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Clinician's Guide to Pediatric Sleep Disorders

2006 Edition, August 30, 2006

Complete Document

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Active, Most Current

Additional Comments:
ISBN: 978-0-8493-9819-3
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Product Details:

  • Revision: 2006 Edition, August 30, 2006
  • Published Date: August 30, 2006
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 370
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


Sleep medicine is still in its infancy. Few medical schools have a department of sleep medicine. Dedicated pediatric sleep programs are even less common. Book stores do not have a designated place to shelve textbooks on the subject. Sleep medicine's borders are ill-defined. Many sleep problems require expertise from a variety of specialties. The specialty spans multiple disciplines including neurology, otolaryngology, psychiatry, and pulmonary. Pediatric sleep disorders encompass a variety of medical conditions; however, the most common diagnosis is sleep-disordered breathing.

Sleep-disordered breathing is a spectrum of disrupted sleep patterns from primary snoring to obstructive sleep apnea. Obstructive sleep apnea exists when the child attempts to breathe but the breath is aborted/interrupted by obstruction in the upper airway. In the 1980s, obstructive sleep apnea was rarely recognized in children and children were presenting to the hospital with severe manifestations of obstructive sleep apnea-heart failure, pulmonary hypertension and failure to thrive. Over the last few decades, obstructive sleep apnea is no longer a "zebra" diagnosis. Nowadays, the most common indication for an adenotonsillectomy is obstructed breathing rather than recurrent infections. In 2002, the American Academy of Pediatrics published guidelines to assist clinicians in the diagnosis and management of obstructive sleep apnea for children. Increasingly, research is demonstrating neurobehavioral and neurocognitive consequences in children who have the mildest forms of sleep-disordered breathing, primary snoring. Sleep-disordered breathing has also been associated with poor school performance and a decreased quality of life.

Although sleep-disordered breathing is the most common pediatric sleep disorder, clinicians should be aware of more obscure sleep disorders which affect a child's health. As an infant, one will sleep most of the time. Subsequently, any condition that affects sleep could interfere with future development. As one ages, inadequate sleep disrupts one's quality of life. With the development of the light bulb, our society was transformed from one where sleep was considered natural to one where it was a luxury. Unfortunately, many people support Thomas Edison's beliefs regarding sleep: "Anything which tends to slow work down is a waste. We are always hearing people talk about ‘loss of sleep' as a calamity. They better call it loss of time, vitality and opportunities." Another myth is that sleep is a passive process. Multiple biological process occur only during sleep. Therefore, disruption of sleep interrupts body homeostasis.

This book provides comprehensive coverage of sleep-disordered breathing but does not neglect other conditions. The primary aim of this book is to educate primary care practitioners so that they may accurately diagnose and treat pediatric sleep disorders. The text is a practical guide to provide the fundamental essentials to recognizing the sleep disorder and to initiate treatment. We have recruited a collection of pediatric specialists-anesthesiologists, neurologists, otolaryngologists, pulmonologists, and psychiatrists to achieve our goal of reaching across disciplines to raise the awareness of pediatric sleep disorders. The authors are renowned in their fields. By providing practical knowledge to the reader, the authors enable the clinician to educate a child's family on their disorder. Since the major pediatric sleep disorder is sleep-disordered breathing, multiple chapters are dedicated to this disorder. Children with sleep-disordered breathing have variable presenting symptoms which may bring them to the attention of a variety of medical specialists: neurologists → sleepiness, otolaryngologists → tonsil hypertrophy, pediatrics → failure to thrive, psychiatry → behavioral, pulmonary → breathing, and urologists → enuresis. Other chapters will enlighten the reader on sleep disorders from infancy through adolescence. Both behavioral and physiologic sleep topics are addressed by the leaders in the field. By reading Clinician's Guide to Pediatric Sleep Disorders, one will become more aware of the consequences of sleep-disordered breathing as well as other common pediatric sleep disorders. The text is a valuable reference for any individual who cares for children.