Following in the steps of the bestselling Sleep Medicine Pearls, this practical resource provides authoritative guidance on the evaluation and management of common pediatric sleep medicine problems using concise clinical vignettes. Experts in this rapidly growing field, led by Drs. Lourdes M. Del Rosso, Richard B. Berry, Suzanne E. Beck, Mary H. Wagner, and Carole L. Marcus, provide a hands-on, case-based approach, perfect for physicians studying for the sleep boards, fellows learning sleep medicine, and physicians who see children in their practice.
1. Part 1: Introduction to Pediatric Sleep Medicine - p. iii 2. Section 1: Evaluation of the Pediatric Sleep Patient - p. iii 3. Chapter 1: Pediatric sleep history: A 4 year-old with snoring, gasping and witnessed apneas - p. iii 4. Chapter 2: A 6-year-old girl with tonsillar hypertrophy, high-arched palate, and snoring - p. g4 5. Chapter 3: A 10-year-old girl with an unusual finding on physical exam - p. g7 6. Section 2: Pediatric Polysomnography - p. g9 7. Chapter 4: Overview of pediatric polysomnography: A newborn infant with snoring and witnessed apnea - p. g9 8. Chapter 5: A 2-week-old infant with some challenging epochs on polysomnography - p. g11 9. Chapter 6: A 14-year-old with an abnormal end-tidal CO2 waveform during polysomnography - p. g14 10. Section 3: Common Polysomnographic Findings in Children - p. g19 11. Chapter 7: A 3-year-old boy with rhythmic activity on electroencephalogram - p. g19 12. Chapter 8: A 3-month-old infant with monomorphic waves on electroencephalogram - p. g21 13. Chapter 9: A newborn infant with an alternating electroencephalogram pattern - p. g24 14. Chapter 10: A 2-month-old infant with sleep-onset REM period on polysomnography - p. g26 15. Chapter 11: An infant with high amplitude on an electroencephalogram recording - p. g28 16. Chapter 12: A 7-month-old infant with a series of central apneas - p. g30 17. Chapter 13: A 15-month-old with central apnea - p. g34 18. Chapter 14: A 19-month-old child with irregular, heavy breathing during sleep - p. g38 19. Chapter 15: A 4-week-old infant with jerking movements during sleep - p. g40 20. Chapter 16: An 8-year-old boy with abnormal capnography on polysomnogram - p. g44 21. Section 4: Artifacts in Pediatric Polysomnography - p. g48 22. Chapter 17: A 13-year-old boy with snoring and abnormal eye movements on polysomnogram - p. g48 23. Chapter 18: A 3-month-old infant who sleeps with a pacifier - p. g50 24. Chapter 19: A 24-month-old girl with uneventful desaturation - p. g54 25. Chapter 20: A 5-year-old child with unusual leg movements on polysomnography - p. g56 26. Chapter 21: A 16-year-old with snoring and diaphoresis - p. g58 27. Chapter 22: A polysomnography finding in an 8-year-old with history of seizures - p. g60 28. Part 2: Clinical Pediatric Sleep Medicine Pearls - p. g62 29. Section 5: Sleep Requirements and Sleep Hygiene - p. g62 30. Chapter 23: A 14-year-old girl who watches TV to fall asleep - p. g62 31. Chapter 24: An 8-year-old with a return to daytime napping - p. g66 32. Chapter 25: A 10-year-old girl sleeps with her parents and her sister - p. g68 33. Section 6: Insomnia - p. g71 34. Chapter 26: A 4-year-old boy with frequent nocturnal awakenings - p. g71 35. Chapter 27: A 14-year-old with difficulty falling asleep - p. g73 36. Section 7: Disorders of Hypersomnolence - p. g77 37. Chapter 28: A 10-year-old boy with excessive sleepiness and new-onset parasomnia - p. g77 38. Chapter 29: A 9-year-old girl with excessive daytime sleepiness and slurred speech - p. g79 39. Chapter 30: A 13-year-old boy with excessive sleepiness who falls asleep watching television - p. g82 40. Chapter 31: A 16-year-old boy who cannot stay up late on weekends - p. g84 41. Section 8: Circadian Sleep Disorders - p. g88 42. Chapter 32: A 4-year-old girl with septo-optic dysplasia and fragmented sleep - p. g88 43. Chapter 33: A 13-year-old boy who falls asleep in school - p. g92 44. Section 9: Sleep-Related Breathing Disorders - p. g96 45. Chapter 34: A 1-month-old premature infant on an apnea