eBook - ePub
Pediatric Sleep Pearls E-Book
Lourdes Del Rosso, Richard B. Berry, Suzanne Beck, Mary H Wagner, Carole L. Marcus
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- 350 pages
- English
- ePUB (adapté aux mobiles)
- Disponible sur iOS et Android
eBook - ePub
Pediatric Sleep Pearls E-Book
Lourdes Del Rosso, Richard B. Berry, Suzanne Beck, Mary H Wagner, Carole L. Marcus
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Ă propos de ce livre
Following in the steps of the bestselling Sleep Medicine Pearls, this practical resource provides authoritative guidance on the evaluation and management of common pediatric sleep medicine problems using concise clinical vignettes. Experts in this rapidly growing field, led by Drs. Lourdes M. Del Rosso, Richard B. Berry, Suzanne E. Beck, Mary H. Wagner, and Carole L. Marcus, provide a hands-on, case-based approach, perfect for physicians studying for the sleep boards, fellows learning sleep medicine, and physicians who see children in their practice.
- Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
- Over 95 cases review key elements in the evaluation and management of a wide variety of pediatric sleep disorders.
- An easy-to-read "pearls" format summarizes 2 to 5 major teaching points for maximum retention. Short, templated chapter s are ideal for use by busy physicians.
- Current scoring criteria from the American Academy of Sleep Medicine manual for sleep and associated events version 2.2, as well as the current International Classification of Sleep Disorders, 3rd Edition (ICSD-3).
- Expert coverage of normal sleep in children, as well as sleep disorders associated with common medical, neurologic, psychiatric, neurodevelopmental, and genetic conditions.
- Up-to-date information on pediatric obstructive sleep apnea syndrome diagnosis and management.
- Numerous illustrations of polysomnographic fragments and pictures of clinical findings help you quickly recognize key pediatric sleep patterns that lead to an accurate diagnosis. All illustrations online are in full color.
- An ideal resource for pediatric sleep medicine specialists, adult sleep medicine specialists, pediatric pulmonologists, pediatric neurologists, pediatric otolaryngologists, general pediatricians, and pediatric psychologists.
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Informations
Sujet
MedicineSous-sujet
Family Medicine & General PracticePart 1
Introduction to Pediatric Sleep Medicine
Section 1
Evaluation of the Pediatric Sleep Patient
Case 1
Pediatric sleep history
A 4 year-old with snoring, gasping and witnessed apneas
Lourdes M. DelRosso
Case Presentation
A 4-year-old boy presented for evaluation of loud snoring, gasping during sleep, witnessed apnea, and increased work of breathing during sleep. The parents noted that the child often sleeps with his neck hyperextended. During the daytime, he is active and playful. He goes to bed at 8 PM and falls asleep within 15 minutes. He does not wake up during the night. He wakes up spontaneously at 8 AM. During the day, he takes a 1-hour nap at noon. He does not have any medical problems and does not take any medication. The review of systems was noncontributory.
Question
Can you diagnose this child with obstructive sleep apnea syndrome (OSAS) based on history alone?
Answer
No. History is helpful in screening patients for OSAS and determining which need further evaluation, but polysomnography (PSG) is the gold standard for the diagnosis of pediatric OSAS.
Discussion
Multiple studies have demonstrated that clinical history alone fails to accurately predict OSAS in children. Although snoring is the most common symptom in children who are diagnosed with OSAS, not all children who snore have OSAS. Indeed, although about 10% of young children snore every night,1 only 1% to 4% of children have OSAS.2 A study of 222 children with symptoms suggestive of OSAS demonstrated that snoring for more than five nights a week had a sensitivity of 77% and a specificity of 48% in detecting pediatric OSAS3; other studies have had similar findings. The American Academy of Pediatrics recommends screening children for snoring at each well-child visit.1 Children who snore every night and have additional symptoms or signs suggestive of OSAS should be evaluated further (Box 1-1). Clinical history alone does not discriminate between habitual snorers and patients with OSAS.4 Other nocturnal symptoms of OSAS include gasping, neck hyperextension, mouth breathing, diaphoresis, sleeping sitting up, and secondary enuresis (bedwetting in a child who was previously dry at night). Parents often describe that the child has increased work of breathing during sleep, with retractions and paradoxical breathing (parents notice the chest caving in or the abdomen moving forcefully). Diurnal symptoms may include inattention, hyperactivity, daytime sleepiness, morning headaches, and poor academic performance.1 Witnessed apneas have a sensitivity of 42% and a specificity of 88%, whereas mouth breathing has a sensitivi...