Presentaties ISMC - Paediatric
52 important questions on Presentaties ISMC - Paediatric
What are the key observations and family history for Zoë, aged 5?
- Sleeps a lot
- Slow development
- No snoring, no Restless Legs Syndrome (RLS)
- Normal behavior
- Mother has idiopathic hypersomnia
- Possible question of Zoë having the same condition
Describe the stages of cataplexy shown in the diagram.
- Strong emotional trigger: Initial stage with emotional stimulus.
- Partial cataplexy:
- - Weakness in the face and neck.
- Complete cataplexy:
- - Weakness in the limbs and trunk progressing to full collapse.
What are some key aspects of pediatric sleep disorders?
- Present differently than in adults.
- High impact on both child and family.
- Not always a behavioral cause, but may lead to behavioral issues.
- Each disorder requires a unique approach.
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What does a hypnogram indicating narcolepsy type 1 typically show?
- Frequent awakenings are visible throughout the sleep cycle.
- Onset of REM sleep occurs quickly after falling asleep.
- Multiple awakenings and fragmented sleep patterns are prominent.
- Daytime REM episodes may indicate an underlying sleep disorder.
What does Ricardo's Hypnogram indicate about sleep stages and interruptions?
- Wake (W): Frequent periods, notably at the start and around 5:00 AM.
- REM (R): Occurs soon after sleep onset and multiple times early morning.
- N1/N2/N3: Varies throughout the night with disruptions.
- Pattern: Sleep is fragmented with multiple awakenings.
What are the key diagnostic methods for narcolepsy?
- Actigraphy: Used to monitor sleep patterns.
- Polysomnography:
- - Excludes other diagnoses.
- - Detects early REM sleep and sleep fragmentation.
- Multiple Sleep Latency Test (MSLT):
- - Shows short sleep latency.
- - Identifies early REM sleep (SOREMPs).
What are Ricardo's health concerns at 14 years old?
- Diagnosed with ADHD
- Experiencing sleep problems
- Requests medication for his conditions
What are the types of sleep disorders listed?
- Insomnia
- Circadian rhythm sleep disorders
- Sleep-related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep-related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
What interventions were part of Zoë's clinical admission for observation?
- Slept a lot
- Well distracted and activated
- Participated in a day program
- Received coaching at home
- Development improved
What are the benefits of using CPAP according to the information provided?
- CPAP provides more energy.
- Users wake earlier and feel more equipped.
- It leads to no bad moods.
- Results in a happier child.
What is the prevalence of OSA in children with Down syndrome and how do parents assess it?
- Snoring prevalence is 7-15% in children.
- Mild OSA is present in 25% of cases.
- Moderate-severe OSA occurs in 1%.
- OSA in Down syndrome has a prevalence of 66%.
- Parents of DS children struggle to predict OSA presence by nighttime symptoms.
What are the risk factors associated with Down syndrome?
- Macroglossia
- Short neck
- Hypotonia
- Small nose and upper airway
- Frequent upper airway infections
- Higher incidence of obesity
What are the notable medical details about Tammy related to her adenotonsillectomy and polygraphy results?
- Adenotonsillectomy performed 7 years ago
- ENT findings: No signs of obstruction
- Polygraphy results:
- - Apnea Hypopnea Index (AHI): 66/h
What are the risk factors for obstructive apneas in children?
- Adenotonsillar hypertrophy
- Obesity
- Allergic rhinitis, nasal septum deviation
- Mandibular hypoplasia
- Craniofacial abnormalities
- Neuromuscular disorders
- Epilepsy
- Complex syndromes
What are common types of sleep disorders?
- Insomnia
- Circadian rhythm sleep disorders
- Sleep related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
What are Tammy's health conditions and sleep characteristics?
- Diagnosed with Down syndrome and celiac disease.
- Sleep schedule: 20.00-8.00h.
- Occasionally sleepy.
- Snores when she has a cold.
- Generally sleeps well.
- Possible concern for apnea.
What are some safety measures depicted?
- Child Safety Gate: Prevents child access to stairs, reducing fall risk.
- Door Handle Lock: Ensures unauthorized access prevention.
- Toys on Stairs: Hazardous; should be cleared to prevent accidents.
