1,721,200 research outputs found
Pediatric sleep in Australia and New Zealand- introduction to the 2nd Special Issue (SI) in the Pediatric Sleep Around The World
No full textThis issue, which is the second Special Issue (SI) in the “Pediatric
Sleep Around The World” series, portrays a contemporary view of
how Australian- and New Zealand-based pediatric sleep researchers have contributed to advancing pediatric sleep education,
research, and patient care.
The main contributions of the “Downunder” researchers were
related to the pediatric sleep disordered breathing/obstructive
sleep apnea (SDB/OSA), sleep in diverse pediatric populations,
the sleep of Indigenous Australian children, the effect of physical
activity on sleep, the knowledge of Australian health professionals
in pediatric sleep disorders and interventions for of pediatric
sleep disorders and pediatric sleep health promotion
Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children
No full textSTUDY OBJECTIVES: To test the hypothesis that children taking trazodone have less leg movements during sleep (LMS) and higher rapid eye movement (REM) sleep atonia than children taking selective serotonin reuptake inhibitors (SSRIs) but more than normal controls. METHODS: Fifteen children (9 girls and 6 boys, mean age 11.7 years, standard deviation [SD] 3.42) taking trazodone (median dosage 50 mg/d, range 25-200 mg) for insomnia and 19 children (11 girls and 8 boys, mean age 13.7 years, SD 3.07) taking SSRIs for depression, anxiety, or both were consecutively recruited, as well as an age- and sex-matched group of 25 control children (17 girls and 8 boys, mean age 13.7 years, SD 3.11). LMS were scored and a series of parameters was calculated, along with the analysis of their time structure. The Atonia Index was then computed for each non-REM sleep stage and for REM sleep. RESULTS: Children taking trazodone exhibited slightly higher leg movement indices than controls but lower than those found in children taking SSRIs and their time structure was different. Chin electromyogram atonia in all sleep stages was not significantly altered in children taking trazodone but was decreased in children taking SSRIs, especially during non-REM sleep. CONCLUSIONS: In children, SSRIs but not trazodone are associated with a significantly increased number of LMS, including periodic LMS, and increased chin tone in all sleep stages. The assessment of periodic limb movement disorder and REM sleep without atonia might not be accurate when children are taking SSRIs because of their significant impact. CITATION: DelRosso LM, Mogavero MP, Bruni O, Schenck CH, Fickenscher A, Ferri R. Trazodone affects periodic leg movements and chin muscle tone during sleep less than selective serotonin reuptake inhibitor antidepressants in children. J Clin Sleep Med. 2022;18(12):2829-2836
Periodic limb movement disorder
No full textPeriodic limb movement disorder (PLMD) is characterized by the occurrence, during sleep of repetitive, highly stereotyped, limb movements (PLMS), with a frequency >15/h (in children >5/h) associated with a clinical sleep disturbance or a complaint of daytime fatigue that cannot be better explained by another cause. A differential diagnosis is required between PLMD and insomnia with excessive daytime sleepiness resulting from restless legs syndrome (RLS) mimics that should rule out the diagnosis of PLMD. PLMD is generally considered to be a rare condition; however, recent data seem to indicate that it might be underdiagnosed. The exact cause of PLMD is not known; however, it is hypothesized that central dopamine may be involved in the pathophysiology of PLMD, given the known treatment efficacy on PLMS of l-dopa and dopamine agonists. A significant association between PLMS and a variant of an intron of the BTBD9 gene on chromosome 6p21.2 has been ascertained that may imply a developmental defect in the sensory-motor spinal organization. Treatment for PLMS can be the same as for RLS and it is expected to effectively reduce the PLMS index; however, studies specifically designed for PLMD are insufficient and treatment is based on clinical judgment. Most information available largely overlaps with that on RLS; however, even if PLMD might be, at least in some cases, a form of RLS or its presenting symptom, it certainly deserves specific attention, diagnosis, and treatment
Association of sleep spindle activity and sleepiness in children with sleep-disordered breathing
No full textStudy Objectives: The association of snoring and sleep-disordered breathing (SDB) with daytime sleepiness is well documented; however, the exact mechanisms, and especially the role of sleep microstructure that may account for this association remain incompletely understood. In a cohort of children with SDB, we aimed to compare sleep spindle activity between children with daytime sleepiness versus those without daytime sleepiness. Methods: Children with SDB who reported daytime sleepiness were recruited and compared with age- and sex-matched SDB controls. Polysomnographic recordings were analyzed evaluating sleep spindle activity. A statistical comparison was carried out in both groups to assess the association between sleepiness and sleep spindle activity. Results: Thirty-three children with SDB (mean age: 7.5 ± 1.7 years) were included, 10 with and 23 without daytime sleepiness. Spindle activity was lower in children with daytime sleepiness compared with those without; in stage N2, median (interquartile range) sleep spindle indexes were 77.5 (37.3) and 116.9 (71.2) (P = .015), respectively. Conclusions: Spindles were significantly reduced in children with SDB and daytime sleepiness. The exact mechanisms of this association remain unknown and future research is needed in order to establish the exact role of sleep spindle activity on daytime symptoms in children with SDB
Neurological aspects of sleep medicine, how sleep evolves, and regulation of function
No full textSleep is not a static but rather is a dynamic state of being, involving variations in cerebral blood flow, neurotransmitters, immune response, and metabolic changes, among others. The maturation and development of the human brain involves changes across the life span, in particular changes from childhood to adulthood. The brain structure and function develop, neuronal networks strengthen, and neurotransmitter signaling is modulated in different ways affecting sleep and wakefulness. The most conspicuous changes in sleep architecture during infancy and early childhood include fundamental parameters studied in sleep medicine: decrease in total sleep time, gradual consolidation of periods of sleep at night or wakefulness during the day hours, decrease in the intensity of (EEG power) of NREM sleep stage 3 slow-wave activity (SWA), and a steady decline in the percentage of time spent in REM sleep. Furthermore, the control of sleep, including the two-process model (the circadian and homeostatic processes), also undergoes significant changes from childhood to adulthood. In this chapter we discuss these changes and processes especially important to help patients during the transition from childhood to adolescence and adulthood
Treatment of pediatric restless legs syndrome
No full textRestless legs syndrome (RLS) is not uncommon in children with an estimated prevalence of 2%. There is clear evidence that RLS affects quality of life, sleep, cognition and behavior in children and adults. Although the diagnosis of RLS can be challenging in young children, the International Restless Legs Study Group (IRLSSG) has published guidelines for diagnosis which include description of symptoms in the child's own words. Once the diagnosis is made, treatment options must be explored. It is commonly accepted that non-pharmacological interventions be recommended to all affected families. These include maintaining a consistent bedtime routine, establishing healthy eating habits and exercise, avoiding caffeine and other substances that can exacerbate RLS, and stretching before bedtime. Pharmacological interventions in children are challenged by the lack of solid data supporting effectiveness and long-term safety. Historically and based on pathophysiology, iron supplementation is the first line therapy in children. Recently intravenous iron supplementation has shown promising results, following studies in adults. Most studies in children on various pharmacological options follow a robust body of data previously published in adult patient with RLS, yet data in children remain scarce. This chapter will discuss both non-pharmacologic and pharmacologic treatment options for children with RLS
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