BOOK
Pediatric Sleep Pearls E-Book
Lourdes M. DelRosso | Richard B. Berry | Suzanne E. Beck | Mary H Wagner | Carole L. Marcus
(2016)
Additional Information
Book Details
Abstract
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.
- Consult this title on your favorite e-reader , conduct rapid searches, and adjust font sizes for optimal readability.
- Over 95 cases review key elements in the evaluation and management of a wide variety of pediatric sleep disorders.
- An easy-to-read "pearls" format summarizes 2 to 5 major teaching points for maximum retention. Short, templated chapters are ideal for use by busy physicians.
- Current scoring criteria from the American Academy of Sleep Medicine manual for sleep and associated events version 2.2, as well as the current International Classification of Sleep Disorders, 3rd Edition (ICSD-3).
- Expert coverage of normal sleep in children, as well as sleep disorders associated with common medical, neurologic, psychiatric, neurodevelopmental, and genetic conditions.
- Up-to-date information on pediatric obstructive sleep apnea syndrome diagnosis and management.
- Numerous illustrations of polysomnographic fragments and pictures of clinical findings help you quickly recognize key pediatric sleep patterns that lead to an accurate diagnosis. All illustrations online are in full color.
- An ideal resource for pediatric sleep medicine specialists, adult sleep medicine specialists, pediatric pulmonologists, pediatric neurologists, pediatric otolaryngologists, general pediatricians, and pediatric psychologists.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| PEDIATRIC SLEEP PEARLS | I | ||
| Copyright | II | ||
| Dedication | III | ||
| Preface | IV | ||
| Contents | V | ||
| Acknowledgments | XII | ||
| I - Introduction to Pediatric Sleep Medicine | 1 | ||
| 1: EVALUATION OF THE PEDIATRIC SLEEP PATIENT | 2 | ||
| 1 - Pediatric sleep history: A 4 year-old with snoring, gasping and witnessed apneas | 2 | ||
| CASE PRESENTATION | 2 | ||
| QUESTION | 2 | ||
| ANSWER | 3 | ||
| DISCUSSION | 3 | ||
| REFERENCES | 4 | ||
| 2 - A 6-year-old girl with tonsillar hypertrophy, high-arched palate, and snoring | 5 | ||
| CASE PRESENTATION | 5 | ||
| PHYSICAL EXAM | 5 | ||
| QUESTION | 5 | ||
| ANSWER | 6 | ||
| DISCUSSION | 6 | ||
| REFERENCES | 7 | ||
| 3 - A 10-year-old girl with an unusual finding on physical exam | 8 | ||
| CASE PRESENTATION | 8 | ||
| PHYSICAL EXAM | 8 | ||
| LABORATORY AND SLEEP FINDINGS | 8 | ||
| QUESTIONS | 8 | ||
| ANSWERS | 9 | ||
| DISCUSSION | 9 | ||
| REFERENCES | 9 | ||
| 2: PEDIATRIC POLYSOMNOGRAPHY | 10 | ||
| 4 - Overview of pediatric polysomnography: A newborn infant with snoring and witnessed apnea | 10 | ||
| CASE PRESENTATION | 10 | ||
| PHYSICAL EXAM | 10 | ||
| QUESTIONS | 10 | ||
| ANSWERS | 11 | ||
| DISCUSSION | 11 | ||
| REFERENCES | 11 | ||
| 5 - A 2-week-old infant with some challenging epochs on polysomnography | 12 | ||
| CASE PRESENTATION | 12 | ||
| QUESTION | 12 | ||
| ANSWER | 13 | ||
| DISCUSSION | 13 | ||
| REFERENCE | 15 | ||
| 6 - A 14-year-old with an abnormal end-tidal CO2 waveform during polysomnography | 16 | ||
| CASE PRESENTATION | 16 | ||
| PHYSICAL EXAM | 16 | ||
| LABORATORY AND SLEEP FINDINGS | 16 | ||
| QUESTION | 17 | ||
| ANSWER | 18 | ||
| DISCUSSION | 18 | ||
| REFERENCES | 19 | ||
| 3: COMMON POLYSOMNOGRAPHIC FINDINGSIN CHILDREN | 20 | ||
| 7 - A 3-year-old boy with rhythmic activity on electroencephalogram | 20 | ||
| CASE PRESENTATION | 20 | ||