monitor - p. g96 46. Chapter 35: A 2-month-old infant turns blue in front of his parents - p. g100 47. Chapter 36: A 1-week-old infant with severely abnormal blood gases - p. g103 48. Chapter 37: A child with central sleep apnea treated with supplemental oxygen - p. g106 49. Chapter 38: A toddler headed for tracheostomy decannulation - p. g110 50. Chapter 39: A school-aged child with snoring - p. g114 51. Chapter 40: Double trouble: Tween siblings with obesity, daytime somnolence, and snoring - p. g118 52. Chapter 41: An infant with respiratory muscle weakness and lethargy - p. g123 53. Chapter 42: A 7-year-old boy with snoring, restless sleep, and obstructive sleep apnea - p. g127 54. Chapter 43: A 2½-year-old girl with snoring, restless sleep, and severe obstructive sleep apnea - p. g132 55. Chapter 44: A school-aged boy with snoring and attention-deficit hyperactivity disorder - p. g136 56. Chapter 45: A 7-year-old boy with obesity and persistent hypoventilation - p. g139 57. Chapter 46: A 6-month-old with laryngomalacia and stridor in sleep - p. g145 58. Chapter 47: Disturbed sleep in a patient with Duchenne muscular dystrophy - p. g150 59. Chapter 48: A 17-year-old with morning headaches - p. g155 60. Chapter 49: A 6-month-old with chronic lung disease of infancy, intermittent snoring, and failure to thrive - p. g159 61. Section 10: Titration Studies in Children - p. g162 62. Chapter 50: A 5-year-old boy with obstructive sleep apnea not tolerating continuous positive airway pressure - p. g162 63. Chapter 51: A child referred for positive airway pressure initiation and titration - p. g166 64. Chapter 52: An adolescent referred for bi-level positive airway pressure titration awakens with leg cramps - p. g169 65. Chapter 53: A 3-year-old girl with irregular breathing on bilevel positive airway pressure - p. g174 66. Chapter 54: Why is the continuous positive airway pressure no longer working? - p. g178 67. Section 11: Sleep and Genetic Syndromes - p. g181 68. Chapter 55: A 3-year-old girl with Down syndrome, chronic otitis media, and snoring - p. g181 69. Chapter 56: An 18-month-old with snoring and achondroplasia - p. g185 70. Chapter 57: A 9-month-old girl with Pfeiffer syndrome and snoring - p. g188 71. Chapter 58: A 3-year-old girl with Prader-Willi syndrome and obesity - p. g191 72. Chapter 59: A 12-day-old infant with Pierre Robin sequence and difficulty breathing - p. g195 73. Chapter 60: A 12-year-old girl with Williams syndrome and frequent nocturnal awakenings - p. g199 74. Chapter 61: A 9-year-old female with Joubert syndrome and breath-holding spells - p. g202 75. Chapter 62: A 4-year-old female with early morning awakenings - p. g205 76. Section 12: Parasomnias - p. g210 77. Chapter 63: A 6-year-old girl who goes to school while sleeping - p. g210 78. Chapter 64: A 3-year-old girl with disruptive nocturnal awakenings - p. g213 79. Chapter 65: An 11-year-old boy with obesity and secondary enuresis - p. g216 80. Chapter 66: A 13-year-old boy with Moebius sequence and violent nocturnal behaviors - p. g219 81. Chapter 67: Brain tumor presenting as somnambulism in an adolescent - p. g224 82. Section 13: Movement Disorders - p. g228 83. Chapter 68: A 9-year-old boy with snoring and leg movements - p. g228 84. Chapter 69: A 5-year-old girl with a rush of energy at bedtime - p. g232 85. Chapter 70: A 4-year-old boy with tooth grinding during sleep - p. g235 86. Chapter 71: A 5-year-old boy with repetitive nocturnal movements - p. g238 87. Section 14: Sleep in Medical Conditions - p. g241 88. Chapter 72: A patient with sickle cell disease and a low baseline sleeping oxygen saturation - p. g241 89. Chapter 73: A 5-month-old baby who wakes and spits up through the night - p. g245 90. Chapter 74: A 3-year-old boy with trisomy 21 and unchanged apnea–hypopnea index after tonsillectomy and adenoidectomy - p. g249 91. Chapter 75: A 10-year-old with snoring and hypoxemia - p. g251 92. Chapter 76: A 13-year-old girl with multiple nocturnal awakenings - p. g254 93. Chapter 77: A 5-year-old with nocturnal cough and