Transient Central Sleep Apnea Runs Triggered by Disorder of Arousal in a Child

Lourdes M DelRosso1,2, Kenneth Martin2, Michelle Marcos2

  • 1University of California, San Francisco, California.

Insights

A child

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Respiratory Medicine

Background:

  • Disorders of arousal (parasomnias) are common in children.
  • Central sleep apnea (CSA) is a sleep-related breathing disorder.
  • The relationship between parasomnias and CSA is not well understood.

Observation:

  • A 5-year-old girl experienced frequent nocturnal episodes of confusional arousals, sleep terrors, and sleepwalking.
  • These episodes, occurring during slow-wave sleep, were followed by periodic breathing with central events and oxyhemoglobin desaturation.
  • Clonazepam initially resolved parasomnias but caused paradoxical behavioral issues; sleep extension and melatonin were effective in reducing episode frequency and intensity.

Findings:

  • This case presents a potential link between parasomnia and central sleep apnea.
  • Central sleep apnea sequences were observed to be triggered by parasomnia events.
  • The severity of central events and desaturation decreased progressively within each run.

Implications:

  • This suggests a possible new classification of "complex parasomnia" involving central sleep apnea.
  • Further research is needed to confirm this association in other pediatric cases.
  • Understanding this link may lead to novel treatment strategies for complex sleep disorders in children.

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