| PHYSICAL EXAM | 20 | ||
| LABORATORY AND SLEEP FINDINGS | 20 | ||
| QUESTIONS | 20 | ||
| ANSWERS | 22 | ||
| DISCUSSION | 22 | ||
| REFERENCES | 22 | ||
| 8 - A 3-month-old infant with monomorphic waves on electroencephalogram | 23 | ||
| CASE PRESENTATION | 23 | ||
| PHYSICAL EXAM | 23 | ||
| LABORATORY AND SLEEP FINDINGS | 23 | ||
| QUESTIONS | 23 | ||
| ANSWERS | 24 | ||
| DISCUSSION | 24 | ||
| REFERENCES | 24 | ||
| 9 - A newborn infant with an alternating electroencephalogram pattern | 25 | ||
| CASE PRESENTATION | 25 | ||
| PHYSICAL EXAM | 25 | ||
| LABORATORY AND SLEEP FINDINGS | 25 | ||
| QUESTIONS | 25 | ||
| ANSWERS | 26 | ||
| DISCUSSION | 26 | ||
| REFERENCES | 26 | ||
| 10 - A 2-month-old infant with sleep-onset REM period on polysomnography | 27 | ||
| CASE PRESENTATION | 27 | ||
| PHYSICAL EXAM | 27 | ||
| QUESTION | 27 | ||
| ANSWER | 28 | ||
| DISCUSSION | 28 | ||
| REFERENCES | 28 | ||
| 11 - An infant with high amplitude on an electroencephalogram recording | 29 | ||
| CASE PRESENTATION | 29 | ||
| QUESTION | 29 | ||
| ANSWER | 30 | ||
| DISCUSSION | 30 | ||
| REFERENCES | 30 | ||
| 12 - A 7-month-old infant with a series of central apneas | 31 | ||
| CASE PRESENTATION | 31 | ||
| PHYSICAL EXAM | 31 | ||
| LABORATORY AND SLEEP FINDINGS | 31 | ||
| QUESTION | 31 | ||
| ANSWER | 33 | ||
| DISCUSSION | 33 | ||
| REFERENCES | 34 | ||
| 13 - A 15-month-old with central apnea | 35 | ||
| CASE PRESENTATION | 35 | ||
| PHYSICAL EXAM | 35 | ||
| LABORATORY AND SLEEP FINDINGS | 35 | ||
| QUESTION | 35 | ||
| ANSWER | 37 | ||
| DISCUSSION | 37 | ||
| REFERENCES | 38 | ||
| 14 - A 19-month-old child with irregular, heavy breathing during sleep | 39 | ||
| CASE PRESENTATION | 39 | ||
| PHYSICAL EXAM | 39 | ||
| LABORATORY AND SLEEP FINDINGS | 39 | ||
| QUESTION | 39 | ||
| ANSWER | 41 | ||
| DISCUSSION | 41 | ||
| REFERENCES | 41 | ||
| 15 - A 4-week-old infant with jerking movements during sleep | 42 | ||
| CASE PRESENTATION | 42 | ||
| PHYSICAL EXAM | 42 | ||
| LABORATORY AND SLEEP FINDINGS | 42 | ||
| QUESTION | 42 | ||
| ANSWER | 43 | ||
| DISCUSSION | 43 | ||
| REFERENCES | 44 | ||
| 16 - An 8-year-old boy with abnormal capnography on polysomnogram | 45 | ||
| CASE PRESENTATION | 45 | ||
| PHYSICAL EXAM | 45 | ||
| LABORATORY AND SLEEP FINDINGS | 45 | ||
| QUESTIONS | 45 | ||
| ANSWERS | 47 | ||
| DISCUSSION | 47 | ||
| REFERENCES | 48 | ||
| 4: ARTIFACTS IN PEDIATRIC POLYSOMNOGRAPHY | 49 | ||
| 17 - A 13-year-old boy with snoring and abnormal eye movements on polysomnogram | 49 | ||
| CASE PRESENTATION | 49 | ||
| PHYSICAL EXAM | 49 | ||
| LABORATORY AND SLEEP FINDINGS | 49 | ||
| QUESTIONS | 49 | ||
| ANSWERS | 51 | ||
| DISCUSSION | 51 | ||
| REFERENCES | 51 | ||
| 18 - A 3-month-old infant who sleeps with a pacifier | 52 | ||
| CASE PRESENTATION | 52 | ||
| QUESTIONS | 52 | ||
| ANSWERS | 53 | ||
| DISCUSSION | 53 | ||
| REFERENCES | 54 | ||
| 19 - A 24-month-old girl with uneventful desaturation | 55 | ||
| CASE PRESENTATION | 55 | ||
| PHYSICAL EXAM | 55 | ||
| LABORATORY AND SLEEP FINDINGS | 55 | ||
| QUESTIONS | 55 | ||
| ANSWERS | 56 | ||
| DISCUSSION | 56 | ||
| REFERENCES | 56 | ||
| 20 - A 5-year-old child with unusual leg movements on polysomnography | 57 | ||
| CASE PRESENTATION | 57 | ||
| QUESTION | 57 | ||
| ANSWER | 58 | ||
| DISCUSSION | 58 | ||
| REFERENCES | 58 | ||
| 21 - A 16-year-old with snoring and diaphoresis | 59 | ||
| CASE PRESENTATION | 59 | ||
| PHYSICAL EXAM | 59 | ||