daytime fatigue - p. g257 94. Section 15: Sleep and Neurologic Conditions - p. g261 95. Chapter 78: A 16-year-old boy with intractable seizure disorder and snoring - p. g261 96. Chapter 79: A 15-year-old girl with Lennox-Gastaut syndrome and breathing pauses - p. g265 97. Chapter 80: A 2-year-old girl with abnormal nocturnal events - p. g269 98. Chapter 81: A 13-year-old boy with snoring and headaches - p. g272 99. Chapter 82: A 13-year-old boy with facial weakness and severe obstructive sleep apnea - p. g276 100. Chapter 83: A 13-year-old girl with medulloblastoma and breathing pauses - p. g280 101. Chapter 84: An 11-year-old with Rett syndrome and cyanotic spells - p. g284 102. Chapter 85: An 11-year-old boy with morning headaches - p. g288 103. Chapter 86: An 11-year-old boy with history of concussion and insomnia - p. g288 104. Section 16: Sleep and Psychiatric Conditions - p. g294 105. Chapter 87: A 16-year-old girl with panic attacks and multiple nocturnal awakenings - p. g294 106. Chapter 88: A 12-year-old girl with fatigue and difficulty falling asleep - p. g296 107. Section 17: Sleep and Neurodevelopmental Disorders - p. g300 108. Chapter 89: An 8-year-old boy with attention-deficit/hyperactivity disorder and multiple nocturnal awakenings - p. g300 109. Chapter 90: A 13-year-old boy with autism spectrum disorder and difficulty falling asleep - p. g302 110. Section 18: Drug Effects on Sleep - p. g306 111. Chapter 91: A 13-year-old girl with excessive daytime sleepiness - p. g306 112. Chapter 92: A 12-year-old girl with narcolepsy and motor tics - p. g310 113. Chapter 93: A 15-year-old girl with narcolepsy type 1 needs sedation for dental work - p. g313 114. Chapter 94: A 14-year-old boy with short stature and snoring - p. g315 115. Chapter 95: A 17-year-old boy with both insomnia and excessive daytime sleepiness - p. g318 116. Chapter 96: A 10-year-old with acute pancreatitis and snoring - p. g321 117. Common Abbreviation List - p. g323 118. Thematic Table of Contents - p. g323 119. Index - p. g326
Following in the steps of the bestselling Sleep Medicine Pearls, this practical resource provides authoritative guidance on the evaluation and management of common pediatric sleep medicine problems using concise clinical vignettes. Experts in this rapidly growing field, led by Drs. Lourdes M. Del Rosso, Richard B. Berry, Suzanne E. Beck, Mary H. Wagner, and Carole L. Marcus, provide a hands-on, case-based approach, perfect for physicians studying for the sleep boards, fellows learning sleep medicine, and physicians who see children in their practice.
1. Part 1: Introduction to Pediatric Sleep Medicine - p. iii 2. Section 1: Evaluation of the Pediatric Sleep Patient - p. iii 3. Chapter 1: Pediatric sleep history: A 4 year-old with snoring, gasping and witnessed apneas - p. iii 4. Chapter 2: A 6-year-old girl with tonsillar hypertrophy, high-arched palate, and snoring - p. g4 5. Chapter 3: A 10-year-old girl with an unusual finding on physical exam - p. g7 6. Section 2: Pediatric Polysomnography - p. g9 7. Chapter 4: Overview of pediatric polysomnography: A newborn infant with snoring and witnessed apnea - p. g9 8. Chapter 5: A 2-week-old infant with some challenging epochs on polysomnography - p. g11 9. Chapter 6: A 14-year-old with an abnormal end-tidal CO2 waveform during polysomnography - p. g14 10. Section 3: Common Polysomnographic Findings in Children - p. g19 11. Chapter 7: A 3-year-old boy with rhythmic activity on electroencephalogram - p. g19 12. Chapter 8: A 3-month-old infant with monomorphic waves on electroencephalogram - p. g21 13. Chapter 9: A newborn infant with an alternating electroencephalogram pattern - p. g24 14. Chapter 10: A 2-month-old infant with sleep-onset REM period on polysomnography - p. g26 15. Chapter 11: An infant with high amplitude on an electroencephalogram recording - p. g28 16. Chapter 12: A 7-month-old infant with a series of central apneas - p. g30 17. Chapter 13: A 15-month-old with central apnea - p. g34 18. Chapter 14: A 19-month-old child with irregular, heavy