periodically stop breathing (apneic) before 36 weeks then increased regular resp after
Do infants go through stages of sleep?
No, they go straight into REM sleep (rapid eye movement stage)
50% REM/NREM
How long do newborns sleep for normally?
16-18hr
What is the sleep-awake state?
3-4hr cycles and then eventually adapt to light-dark/social cues
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
How is sleep apnoea assessed in children?
Polysomnography Direct behavioural observation Time-lapse video Movement sensors in cot mattress Oxygen/CO2 monitoring
What are abnormal sleep behaviours in infants?
Napping and enuresis after 3-5yr
1yr old if sleeps 8hr night and no nap (should be +12hrs)
What are normal sleep behaviours in infants?
Sleep walking in toddlers
REM onset in first 3 months
Sleep terrors
Hypnic jerks
What can cause sleeplessness on children?
Behavioural problems: infants 1+yr arousal for 1-5min
Medication: Beta 2 agonists
Neurological: melatonin
What conditions can cause excessive sleepiness?
Insufficient sleep
OSAS
Narcolepsy (often undiagnosed in childhood)
What is primary snoring?
Snoring without: Apnoea Hypoventilation Hypoxia Hypercapnia Daytime symptoms
How does OSAS affect infants?
Morbidity: Failure to thrive Neurocognitive defects/ADHD Systemic hypertension Cor pulmonale
How does OSAS affect children in comparison to adults?
Less daytime sleepiness Less obesity Mouth breathing Enlarged tonsils Obstructive pattern is hypoventilation (apnoea in adults)
How are sleep apnoea treated in children?
Adenotonsillectomy
(CPAP)
Weight loss
Avoid environmental tobacco smoke