| LABORATORY AND SLEEP FINDINGS | 59 | ||
| QUESTION | 59 | ||
| ANSWER | 60 | ||
| DISCUSSION | 60 | ||
| REFERENCES | 60 | ||
| 22 - A polysomnography finding in an 8-year-old with history of seizures | 61 | ||
| CASE PRESENTATION | 61 | ||
| QUESTION | 61 | ||
| ANSWER | 62 | ||
| DISCUSSION | 62 | ||
| REFERENCES | 62 | ||
| II - Clinical Pediatric Sleep Medicine Pearls | 63 | ||
| 5: SLEEP REQUIREMENTS AND SLEEP HYGIENE | 64 | ||
| 23 - A 14-year-old girl who watches TV to fall asleep | 64 | ||
| CASE PRESENTATION | 64 | ||
| LABORATORY AND SLEEP FINDINGS | 64 | ||
| QUESTION | 64 | ||
| ANSWER | 65 | ||
| DISCUSSION | 65 | ||
| REFERENCES | 66 | ||
| 24 - An 8-year-old with a return to daytime napping | 67 | ||
| CASE PRESENTATION | 67 | ||
| PHYSICAL EXAM | 67 | ||
| QUESTION | 67 | ||
| ANSWER | 68 | ||
| DISCUSSION | 68 | ||
| REFERENCES | 68 | ||
| 25 - A 10-year-old girl sleeps with her parents and her sister | 69 | ||
| CASE PRESENTATION | 69 | ||
| PHYSICAL EXAM | 69 | ||
| LABORATORY AND SLEEP FINDINGS | 69 | ||
| QUESTION | 69 | ||
| ANSWER | 70 | ||
| DISCUSSION | 70 | ||
| REFERENCES | 71 | ||
| 6: INSOMNIA | 72 | ||
| 26 - A 4-year-old boy with frequent nocturnal awakenings | 72 | ||
| CASE PRESENTATION | 72 | ||
| PHYSICAL EXAM | 72 | ||
| QUESTION | 72 | ||
| ANSWER | 73 | ||
| DISCUSSION | 73 | ||
| REFERENCES | 73 | ||
| 27 - A 14-year-old with difficulty falling asleep | 74 | ||
| CASE PRESENTATION | 74 | ||
| PHYSICAL EXAM | 74 | ||
| LABORATORY AND SLEEP FINDINGS | 74 | ||
| QUESTION | 74 | ||
| ANSWER | 76 | ||
| DISCUSSION | 76 | ||
| REFERENCES | 77 | ||
| 7: DISORDERS OF HYPERSOMNOLENCE | 78 | ||
| 28 - A 10-year-old boy with excessive sleepiness and new-onset parasomnia | 78 | ||
| CASE PRESENTATION | 78 | ||
| PHYSICAL EXAM | 78 | ||
| LABORATORY AND SLEEP FINDINGS | 78 | ||
| QUESTIONS | 78 | ||
| ANSWERS | 79 | ||
| DISCUSSION | 79 | ||
| REFERENCES | 79 | ||
| 29 - A 9-year-old girl with excessive daytime sleepiness and slurred speech | 80 | ||
| CASE PRESENTATION | 80 | ||
| PHYSICAL EXAM | 80 | ||
| LABORATORY AND SLEEP FINDINGS | 80 | ||
| QUESTION | 80 | ||
| ANSWER | 81 | ||
| DISCUSSION | 81 | ||
| REFERENCES | 82 | ||
| 30 - A 13-year-old boy with excessive sleepiness who falls asleep watching television | 83 | ||
| CASE PRESENTATION | 83 | ||
| PHYSICAL EXAM | 83 | ||
| LABORATORY AND SLEEP FINDINGS | 83 | ||
| QUESTION | 83 | ||
| ANSWER | 85 | ||
| DISCUSSION | 85 | ||
| REFERENCES | 85 | ||
| 31 - A 16-year-old boy who cannot stay up late on weekends | 86 | ||
| CASE PRESENTATION | 86 | ||
| PHYSICAL EXAM | 86 | ||
| LABORATORY AND SLEEP FINDINGS | 86 | ||
| QUESTION | 86 | ||
| ANSWER | 87 | ||
| DISCUSSION | 87 | ||
| REFERENCES | 88 | ||
| 8: CIRCADIAN SLEEP DISORDERS | 89 | ||
| 32 - A 4-year-old girl with septo-optic dysplasia and fragmented sleep | 89 | ||
| CASE PRESENTATION | 89 | ||
| PHYSICAL EXAM | 89 | ||
| LABORATORY AND SLEEP FINDINGS | 89 | ||
| QUESTION | 89 | ||
| ANSWER | 90 | ||
| DISCUSSION | 90 | ||
| REFERENCES | 92 | ||
| 33 - A 13-year-old boy who falls asleep in school | 93 | ||
| CASE PRESENTATION | 93 | ||
| PHYSICAL EXAM | 93 | ||
| LABORATORY AND SLEEP FINDINGS | 93 | ||
| QUESTIONS | 93 | ||
| ANSWERS | 95 | ||
| DISCUSSION | 95 | ||
| REFERENCES | 96 | ||
| 9: SLEEP-RELATED BREATHING DISORDERS | 97 | ||
| 34 - A 1-month-old premature infant on an apnea monitor | 97 | ||
| CASE PRESENTATION | 97 | ||
| PHYSICAL EXAM | 97 | ||
| LABORATORY AND SLEEP FINDINGS | 97 | ||