breathing during sleep - p. g38 19. Chapter 15: A 4-week-old infant with jerking movements during sleep - p. g40 20. Chapter 16: An 8-year-old boy with abnormal capnography on polysomnogram - p. g44 21. Section 4: Artifacts in Pediatric Polysomnography - p. g48 22. Chapter 17: A 13-year-old boy with snoring and abnormal eye movements on polysomnogram - p. g48 23. Chapter 18: A 3-month-old infant who sleeps with a pacifier - p. g50 24. Chapter 19: A 24-month-old girl with uneventful desaturation - p. g54 25. Chapter 20: A 5-year-old child with unusual leg movements on polysomnography - p. g56 26. Chapter 21: A 16-year-old with snoring and diaphoresis - p. g58 27. Chapter 22: A polysomnography finding in an 8-year-old with history of seizures - p. g60 28. Part 2: Clinical Pediatric Sleep Medicine Pearls - p. g62 29. Section 5: Sleep Requirements and Sleep Hygiene - p. g62 30. Chapter 23: A 14-year-old girl who watches TV to fall asleep - p. g62 31. Chapter 24: An 8-year-old with a return to daytime napping - p. g66 32. Chapter 25: A 10-year-old girl sleeps with her parents and her sister - p. g68 33. Section 6: Insomnia - p. g71 34. Chapter 26: A 4-year-old boy with frequent nocturnal awakenings - p. g71 35. Chapter 27: A 14-year-old with difficulty falling asleep - p. g73 36. Section 7: Disorders of Hypersomnolence - p. g77 37. Chapter 28: A 10-year-old boy with excessive sleepiness and new-onset parasomnia - p. g77 38. Chapter 29: A 9-year-old girl with excessive daytime sleepiness and slurred speech - p. g79 39. Chapter 30: A 13-year-old boy with excessive sleepiness who falls asleep watching television - p. g82 40. Chapter 31: A 16-year-old boy who cannot stay up late on weekends - p. g84 41. Section 8: Circadian Sleep Disorders - p. g88 42. Chapter 32: A 4-year-old girl with septo-optic dysplasia and fragmented sleep - p. g88 43. Chapter 33: A 13-year-old boy who falls asleep in school - p. g92 44. Section 9: Sleep-Related Breathing Disorders - p. g96 45. Chapter 34: A 1-month-old premature infant on an apnea monitor - p. g96 46. Chapter 35: A 2-month-old infant turns blue in front of his parents - p. g100 47. Chapter 36: A 1-week-old infant with severely abnormal blood gases - p. g103 48. Chapter 37: A child with central sleep apnea treated with supplemental oxygen - p. g106 49. Chapter 38: A toddler headed for tracheostomy decannulation - p. g110 50. Chapter 39: A school-aged child with snoring - p. g114 51. Chapter 40: Double trouble: Tween siblings with obesity, daytime somnolence, and snoring - p. g118 52. Chapter 41: An infant with respiratory muscle weakness and lethargy - p. g123 53. Chapter 42: A 7-year-old boy with snoring, restless sleep, and obstructive sleep apnea - p. g127 54. Chapter 43: A 2½-year-old girl with snoring, restless sleep, and severe obstructive sleep apnea - p. g132 55. Chapter 44: A school-aged boy with snoring and attention-deficit hyperactivity disorder - p. g136 56. Chapter 45: A 7-year-old boy with obesity and persistent hypoventilation - p. g139 57. Chapter 46: A 6-month-old with laryngomalacia and stridor in sleep - p. g145 58. Chapter 47: Disturbed sleep in a patient with Duchenne muscular dystrophy - p. g150 59. Chapter 48: A 17-year-old with morning headaches - p. g155 60. Chapter 49: A 6-month-old with chronic lung disease of infancy, intermittent snoring, and failure to thrive - p. g159 61. Section 10: Titration Studies in Children - p. g162 62. Chapter 50: A 5-year-old boy with obstructive sleep apnea not tolerating continuous positive airway pressure - p. g162 63. Chapter 51: A child referred for positive airway pressure initiation and titration - p. g166 64. Chapter 52: An adolescent referred for bi-level positive airway pressure titration awakens with leg cramps - p. g169 65. Chapter 53: A 3-year-old girl with irregular breathing on bilevel positive airway pressure - p. g174 66. Chapter 54: Why is the continuous positive airway pressure no longer working? - p. g178 67. Section 11: Sleep and Genetic Syndromes - p. g181 68. Chapter 55: A 3-year-old girl with Down