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Related Concept Videos

Sleep Apnea01:21

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Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Sleep-Wake Cycles01:24

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Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and  rapid eye movement (REM).
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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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How do we recognize the child with OSAS?

Koen F Joosten1, Helena Larramona2, Silvia Miano3

  • 1Erasmus MC, Pediatric Intensive Care, Sophia Children's Hospital, Rotterdam, The Netherlands.

Pediatric Pulmonology
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Summary

Childhood obstructive sleep apnea syndrome (OSAS) presents with varied symptoms and risk factors. Diagnosis relies on polysomnography, but oximetry and questionnaires can identify high-risk children when it

Keywords:
diagnostic toolsendoscopyobstructive sleep apnea syndromepolysomnography

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Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep-disordered breathing (SDB) encompasses primary snoring to obstructive sleep apnea syndrome (OSAS) in children.
  • Clinical suspicion for OSAS arises from parental reports of symptoms and physical exam findings indicating upper airway obstruction.
  • Symptoms include snoring, apneic events, daytime sleepiness, hyperactivity, poor school performance, growth issues, and enuresis.

Purpose of the Study:

  • To review the clinical spectrum, diagnosis, and management of obstructive sleep-disordered breathing in children.
  • To highlight risk factors and diagnostic challenges, particularly in resource-limited settings.

Main Methods:

  • Review of clinical presentations, risk factors, and diagnostic modalities for childhood OSAS.
  • Discussion of polysomnography as the gold standard, with alternatives like nocturnal oximetry and sleep questionnaires.
  • Inclusion of upper airway endoscopy and MRI for identifying obstruction levels.

Main Results:

  • Childhood OSAS has diverse symptoms and risk factors, including prematurity, family history, obesity, and African American ethnicity.
  • Polysomnography is definitive but not always feasible; oximetry and questionnaires serve as screening tools.
  • Endoscopy and MRI aid in localizing airway obstruction in complex cases.

Conclusions:

  • Childhood OSAS is a spectrum of SDB with significant clinical manifestations and morbidities.
  • Accurate diagnosis requires considering clinical suspicion, risk factors, and available diagnostic tools, adapting to resource availability.
  • Further investigation with imaging may be necessary for complex cases to guide treatment.