| QUESTION | 97 | ||
| ANSWER | 99 | ||
| DISCUSSION | 99 | ||
| REFERENCES | 100 | ||
| 35 - A 2-month-old infant turns blue in front of his parents | 101 | ||
| CASE PRESENTATION | 101 | ||
| PHYSICAL EXAM | 101 | ||
| QUESTION | 101 | ||
| ANSWER | 102 | ||
| DISCUSSION | 102 | ||
| REFERENCES | 103 | ||
| 36 - A 1-week-old infant with severely abnormal blood gases | 104 | ||
| CASE PRESENTATION | 104 | ||
| PHYSICAL EXAM | 104 | ||
| LABORATORY AND SLEEP FINDINGS | 104 | ||
| QUESTION | 104 | ||
| ANSWER | 105 | ||
| DISCUSSION | 105 | ||
| REFERENCES | 106 | ||
| 37 - A child with central sleep apnea treated with supplemental oxygen | 107 | ||
| CASE PRESENTATION | 107 | ||
| PHYSICAL EXAM | 107 | ||
| LABORATORY AND SLEEP FINDINGS | 107 | ||
| QUESTIONS | 107 | ||
| ANSWERS | 109 | ||
| DISCUSSION | 109 | ||
| REFERENCES | 110 | ||
| 38 - A toddler headed for tracheostomy decannulation | 111 | ||
| CASE PRESENTATION | 111 | ||
| PHYSICAL EXAM | 111 | ||
| LABORATORY AND SLEEP FINDINGS | 111 | ||
| QUESTIONS | 111 | ||
| ANSWERS | 113 | ||
| DISCUSSION | 113 | ||
| REFERENCES | 114 | ||
| 39 - A school-aged child with snoring | 115 | ||
| CASE PRESENTATION | 115 | ||
| PHYSICAL EXAM | 115 | ||
| LABORATORY AND SLEEP FINDINGS | 115 | ||
| QUESTIONS | 115 | ||
| ANSWERS | 117 | ||
| DISCUSSION | 117 | ||
| REFERENCES | 118 | ||
| 40 - Double trouble: Tween siblings with obesity, daytime somnolence, and snoring | 119 | ||
| CASE PRESENTATION | 119 | ||
| PHYSICAL EXAM (11-YEAR-OLD BOY) | 119 | ||
| PHYSICAL EXAM (12-YEAR-OLD GIRL) | 119 | ||
| LABORATORY AND SLEEP FINDINGS | 119 | ||
| QUESTIONS | 120 | ||
| ANSWERS | 121 | ||
| DISCUSSION | 121 | ||
| REFERENCES | 123 | ||
| 41 - An infant with respiratory muscle weakness and lethargy | 124 | ||
| CASE PRESENTATION | 124 | ||
| PHYSICAL EXAM | 124 | ||
| LABORATORY AND SLEEP FINDINGS | 124 | ||
| QUESTIONS | 124 | ||
| ANSWERS | 126 | ||
| DISCUSSION | 126 | ||
| REFERENCES | 127 | ||
| 42 - A 7-year-old boy with snoring, restless sleep, and obstructive sleep apnea | 128 | ||
| CASE PRESENTATION | 128 | ||
| PHYSICAL EXAM | 128 | ||
| LABORATORY AND SLEEP FINDINGS | 128 | ||
| QUESTIONS | 128 | ||
| ANSWERS | 130 | ||
| DISCUSSION | 130 | ||
| REFERENCES | 132 | ||
| 43 - A 2½-year-old girl with snoring, restless sleep, and severe obstructive sleep apnea | 133 | ||
| CASE PRESENTATION | 133 | ||
| PHYSICAL EXAM | 133 | ||
| LABORATORY AND SLEEP FINDINGS | 134 | ||
| QUESTIONS | 134 | ||
| ANSWERS | 135 | ||
| DISCUSSION | 135 | ||
| REFERENCES | 136 | ||
| 44 - A school-aged boy with snoring and attention-deficit hyperactivity disorder | 137 | ||
| CASE PRESENTATION | 137 | ||
| PHYSICAL EXAM | 137 | ||
| LABORATORY AND SLEEP FINDINGS | 137 | ||
| QUESTION | 137 | ||
| ANSWER | 138 | ||
| DISCUSSION | 138 | ||
| REFERENCES | 139 | ||
| 45 - A 7-year-old boy with obesity and persistent hypoventilation | 141 | ||
| CASE PRESENTATION | 141 | ||
| PHYSICAL EXAM | 141 | ||
| LABORATORY AND SLEEP FINDINGS | 141 | ||
| QUESTIONS | 142 | ||
| ANSWERS | 144 | ||
| DISCUSSION | 144 | ||
| REFERENCES | 145 | ||
| 46 - A 6-month-old with laryngomalacia and stridor in sleep | 146 | ||
| CASE PRESENTATION | 146 | ||
| PHYSICAL EXAM | 146 | ||
| LABORATORY AND SLEEP FINDINGS | 147 | ||
| QUESTIONS | 147 | ||
| ANSWERS | 149 | ||
| DISCUSSION | 149 | ||
| REFERENCES | 150 | ||
| 47 - Disturbed sleep in a patient with Duchenne muscular dystrophy*,†| 151 | ||
| CASE PRESENTATION | 151 | ||
