Sleep (system call)

Sleep disordered breathing

Operating system

Psychology

Obstructive sleep apnea

Breathing

Computer science

Anesthesia

Medicine

Physical medicine and rehabilitation

Pediatrics in Review

1. null Kevin Gipson, MD, MS*2. null Mengdi Lu, MD*3. null T. Bernard Kinane, MD* 1. null *Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA* null null Abbreviations: null null null AAP: null null null null : null null American Academy of Pediatrics null null null AHI: null null null null : null null apnea-hypopnea index null null null AT: null null null null : null null adenotonsillectomy null null null Bi-level: null null null null : null null bilevel positive airway pressure null null null CPAP: null null null null : null null continuous positive airway pressure null null null CSA: null null null null : null null central sleep apnea null null null FDA: null null null null : null null Food and Drug Administration null null null OSA: null null null null : null null obstructive sleep apnea null null null PAP: null null null null : null null positive airway pressure null null null PSG: null null null null : null null polysomnography null null null SDB: null null null null : null null sleep-disordered breathingAn estimated 1% to 5% of children have sleep-disordered breathing related to obstructive sleep apnea, with a smaller proportion of children having central or mixed sleep apnea. Improved screening for sleep-disordered breathing in the general pediatrics clinic, coupled with effective management strategies, has the potential to have wide-ranging benefits on the patient’s long-term health and development.After completing this article, readers should be able to:1. null Recognize the signs and symptoms of obstructive sleep apnea in pediatric and adolescent patients.2. null Understand the role of in-laboratory sleep studies in the evaluation of pediatric patients with suspected sleep-disordered breathing.3. null Weigh the indications, benefits, and risks of various therapies for obstructive sleep apnea.4. null Have a general understanding of, and maintain an appropriate index of suspicion for, comorbid central sleep apnea when a patient presents with signs of sleep-disordered breathing.Sleep is central to a healthy childhood, and sleep-disordered breathing (SDB)—the disruption of normal respiratory patterns and ventilation during sleep—is implicated in several behavioral and physical health issues. Although we now have strong evidence that chronic, unchecked obstructive sleep apnea (OSA) can lead to hypertension, cardiovascular disease, metabolic disorders, obesity, and neuropsychiatric and developmental issues, the full scope of the effect of SDB on health remains underappreciated by many clinicians (Table 1).View this table:Table 1. Disease States Associated with or Complicated by Chronic Sleep-Disordered BreathingSleep research has rapidly expanded and evolved in the past few decades. Of recent note, chronobiologists Hall, Rosbash, and Young received the 2017 Nobel prize in medicine for their work on the cell’s internal clock. While the biological role of sleep remains mysterious, as famed researcher Allan Rechtschaffen once remarked, “If sleep …

Sleep-Disordered Breathing in Children