syndrome, chronic otitis media, and snoring - p. g181 69. Chapter 56: An 18-month-old with snoring and achondroplasia - p. g185 70. Chapter 57: A 9-month-old girl with Pfeiffer syndrome and snoring - p. g188 71. Chapter 58: A 3-year-old girl with Prader-Willi syndrome and obesity - p. g191 72. Chapter 59: A 12-day-old infant with Pierre Robin sequence and difficulty breathing - p. g195 73. Chapter 60: A 12-year-old girl with Williams syndrome and frequent nocturnal awakenings - p. g199 74. Chapter 61: A 9-year-old female with Joubert syndrome and breath-holding spells - p. g202 75. Chapter 62: A 4-year-old female with early morning awakenings - p. g205 76. Section 12: Parasomnias - p. g210 77. Chapter 63: A 6-year-old girl who goes to school while sleeping - p. g210 78. Chapter 64: A 3-year-old girl with disruptive nocturnal awakenings - p. g213 79. Chapter 65: An 11-year-old boy with obesity and secondary enuresis - p. g216 80. Chapter 66: A 13-year-old boy with Moebius sequence and violent nocturnal behaviors - p. g219 81. Chapter 67: Brain tumor presenting as somnambulism in an adolescent - p. g224 82. Section 13: Movement Disorders - p. g228 83. Chapter 68: A 9-year-old boy with snoring and leg movements - p. g228 84. Chapter 69: A 5-year-old girl with a rush of energy at bedtime - p. g232 85. Chapter 70: A 4-year-old boy with tooth grinding during sleep - p. g235 86. Chapter 71: A 5-year-old boy with repetitive nocturnal movements - p. g238 87. Section 14: Sleep in Medical Conditions - p. g241 88. Chapter 72: A patient with sickle cell disease and a low baseline sleeping oxygen saturation - p. g241 89. Chapter 73: A 5-month-old baby who wakes and spits up through the night - p. g245 90. Chapter 74: A 3-year-old boy with trisomy 21 and unchanged apnea–hypopnea index after tonsillectomy and adenoidectomy - p. g249 91. Chapter 75: A 10-year-old with snoring and hypoxemia - p. g251 92. Chapter 76: A 13-year-old girl with multiple nocturnal awakenings - p. g254 93. Chapter 77: A 5-year-old with nocturnal cough and daytime fatigue - p. g257 94. Section 15: Sleep and Neurologic Conditions - p. g261 95. Chapter 78: A 16-year-old boy with intractable seizure disorder and snoring - p. g261 96. Chapter 79: A 15-year-old girl with Lennox-Gastaut syndrome and breathing pauses - p. g265 97. Chapter 80: A 2-year-old girl with abnormal nocturnal events - p. g269 98. Chapter 81: A 13-year-old boy with snoring and headaches - p. g272 99. Chapter 82: A 13-year-old boy with facial weakness and severe obstructive sleep apnea - p. g276 100. Chapter 83: A 13-year-old girl with medulloblastoma and breathing pauses - p. g280 101. Chapter 84: An 11-year-old with Rett syndrome and cyanotic spells - p. g284 102. Chapter 85: An 11-year-old boy with morning headaches - p. g288 103. Chapter 86: An 11-year-old boy with history of concussion and insomnia - p. g288 104. Section 16: Sleep and Psychiatric Conditions - p. g294 105. Chapter 87: A 16-year-old girl with panic attacks and multiple nocturnal awakenings - p. g294 106. Chapter 88: A 12-year-old girl with fatigue and difficulty falling asleep - p. g296 107. Section 17: Sleep and Neurodevelopmental Disorders - p. g300 108. Chapter 89: An 8-year-old boy with attention-deficit/hyperactivity disorder and multiple nocturnal awakenings - p. g300 109. Chapter 90: A 13-year-old boy with autism spectrum disorder and difficulty falling asleep - p. g302 110. Section 18: Drug Effects on Sleep - p. g306 111. Chapter 91: A 13-year-old girl with excessive daytime sleepiness - p. g306 112. Chapter 92: A 12-year-old girl with narcolepsy and motor tics - p. g310 113. Chapter 93: A 15-year-old girl with narcolepsy type 1 needs sedation for dental work - p. g313 114. Chapter 94: A 14-year-old boy with short stature and snoring - p. g315 115. Chapter 95: A 17-year-old boy with both insomnia and excessive daytime sleepiness - p. g318 116. Chapter 96: A 10-year-old with acute pancreatitis and snoring - p. g321 117. Common Abbreviation List - p. g323 118. Thematic Table of Contents - p. g323 119. Index - p. g326