What is confusional arousal, and how common is it in children?
- Brief episodes: Involve partial awakening.
- Prevalence: Occurs at least once in almost all children.
- Age group: Affects 17% of children aged 3-13 years.
What are the key points noted in David's sleep diary?
- Date Range: Entries are from different days, labeled as DAG 1 to DAG 6.
- Bedtime and Wake Time: Times are noted for each day, e.g., 22:15 to 6:15.
- Awake Periods: Times when David was awake during the night are marked.
What are examples of Non-REM parasomnia?
- Confusional arousal: Episodes of confusion during waking.
- Sleep terrors: Sudden terror during sleep, often with screaming.
- Sleep walking: Walking or performing other complex behaviors while asleep.
What are the characteristics and prevalence of sleepwalking?
- Confusion with eyes open during episodes
- Exhibits bizarre behavior
- Generally self-limiting condition
- Prevalence ranges from 3-14.5%
- Peak occurrence is between 8-12 years of age
What is the timing of sleep terrors in relation to sleep onset and behavior?
- Occur during Non-REM sleep.
- Appear 1-4 hours after sleep onset.
- Can repeat later at night.
- Usually happen before midnight.
What are the characteristics of a sleep terror?
- Feels like intense fear.
- The person is inconsolable during the episode.
- Episodes last from a few minutes up to 40 minutes.
What are some types of sleep disorders?
- Insomnia
- Circadian rhythm sleep disorders
- Sleep-related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep-related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
What are some treatments for parasomnia?
- Maintain sleep hygiene for improved quality.
- Pee before going to bed to reduce disturbances.
- Set a scheduled wake up time to regulate sleep.
- Avoid waking during episodes.
- Create a safe environment to prevent injuries.
What are the characteristics of sleep terror as opposed to regular behavior?
- Challenges include difficulty in contact.
- Defensive reactions instead of hugging.
- Normal comforting methods ineffective.
- Behavior contrasts with daytime activities.
- Absence of memory the next day.
What characterizes Non-REM parasomnia and its timing in sleep?
- Non-REM parasomnia occurs 1-4 hours after sleep onset.
- It's associated with deep sleep stages.
- Common examples include sleep terrors and sleepwalking.
What are the characteristics and prevalence of sleep terrors in children?
- Peak Age: 5-7 years
- Prevalence: 1-6.5% in children aged 1-12 years
- Concurrent Behavior: 10% also experience sleepwalking
When do nightmares and behavior insomnia typically occur?
- Nightmares usually occur during REM sleep.
- Typically happen in the latter part of the night.
- Behavior insomnia is also more frequent during this time.
What are the different types of sleep disorders listed?
- Insomnia
- Circadian rhythm sleep disorders
- Sleep related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
What is common about parasomnias in children?
- Parasomnias in children often occur during NREM (Non-Rapid Eye Movement) sleep.
- Associated with conditions like epilepsy, ADHD, and neurodevelopmental disorders.
What are the categories of sleep disorders?
- Insomnia: Difficulty falling/staying asleep.
- Circadian rhythm sleep disorders: Disruption in the sleep-wake cycle.
- Sleep-related breathing disorders: Includes apnea.
- Hypersomnias: Excessive daytime sleepiness.
- Parasomnias: Abnormal movements/behaviors.
- Sleep-related movement disorders: Involuntary movements.
- Isolated symptoms: Normal sleep variants.
- Other sleep disorders: Various other types.
How is amnesia related to parasomnia?
- Amnesia can occur with parasomnias.
- It often accompanies sleep disorders, especially when related to neurological conditions.
What sleep issues is a 3-year-old experiencing?
- Sleep problems increasing for 1 year.
- Refusal at bedtime.
- After sleep:
- - 1-2 nightmares/night with 10-45 min tantrums.
- - 10x/night brief crying, requires parental intervention.
What are the characteristics of the limit setting type in parenting?
- Parents lose control of child's behavior.
- Bedtime resistance occurs.
- Limits are few, inconsequent, or unpredictable.
- Causes sleeping problems.
- Associated with co-sleeping.
What are the types of pediatric insomnia?
- Sleep onset association type: Difficulty falling asleep without specific conditions.
- Limit setting type: Behavioral limits set by caregivers are insufficient.
