Study Design And Population Of Pediatric Sleep Centre

Adolescents today face a widespread chronic health problem: sleep deprivation. Research shows that getting enough sleep is a biological necessity. Sleep is essential for a person’s health and wellbeing, according to the National Sleep Foundation (NSF). Teens are among those least likely to get enough sleep; while they need on average 9 1/4 hours of sleep per night for optimal performance and health and brain development, teens average fewer than 7 hours per school night, and most report feeling tired during the day (Nationwide Childrens, 2003). The root of the problem is early school start times.

Sleep disorders alter ones sleep pattern and often results in the inability to either sleep or sleep soundly. They often cause you to feel restless, tired, fatigued, and irritable. It is estimated that nearly 75 percent of adult Americans experience sleep disorder symptoms at least a few nights per week. At the same time, sleep disturbances in some form are seen in as many as 25 to 30 percent of infants and children (“Sleep Disorders” 2013). Clearly a huge conundrum in the world, sleep disorders affect an inordinate amount of people. Millions of people suffer or have suffered from a sleep disorder at one point in their lives and if mistreated can impact organ systems functioning negatively. Physical disturbances, medical issues,

Although obstructive sleep apnea (OSA) is known to be a common form of sleep-disordered breathing and increase the overall risk of mortality by one and a half times in serious cases, many patients with OSA remain undiagnosed and unrecognized by healthcare professionals (Stuart et al, 2013). Depending on the source, up to approximately 10% of women and 25% of men have OSA, while the overall prevalence of OSA in the general population is between 3% and 7%. OSA is more common in individuals who are obese, older, male, African American or of Pacific Island descent, have a family history of OSA, or have a large neck size/small airway. Patients with OSA have been shown to have a higher incidence of significant systemic conditions such as hypertension, cerebrovascular accident, myocardial infarction, arrhythmias, diabetes, and dementia. Some of the eye problems linked to OSA include glaucoma/other optic neuropathies, retinal vein occlusions, central serous retinopathy (CSR), papilledema/idiopathic intracranial hypertension (IIH), floppy eyelid syndrome (FES), and corneal disorders (i.e. keratoconus). This provides optometrists and ophthalmologists with a tremendous opportunity to play an important role in diagnosing and managing patients with OSA as well as improving their quality of life.

This paper will explore the case story of “A Day in the Sleep Clinic”. I will explore the aspects of Dr. Williams' behavior that influence the decisions of the families he works with and possibly influence the ultimate health outcomes of their children. I will explain the roles culture, ethnicity, race, and socioeconomic status play in families' experiences in the healthcare system. Finally, I will discuss factors, other than provider-patient communication, influence disparities in health outcomes.

Obstructive Sleep Apnea, OSA, is a very highly widespread and underdiagnosed disease (Kerner & Roose, 2016). The ailment can affect the person and the people around the affected individual immensely. When one takes the time to diagnose a case of OSA it can be helped and treated. Many different factors should be taken into account when dealing with Obstructive Sleep Apnea, including the psychological perspective it falls under, the research methods used to investigate it, the positive and negative components of the condition, and the controversies associated with it.

The sleep assessment conducted on the patient had an interesting dynamic in how we think we sleep opposed to how our partner says we sleep. The patient wakes up every morning at 6 a.m. and takes a nap right after lunchtime approximately at 1 p.m. The daily naps, according to the patient, last about forty-five minutes to an hour. When asked about restlessness when waking up the patient with a stern voice and pointed finger says, "When I'm up I'm up and ready to go." The patient also explained that they have no trouble staying asleep; however going to sleep can be challenging depending on if anything troubling is on her mind.

The intention of this paper is to describe the epidemiology and risk factors of the most common respiratory sleep disorder, obstructive sleep apnea (OSA), and to examine the link between OSA and the array of negative health issues, concentrating on the cardiovascular evidence.

All groups were age and gender matched. The mean BMI of the IFL group was significantly higher than NFL group with no significant difference between IFL and OSAS group. The PTT Ar in the IFL groups was significantly higher than that found in the NFL group denoting the higher degree of cardiovascular arousal in the IFL group. The highest level of PTT Ar was found in the OSAS group denoting the highest degree of cardiovascular arousal compared with the

If cots placed near to the electric cod or blinds, it may be dangerous to the babies and children

OSA is a common disorder that is caused by intermittent collapse of upper airway during sleep leading to brain arousal, changes in intrathoracic pressure, and intermittent episodes of hypoxemia and reoxygenation. OSA is increasingly being recognized as a major public health burden, with a strong focus on the associated cardiovascular risk (Phillips and O'Driscoll, 2013).