| PHYSICAL EXAM | 151 | ||
| Pulmonary Function Testing | 151 | ||
| Chest Radiograph | 151 | ||
| QUESTION | 152 | ||
| ANSWER | 153 | ||
| REFERENCES | 155 | ||
| 48 - A 17-year-old with morning headaches | 156 | ||
| CASE PRESENTATION | 156 | ||
| PHYSICAL EXAM | 156 | ||
| LABORATORY AND SLEEP FINDINGS | 156 | ||
| Pulmonary Function Tests | 156 | ||
| QUESTION | 156 | ||
| ANSWER | 158 | ||
| DISCUSSION | 158 | ||
| REFERENCES | 159 | ||
| 49 - A 6-month-old with chronic lung disease of infancy, intermittent snoring, and failure to thrive | 160 | ||
| CASE PRESENTATION | 160 | ||
| PHYSICAL EXAM | 160 | ||
| LABORATORY AND SLEEP FINDINGS | 160 | ||
| QUESTION | 160 | ||
| ANSWER | 161 | ||
| DISCUSSION | 161 | ||
| REFERENCES | 163 | ||
| 10: TITRATION STUDIES IN CHILDREN | 164 | ||
| 50 - A 5-year-old boy with obstructive sleep apnea not tolerating continuous positive airway pressure | 164 | ||
| CASE PRESENTATION | 164 | ||
| PHYSICAL EXAM | 164 | ||
| LABORATORY AND SLEEP FINDINGS | 164 | ||
| QUESTION | 164 | ||
| ANSWER | 165 | ||
| DISCUSSION | 165 | ||
| REFERENCES | 166 | ||
| 51 - A child referred for positive airway pressure initiation and titration | 167 | ||
| CASE PRESENTATION | 167 | ||
| PHYSICAL EXAM | 167 | ||
| LABORATORY AND SLEEP FINDINGS | 167 | ||
| QUESTIONS | 167 | ||
| ANSWERS | 168 | ||
| DISCUSSION | 168 | ||
| REFERENCES | 169 | ||
| 52 - An adolescent referred for bi-level positive airway pressure titration awakens with leg cramps | 171 | ||
| CASE PRESENTATION | 171 | ||
| PHYSICAL EXAM | 171 | ||
| LABORATORY AND SLEEP FINDINGS | 171 | ||
| QUESTIONS | 171 | ||
| ANSWERS | 173 | ||
| DISCUSSION | 173 | ||
| REFERENCES | 174 | ||
| 53 - A 3-year-old girl with irregular breathing on bilevel positive airway pressure | 175 | ||
| CASE PRESENTATION | 175 | ||
| PHYSICAL EXAM | 175 | ||
| QUESTIONS | 175 | ||
| ANSWERS | 177 | ||
| DISCUSSION | 177 | ||
| REFERENCES | 178 | ||
| 54 - Why is the continuous positive airway pressure no longer working? | 179 | ||
| CASE PRESENTATION | 179 | ||
| PHYSICAL EXAM | 179 | ||
| QUESTION | 179 | ||
| ANSWER | 180 | ||
| DISCUSSION | 180 | ||
| REFERENCES | 181 | ||
| 11: SLEEP AND GENETIC SYNDROMES | 182 | ||
| 55 - A 3-year-old girl with Down syndrome, chronic otitis media, and snoring | 182 | ||
| CASE PRESENTATION | 182 | ||
| PHYSICAL EXAM | 182 | ||
| LABORATORY AND SLEEP FINDINGS | 182 | ||
| QUESTIONS | 182 | ||
| ANSWERS | 183 | ||
| DISCUSSION | 183 | ||
| REFERENCES | 185 | ||
| 56 - An 18-month-old with snoring and achondroplasia | 186 | ||
| CASE PRESENTATION | 186 | ||
| PHYSICAL EXAM | 186 | ||
| LABORATORY AND SLEEP FINDINGS | 186 | ||
| QUESTION | 186 | ||
| ANSWER | 188 | ||
| DISCUSSION | 188 | ||
| REFERENCES | 188 | ||
| 57 - A 9-month-old girl with Pfeiffer syndrome and snoring | 189 | ||
| CASE PRESENTATION | 189 | ||
| PHYSICAL EXAM | 189 | ||
| LABORATORY AND SLEEP FINDINGS | 189 | ||
| QUESTIONS | 189 | ||
| ANSWERS | 191 | ||
| DISCUSSION | 191 | ||
| REFERENCES | 191 | ||
| 58 - A 3-year-old girl with Prader-Willi syndrome and obesity | 192 | ||
| CASE PRESENTATION | 192 | ||
| PHYSICAL EXAM | 192 | ||
| LABORATORY AND SLEEP FINDINGS | 192 | ||
| QUESTIONS | 192 | ||
| ANSWERS | 194 | ||
| DISCUSSION | 194 | ||
| REFERENCES | 195 | ||
| 59 - A 12-day-old infant with Pierre Robin sequence and difficulty breathing | 196 | ||
| CASE PRESENTATION | 196 | ||
| PHYSICAL EXAM | 196 | ||
| LABORATORY AND SLEEP FINDINGS | 196 | ||
| QUESTION | 196 | ||