- Combined type: Features of both sleep onset and limit setting.
What is the main focus of the presentation indicated by ISMC?
- Topic: Pediatric Sleep Disorders
- Source: Chanelle Nibbelink, Washington Post
- Illustration: Features a comforting scene, emphasizing connection during sleep.
What is the prevalence of the condition mentioned?
- The prevalence ranges from 10-30%.
- It can be up to 80% in contexts involving neurodevelopmental disorders.
What are key milestones in sleep development?
- Sleep consolidation: Achieving longer periods of continuous sleep.
- Sleep regulation: Ability for self-soothing to return to sleep independently.
What are Tim's sleep challenges at 2 years old?
- Never slept through the night
- Needs a bottle of milk to fall asleep
- 2-5 awakenings per night
- Can only be consoled with a bottle
- Sleeps in parents’ bed after 3.00 AM
- Parents are exhausted
What are the consequences of sleep deprivation?
- Excessive daytime sleepiness
- Behavioral problems
- Concentration or memory impairment
- Mood disturbances
- Abuse of cigarettes, alcohol, and drugs
- Obesity
- Headache and stomach ache
- Infections
- Impaired growth
- Family problems
What are some types of pediatric sleep disorders?
- Over 80 identified sleep disorders.
- Insomnia
- Circadian rhythm sleep disorders
- Sleep related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
How does sleep consolidation develop according to the Verhulst 2005 study?
- Newborn: Frequent sleep-wake cycles.
- 1 Year: Longer sleep periods, fewer interruptions.
- 4 Years: More consistent sleep patterns.
- 10 Years: Increased consolidated sleep.
- Adult: Predominantly consolidated night sleep.
How does sleep development change from newborn to adulthood?
- Newborn:
- - Polyphasic sleep pattern
- - Spread throughout 24 hours
- 1 year:
- - Longer sleep periods at night
- 4 years:
- - Consolidated nighttime sleep
- - Daytime naps
- 10 years:
- - Reduced need for naps
- - Longer nighttime sleep
- Adult:
- - Monophasic sleep
- - Mainly during nighttime
How much of our lives do we spend sleeping according to the ISMC presentation?
- We spend approximately 1/3 of our lives sleeping.
- This statistic highlights the significant portion of time dedicated to rest across a lifetime.
- Visual representation shows life stages from infancy to old age.
What characterizes the Sleep Onset Association type in children?
- Children fall asleep with specific conditions present at bedtime.
- They need these conditions after nighttime arousals to resume sleep.
- Absence leads to prolonged night wakings.
- Linked with reactive co-sleeping.
What does the hypnogram of a child show about sleep patterns?
- Sleep stages include Awake, REM, NREM 1, 2, 3, and 4.
- Sleep onset time marks the start of sleep.
- REM latency is the time from sleep onset to REM.
- Normal wakings occur at night.
- Deep sleep (NREM 3 and 4) occurs early in the night.
- Light sleep (NREM 1 and 2) and REM dominate later.
How does sleep development change with age according to the chart?
- Newborns (1-15 days): ~16 hours sleep, balanced REM and Non-REM.
- 3-5 months: ~15 hours, more Non-REM than REM.
- 6-23 months: ~14 hours, decline in REM.
- 2-3 years: ~13 hours, continued decline in REM.
- 5-85 years: Sleep decreases from ~12 to ~6 hours, with increased Non-REM proportion.
What are some types of sleep disorders?
- Insomnia
- Circadian rhythm sleep disorders
- Sleep related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
What are the main types of sleep disorders?
- Insomnia
- Circadian rhythm sleep disorders
- Sleep related breathing disorders
- Hypersomnias of central origin
- Parasomnias
- Sleep related movement disorders
- Isolated symptoms and normal variants
- Other sleep disorders
What is disclosed about the speaker's interests?
- The speaker's interests disclosure states there is no conflict.
- Potential conflicts of interest are specifically noted as none.
- The disclosure is from a presentation associated with ISMC.
Who is the presenter of the talk on pediatric sleep disorders?
- Nicole Wolters is the presenter.
- Works as a pediatrician-somnologist.
- Affiliated with the Center for Sleep Medicine ZGT Hengelo.
- Presentation held on 9-6-2022.
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