​Sleep apnea is a chronic sleep disorder which causes repeated cessation of breath (apnea) while a person is sleeping. Some characteristics of sleep apnea are loud snoring, breathlessness, waking up from sleep, and daytime sleepiness. It is estimated that only 2-4% of the general population has sleep apnea.1-3 Compared to the general population, sleep apnea is much more common in patients with end stage renal disease (ESRD). The prevalence of sleep apnea in ESRD patients, according to many reports, fall between 50 and 60%.2-4This estimate mainly derives from self-report questionnaire results. Other reports estimate that sleep apnea occurs in about 70-80% of ESRD patients.1, 3.5 This higher estimate results from polysomnography tests results.3

Dysfunctional Beliefs About Child Sleep Scale, (DBACS). Parents dysfunctional beliefs about children's sleep were analyzed using a an instrument adapted from a DBAS scale for adults. The original had 28 items that were modified to tap into parents dysfunctional beliefs about their child's’ sleep. Two changes were made from the original version, items pertaining to growing older were excluded as they are not relevant to children; word substitutions, the second change, were made to the remaining 22 items. The Child Sleep Habits Questionnaire, (CSHQ), was used to measure the reports made by parents on children with SRP’s. Mothers and fathers were asked to observe their child's sleep behaviors for a week. The CSHQ consists of 45 items forming 8 subscales determine fundamental sleep domains: bedtime resistance, sleep-onset delay, sleep disordered breathing and daytime sleepiness. Parents were asked to rate items on a 3 point scale, and indicate whether they felt there was a problem for their child. Another way to measure an SRP is the Self Sleep Report (SSR), used to measure self reported SRP’s by the children. Sleep diaries and the use of Actigraphs, are used to measure sleep objectively, Actigraphs are motion loggers and it records when the wearer is active or inactive, the periods of inactivity are later logged as rest or sleep. Using Actiwatch-64 and Actiware-CT 5.2, this device and software have shown good concordance against polysomnography in children. The sleep variables measured were: Sleep Onset Latency, Total Sleep Time, and sleep efficiency percent. participants recorded the information a sleep diary; the time they went to bed, lights out, time spent asleep and the time they got out of bed.

Almost half of children’s life is spent asleep. Therefore, it is important for the clinicians to know the effect of sleep on respiratory diseases. (Marcus, 2001) Sleep disordered breathing may lead to serious and miserable complications such as sleep fragmentation, cognitive and behavioral changes, growth retardation, pulmonary hypertension and cor pulmonale. Unfortunately the prevalence of sleep related breathing disorders is high (3-12% of pediatric population); obstructive sleep apnea syndrome alone affects 3% of children.(Church 2012) Before the development of sleep studies, pediatricians mainly depended on history and physical examination for the diagnosis of sleep disorders. Researchers have tried to formulate clinical score questionnaires as an alternative to polysomnography. For the first time in 1984, the role of history and physical examination in the diagnosis of OSAS was assessed by Brouillete. However, several studies have demonstrated that clinical presentation alone cannot differentiate sleep related breathing disorders such as primary snoring from OSAS. Brietzke SE (Brietzke, Katz et al. 2004) showed that only 55.8% of patients were identified by clinical presentation as OSAS; were confirmed by polysomnography later. This unreliability could be caused by several factors; the most significant one is inaccuracy of history as some parents may overestimate difficulties in

The first and most researched sleep disorder is sleep apnea. Sleep apnea does not affect children as often as it effects adults, but it is still a rising concern. Sleep apnea occurs in about 2 per cent of children, mainly between the ages of one through eight. But it can also show up in older children and even infants. (Klein). Research says that young blacks are more at risk than young whites. (Fritz p 83). Children with sleep apnea briefly stop breathing many times during the night due to an obstruction in the respiratory tract. Most of the time it is related to enlarged tonsils and adenoids or to obesity. As the child will gasp for there breath during sleep, they awaken for a few moments to regain there normal breathing and then they immediately return back to sleep. Because the child will be awoken by this many times during the night, this cause sleep deprivation. (Common Sleep Problems AA). The physical symptoms of sleep apnea are excessive daytime sleepiness, snoring, restless sleep, heavy and irregular breathing, excessive perspiring during the night, bad dreams, sleeping with there mouth open, sleeps in strange positions, morning headaches, learning problems, excessive irritability, depression, changes in personality, difficulty

However, obstructive sleep apnea is just the opposite in which, it affects around two to four percent of kids’. The results of sleep