Pediatric Sleep Medicine Unit

It is also manifested by the presence of snoring and airway obstructions during sleep. Consequently, sleep is not restorative, so patients present hyperactivity and attention deficit, unlike adults, in whom it manifests as daytime sleepiness. The most frequent cause in children is adenotonsillar hypertrophy (80%), which is resolved in most cases with surgical treatment. In the rest of the patients there is usually a malformation of the facial mass. The association between SAHS and overweight-obesity is increasingly frequent, with similar characteristics as in adult patients.

SIDS is characterized by the sudden death of an apparently healthy infant under one year of age. This disorder has been related to different factors, such as lying the infant face down, exposure of the infant to tobacco smoke, prematurity, and constitutional factors, such as physiological immaturity, probable respiratory events during sleep or a dysfunction of certain brain structures, also with manifestations that appear during sleep.

Less frequent than in adults and with the same symptoms (urgent need to move the legs, in many cases accompanied by an unpleasant sensation or pain in the legs, which appears at rest, worsens in the afternoon-evening and improves when moving them). In children and adolescents there is often a family history and they are frequently associated with attention deficit hyperactivity disorder and iron deficiency, with treatment significantly improving symptoms.

Disorder characterized by excessive daytime sleepiness different from adults (in children, naps may be prolonged, not restorative and not irrepressible), with weakness that, unlike adults, appears more frequently in facial muscles, not always caused by emotions. Likewise, nocturnal sleep is very fragmented, with hallucinations upon awakening or falling asleep and episodes of sleep paralysis. Narcolepsy is a rare disease, most frequently in adolescence, related to autoimmunity against a specific group of neurons that synthesize a peptide called hypocretin. Symptomatic treatment of narcolepsy allows the patient to perform normal activities, with supervision and significant improvement in quality of life.

These undesirable events during sleep appear as a consequence of a dissociation of sleep phases. In children, the most frequent are disorders of the transition between wakefulness and sleep (night terrors, sleepwalking), often related to genetic factors and with a lower prevalence in adolescence and adulthood. In very few cases it is necessary to establish a pharmacological treatment, resolving easily in most cases.

In adolescents, their “biological clock” (suprachiasmatic brain nucleus) is often delayed with respect to the natural night-day cycle. As a consequence of this phenomenon, a disorder called “sleep phase delay syndrome” occurs, characterized by a delay in the reconciliation of sleep, resulting in poor sleep during the school period, when they have to wake up early. This results in fatigue and daytime sleepiness, apathy, lack of motivation, irritability, oppositionism and, ultimately, depression and school failure. The treatment of this disorder is simple, achieving the resolution of the symptoms.