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[Common causes of sleep disturbances in Icelandic children who undergo sleep studies.]
1Department of Childrens Medicine, Landspitali University Hospital, Fossvogi, 108 Reykjavík, Iceland. hakonh@landspitali.is.
Insights
Organic causes like obstructive sleep apnea (OSA) and gastroesophageal reflux (GER) are common in children with sleep disturbances. Sleep studies are crucial for diagnosing these conditions and guiding effective treatment strategies.
Area of Science:
- Pediatric Sleep Medicine
- Gastroenterology
Context:
- Sleep disturbances are prevalent in children, often attributed to behavioral issues.
- Organic causes, such as obstructive sleep apnea (OSA) and gastroesophageal reflux (GER), are less understood in pediatric populations.
- This study addresses the investigation of OSA and GER in Icelandic children experiencing sleep disturbances.
Purpose:
- To investigate the prevalence and severity of organic causes of sleep disturbances in Icelandic children.
- To evaluate the efficacy of sleep studies and pH monitoring in diagnosing OSA and GER.
- To determine appropriate therapeutic interventions for identified conditions.
Summary:
- A sleep study was conducted on 190 children (0-18 years) referred for sleep disturbances.
- Of 61 children suspected of OSA, 46 showed positive results, leading to therapy changes.
- Of 89 children with suspected GER, 69 were diagnosed, prompting treatment adjustments.
Impact:
- Highlights the significant role of OSA and GER as underlying causes of pediatric sleep disturbances.
- Emphasizes the importance of sleep studies in the comprehensive evaluation of children with sleep issues.
- Facilitates targeted treatments, including surgical or CPAP/BiPAP for OSA and medication for GER.
Introduction:
Sleep disturbances are common problems in children. Frequently, these problems are attributed to learned behavioral patterns, but little is known about organic causes of sleep disturbances in children. Obstructive sleep apnea (OSA) is a common cause of sleep disordered breathing in adults. Gastroesophageal reflux (GER) is also common in this population. Less is known about OSA and GER as potential causative agents of sleep disturbances in children, and these medical problems have not been addressed in Icelandic children. This study was designed to investigate the organic causes of sleep disordered breathing in Icelandic children, evaluate their severity and possible therapies.
Material And Methods:
One hundred and ninty children who were referred to the Pediatric Department at Reykjavik Hospital due to sleep disturbances were hospitalized over night and a sleep study was recorded, using the sleep equipment, EMBLA. The latter machine has 16 channels that record informations about sleep patterns and breathing. The children were 0-18 years of age. Informations were collected from EEGs, EMGs, and eye movements to determine sleep stages, and with respiratory belts with sensors on the chest and abdomen as well as an air-flow sensor that measures airflow through the nose and mouth. When GER was suspected, a pH meter was inserted and the pH values were measured in the upper and lower parts of the esophagus.
Results:
The results demonstrate that a large number of children who suffer from sleep disturbances have an underlying disease. Of 61 children who underwent a sleep study and were suspected to have OSA, 46 had a positive study that resulted in a change in therapy. In addition, 69 of 89 children who underwent pH measurements in the esophagus were diagnosed with GER which prompted changes in therapy.
Conclusions:
The study demonstrates that both OSA and GER are common problems in children with sleep disturbances. We conclude that sleep studies are important in the overall workup of children with sleep disturbances, and can provide valuable informations regarding the causes, prevalence and severity of these medical problems. Sleep studies also facilitate the selection of children who require specific treatments such as operation of the oropharynx or CPAP/BiPAP treatment for OSA, or drug therapy for GER.
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