| ANSWER | 198 | ||
| DISCUSSION | 198 | ||
| REFERENCES | 199 | ||
| 60 - A 12-year-old girl with Williams syndrome and frequent nocturnal awakenings | 200 | ||
| CASE PRESENTATION | 200 | ||
| PHYSICAL EXAM | 200 | ||
| LABORATORY AND SLEEP FINDINGS | 200 | ||
| QUESTION | 200 | ||
| ANSWER | 202 | ||
| DISCUSSION | 202 | ||
| REFERENCES | 202 | ||
| 61 - A 9-year-old female with Joubert syndrome and breath-holding spells | 203 | ||
| CASE PRESENTATION | 203 | ||
| PHYSICAL EXAM | 203 | ||
| LABORATORY AND SLEEP FINDINGS | 203 | ||
| QUESTION | 203 | ||
| ANSWER | 205 | ||
| DISCUSSION | 205 | ||
| REFERENCES | 205 | ||
| 62 - A 4-year-old female with early morning awakenings | 206 | ||
| CASE PRESENTATION | 206 | ||
| PHYSICAL EXAMINATION | 206 | ||
| LABORATORY AND SLEEP FINDINGS | 206 | ||
| QUESTIONS | 206 | ||
| ANSWERS | 208 | ||
| DISCUSSION | 208 | ||
| REFERENCES | 209 | ||
| 12: PARASOMNIAS | 210 | ||
| 63 - A 6-year-old girl who goes to school while sleeping | 210 | ||
| CLINICAL PRESENTATION | 210 | ||
| PHYSICAL EXAM | 210 | ||
| LABORATORY AND SLEEP FINDINGS | 210 | ||
| QUESTION | 210 | ||
| ANSWER | 212 | ||
| DISCUSSION | 212 | ||
| REFERENCES | 213 | ||
| 64 - A 3-year-old girl with disruptive nocturnal awakenings | 214 | ||
| CASE PRESENTATION | 214 | ||
| PHYSICAL EXAMINATION | 214 | ||
| LABORATORY AND SLEEP FINDINGS | 214 | ||
| QUESTION | 214 | ||
| ANSWER | 215 | ||
| DISCUSSION | 215 | ||
| REFERENCES | 216 | ||
| 65 - An 11-year-old boy with obesity and secondary enuresis | 217 | ||
| CASE PRESENTATION | 217 | ||
| PHYSICAL EXAM | 217 | ||
| LABORATORY AND SLEEP FINDINGS | 217 | ||
| QUESTIONS | 217 | ||
| ANSWERS | 219 | ||
| DISCUSSION | 219 | ||
| REFERENCES | 219 | ||
| 66 - A 13-year-old boy with Moebius sequence and violent nocturnal behaviors | 221 | ||
| CASE PRESENTATION | 221 | ||
| PHYSICAL EXAM | 221 | ||
| LABORATORY AND SLEEP FINDINGS | 221 | ||
| QUESTION | 221 | ||
| ANSWER | 223 | ||
| DISCUSSION | 223 | ||
| REFERENCES | 224 | ||
| 67 - Brain tumor presenting as somnambulism in an adolescent* | 225 | ||
| INTRODUCTION | 225 | ||
| CASE REPORT | 225 | ||
| DISCUSSION | 227 | ||
| CONCLUSION | 228 | ||
| REFERENCES | 228 | ||
| 13: MOVEMENT DISORDERS | 229 | ||
| 68 - A 9-year-old boy with snoring and leg movements | 229 | ||
| CASE PRESENTATION | 229 | ||
| PHYSICAL EXAM | 229 | ||
| LABORATORY AND SLEEP FINDINGS | 229 | ||
| QUESTION | 229 | ||
| ANSWER | 231 | ||
| DISCUSSION | 231 | ||
| REFERENCES | 232 | ||
| 69 - A 5-year-old girl with a rush of energy at bedtime | 233 | ||
| CASE PRESENTATION | 233 | ||
| PHYSICAL EXAM | 233 | ||
| LABORATORY AND SLEEP FINDINGS | 233 | ||
| QUESTION | 233 | ||
| ANSWER | 234 | ||
| DISCUSSION | 234 | ||
| REFERENCES | 235 | ||
| 70 - A 4-year-old boy with tooth grinding during sleep | 236 | ||
| CASE PRESENTATION | 236 | ||
| PHYSICAL EXAM | 236 | ||
| QUESTIONS | 236 | ||
| ANSWERS | 237 | ||
| DISCUSSION | 237 | ||
| REFERENCES | 238 | ||
| 71 - A 5-year-old boy with repetitive nocturnal movements | 239 | ||
| CASE PRESENTATION | 239 | ||
| PHYSICAL EXAM | 239 | ||
| LABORATORY AND SLEEP FINDINGS | 239 | ||
| QUESTION | 239 | ||
| ANSWER | 241 | ||
| DISCUSSION | 241 | ||
| REFERENCES | 241 | ||
| 14: SLEEP IN MEDICAL CONDITIONS | 242 | ||
| 72 - A patient with sickle cell disease and a low baseline sleeping oxygen saturation* | 242 | ||
| PHYSICAL EXAM | 242 | ||
| LABORATORY STUDY | 242 | ||
| SUMMARY OF SLEEP STUDY RESULTS | 242 | ||
| QUESTION | 242 | ||
