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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Narcolepsy with obstructive sleep apnea in a 4-year-old Korean girl: a case report

Soonhak Kwon1, Kyungmi Jang, Sukyung Hwang

  • 1Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea.

Journal of Korean Medical Science
|May 17, 2013
PubMed

Insights

Severe snoring in a child may indicate both obstructive sleep apnea (OSA) and narcolepsy. Early diagnosis with a multiple sleep latency test (MSLT) is crucial, especially if symptoms persist after OSA treatment.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurology

Background:

  • Obstructive sleep apnea (OSA) is common in children, often linked to enlarged tonsils.
  • Narcolepsy is a chronic neurological disorder affecting sleep-wake cycles.

Observation:

  • A 4-year-old girl presented with severe snoring, restless sleep, and daytime sleepiness.
  • Initial polysomnography revealed mild OSA (AHI 5.2), treated with tonsillectomy and adenoidectomy.
  • Post-surgery, sleep improved but daytime sleepiness persisted, prompting further investigation.

Findings:

  • Multiple sleep latency tests (MSLT) indicated shortened mean sleep latency and sleep-onset REM periods (SOREMPs), consistent with narcolepsy without cataplexy.
  • Post-operative polysomnography showed a normal AHI of 0.2, confirming effective OSA treatment.
  • The patient was diagnosed with both OSA and narcolepsy.

Implications:

  • Pediatric OSA can mask or coexist with narcolepsy, complicating diagnosis.
  • MSLT is essential for diagnosing narcolepsy in children with persistent daytime sleepiness despite OSA treatment.
  • Timely diagnosis and management of both conditions are vital for improving children's quality of life.

Keywords:
ChildrenNarcolepsy Without CataplexyObstructive Sleep Apnea

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