| ANSWER | 242 | ||
| REFERENCES | 245 | ||
| 73 - A 5-month-old baby who wakes and spits up through the night | 246 | ||
| CASE PRESENTATION | 246 | ||
| PHYSICAL EXAM | 246 | ||
| LABORATORY AND SLEEP FINDINGS | 246 | ||
| QUESTION | 246 | ||
| ANSWER | 248 | ||
| DISCUSSION | 248 | ||
| REFERENCES | 249 | ||
| 74 - A 3-year-old boy with trisomy 21 and unchanged apnea–hypopnea index after tonsillectomy and adenoidectomy | 250 | ||
| CASE PRESENTATION | 250 | ||
| PHYSICAL EXAM | 250 | ||
| LABORATORY AND SLEEP FINDINGS | 250 | ||
| QUESTION | 250 | ||
| ANSWER | 251 | ||
| DISCUSSION | 251 | ||
| REFERENCES | 251 | ||
| 75 - A 10-year-old with snoring and hypoxemia | 252 | ||
| CASE PRESENTATION | 252 | ||
| PHYSICAL EXAM | 252 | ||
| LABORATORY AND SLEEP FINDINGS | 252 | ||
| QUESTION | 252 | ||
| ANSWER | 254 | ||
| DISCUSSION | 254 | ||
| REFERENCES | 254 | ||
| 76 - A 13-year-old girl with multiple nocturnal awakenings | 255 | ||
| CASE PRESENTATION | 255 | ||
| PHYSICAL EXAM | 255 | ||
| LABORATORY AND SLEEP FINDINGS | 255 | ||
| QUESTION | 255 | ||
| ANSWER | 257 | ||
| DISCUSSION | 257 | ||
| REFERENCES | 257 | ||
| 77 - A 5-year-old with nocturnal cough and daytime fatigue | 258 | ||
| CASE PRESENTATION | 258 | ||
| PHYSICAL EXAM | 258 | ||
| LABORATORY AND SLEEP FINDINGS | 258 | ||
| QUESTION | 258 | ||
| ANSWER | 260 | ||
| DISCUSSION | 260 | ||
| REFERENCES | 261 | ||
| 15: SLEEP AND NEUROLOGIC CONDITIONS | 262 | ||
| 78 - A 16-year-old boy with intractable seizure disorder and snoring | 262 | ||
| CASE PRESENTATION | 262 | ||
| PHYSICAL EXAMINATION | 262 | ||
| LABORATORY AND SLEEP FINDINGS | 262 | ||
| QUESTION | 262 | ||
| ANSWER | 264 | ||
| DISCUSSION | 264 | ||
| REFERENCES | 265 | ||
| 79 - A 15-year-old girl with Lennox-Gastaut syndrome and breathing pauses | 266 | ||
| CASE PRESENTATION | 266 | ||
| PHYSICAL EXAM | 266 | ||
| LABORATORY AND SLEEP FINDINGS | 266 | ||
| QUESTION | 267 | ||
| ANSWER | 268 | ||
| DISCUSSION | 268 | ||
| REFERENCES | 269 | ||
| 80 - A 2-year-old girl with abnormal nocturnal events | 270 | ||
| CASE PRESENTATION | 270 | ||
| PHYSICAL EXAM | 270 | ||
| LABORATORY AND SLEEP FINDINGS | 270 | ||
| QUESTION | 270 | ||
| ANSWER | 272 | ||
| DISCUSSION | 272 | ||
| REFERENCES | 272 | ||
| 81 - A 13-year-old boy with snoring and headaches | 273 | ||
| CASE PRESENTATION | 273 | ||
| PHYSICAL EXAM | 273 | ||
| LABORATORY AND SLEEP FINDINGS | 273 | ||
| QUESTION | 273 | ||
| ANSWER | 275 | ||
| DISCUSSION | 275 | ||
| REFERENCES | 276 | ||
| 82 - A 13-year-old boy with facial weakness and severe obstructive sleep apnea | 277 | ||
| CASE PRESENTATION | 277 | ||
| PHYSICAL EXAM | 277 | ||
| LABORATORY AND SLEEP FINDINGS | 277 | ||
| QUESTION | 277 | ||
| ANSWER | 279 | ||
| DISCUSSION | 279 | ||
| REFERENCES | 280 | ||
| 83 - A 13-year-old girl with medulloblastoma and breathing pauses | 281 | ||
| CASE PRESENTATION | 281 | ||
| PHYSICAL EXAM | 281 | ||
| LABORATORY AND SLEEP FINDINGS | 281 | ||
| QUESTION | 281 | ||
| ANSWER | 283 | ||
| DISCUSSION | 283 | ||
| REFERENCES | 284 | ||
| 84 - An 11-year-old with Rett syndrome and cyanotic spells | 285 | ||
| CASE PRESENTATION | 285 | ||
| PHYSICAL EXAM | 285 | ||
| LABORATORY AND SLEEP FINDINGS | 285 | ||
| QUESTION | 285 | ||
| ANSWER | 287 | ||
| DISCUSSION | 287 | ||
| REFERENCES | 288 | ||
| 85 - An 11-year-old boy with morning headaches | 289 | ||
| CASE PRESENTATION | 289 | ||
| PHYSICAL EXAM | 289 | ||
| LABORATORY AND SLEEP FINDINGS | 289 | ||
| QUESTION | 289 | ||
| ANSWER | 290 | ||
| DISCUSSION | 290 | ||
| REFERENCES | 290 | ||
| 86 - An 11-year-old boy with history of concussion and insomnia | 292 | ||
| CLINICAL PRESENTATION | 292 | ||
| PHYSICAL EXAM | 292 | ||
| LABORATORY AND SLEEP FINDINGS | 292 | ||
| QUESTION | 292 | ||
| ANSWER | 293 | ||
| DISCUSSION | 293 | ||
| REFERENCES | 294 | ||
| 16: SLEEP AND PSYCHIATRIC CONDITIONS | 295 | ||
| 87 - A 16-year-old girl with panic attacks and multiple nocturnal awakenings | 295 | ||
| CASE PRESENTATION | 295 | ||
| PHYSICAL EXAM | 295 | ||
| QUESTION | 295 | ||
| ANSWER | 296 | ||
| DISCUSSION | 296 | ||
| REFERENCES | 296 | ||
| 88 - A 12-year-old girl with fatigue and difficulty falling asleep | 297 | ||
| CASE PRESENTATION | 297 | ||
| PHYSICAL EXAM | 297 | ||
| LABORATORY AND SLEEP FINDINGS | 297 | ||
| QUESTION | 297 | ||
| ANSWER | 299 | ||
| DISCUSSION | 299 | ||
| REFERENCES | 300 | ||
| 17: SLEEP AND NEURODEVELOPMENTAL DISORDERS | 301 | ||
| 89 - An 8-year-old boy with attention-deficit/hyperactivity disorder and multiple nocturnal awakenings | 301 | ||
| CASE PRESENTATION | 301 | ||
| LABORATORY AND SLEEP FINDINGS | 301 | ||
| QUESTION | 301 | ||
| ANSWER | 302 | ||
| DISCUSSION | 302 | ||
| REFERENCES | 302 | ||
| 90 - A 13-year-old boy with autism spectrum disorder and difficulty falling asleep | 304 | ||
| CASE PRESENTATION | 304 | ||
| PHYSICAL EXAM | 304 | ||
| QUESTION | 304 | ||
| ANSWER | 305 | ||
| DISCUSSION | 305 | ||
| REFERENCES | 306 | ||
| 18: DRUG EFFECTS ON SLEEP | 307 | ||
| 91 - A 13-year-old girl with excessive daytime sleepiness | 307 | ||
| CASE PRESENTATION | 307 | ||
| PHYSICAL EXAM | 307 | ||
| LABORATORY AND SLEEP FINDINGS | 307 | ||
| QUESTION | 307 | ||
| ANSWER | 309 | ||
| DISCUSSION | 309 | ||
| REFERENCES | 310 | ||
| 92 - A 12-year-old girl with narcolepsy and motor tics | 311 | ||
| CASE PRESENTATION | 311 | ||
| PHYSICAL EXAM | 311 | ||
| QUESTIONS | 311 | ||
| ANSWERS | 312 | ||
| DISCUSSION | 312 | ||
| REFERENCES | 313 | ||
| 93 - A 15-year-old girl with narcolepsy type 1 needs sedation for dental work | 314 | ||
| CASE PRESENTATION | 314 | ||
| PHYSICAL EXAM | 314 | ||
| QUESTION | 314 | ||
| ANSWER | 315 | ||
| DISCUSSION | 315 | ||
| REFERENCES | 315 | ||
| 94 - A 14-year-old boy with short stature and snoring | 316 | ||
| CASE PRESENTATION | 316 | ||
| PHYSICAL EXAM | 316 | ||
| LABORATORY AND SLEEP FINDINGS | 316 | ||
| QUESTION | 317 | ||
| ANSWER | 318 | ||
| DISCUSSION | 318 | ||
| REFERENCES | 318 | ||
| 95 - A 17-year-old boy with both insomnia and excessive daytime sleepiness | 319 | ||
| CASE PRESENTATION | 319 | ||
| LABORATORY AND SLEEP FINDINGS | 319 | ||
| QUESTION | 319 | ||
| ANSWER | 320 | ||
| DISCUSSION | 320 | ||
| REFERENCES | 321 | ||
| r96 - A 10-year-old with acute pancreatitis and snoring | 322 | ||
| CASE PRESENTATION | 322 | ||
| PHYSICAL EXAM | 322 | ||
| LABORATORY AND SLEEP FINDINGS | 322 | ||
| QUESTION | 322 | ||
| ANSWER | 323 | ||
| DISCUSSION | 323 | ||
| REFERENCES | 323 | ||
| Common Abbreviation List | 324 | ||
| Thematic Table of Contents | 325 | ||
| PREFACE | 325 | ||
| Index | 327 | ||
| A | 327 | ||
| B | 328 | ||
| C | 328 | ||
| D | 329 | ||
| E | 330 | ||
| F | 331 | ||
| G | 331 | ||
| H | 331 | ||
| I | 332 | ||
| J | 332 | ||
| K | 332 | ||
| L | 332 | ||
| M | 333 | ||
| N | 333 | ||
| O | 334 | ||
| P | 335 | ||
| R | 336 | ||
| S | 336 | ||
| T | 338 | ||
| U | 339 | ||
| V | 339 | ||
| W | 339 | ||
| IBC | ES2 |