Many fields of medicine have looked at the issue of transitioning care from pediatrics to adults. This book focuses on that transition within the field of sleep medicine. This book gathers and presents in volume information that will assist practitioners to transition the care of their pediatric patients suffering from sleep disorders.
The book will discuss anatomical, physiological and psychological aspects as children grow into adulthood. Specifically, changes in brain function and anatomy, cardiorespiratory function and anatomy, and changes in facial structure are explored. Also discussed are the tools that are used for assessing sleep and how it may apply differently to children and adults. Chapters cover each group of sleep disorders with focus on how the diagnosis, prognosis, and management may change with the transition from childhood through adolescence to adulthood. In addition, gaps in needs and research are discussed.
Author(s): Amir Sharafkhaneh, David Gozal
Publisher: Springer
Year: 2023
Language: English
Pages: 286
City: Cham
Foreword
Contents
Contributors
1: A Brief History of Sleep Medicine in Children and Adults
1.1 Introduction
1.2 Sleep Medicine in Ancient Cultures
1.3 Sleep in the Scriptures
1.4 Scientific History of Sleep Medicine
1.5 History of Polysomnography in Sleep Medicine
1.6 History of Sleep Medicine as a Medical Field
1.7 Education and Training History of Sleep Medicine
References
2: Neurological Aspects of Sleep Medicine, How Sleep Evolves, and Regulation of Function
2.1 Introduction
2.2 Brain Changes Across the Life Span
Structural Brain Changes
Functional Changes in Neurotransmitters
2.3 EEG and Sleep Changes
2.4 Circadian and Homeostatic Changes
Circadian Changes from Adolescence to Adulthood
Homeostatic Changes from Adolescence to Adulthood
2.5 Clinical Implications
2.6 Summary
References
3: Cardiorespiratory Changes as They Relate to Sleep in Transition from Pediatric to Adulthood
3.1 Introduction
3.2 UAW Anatomy
3.3 Tonsils and Adenoids
3.4 UAW Length
3.5 UAW Physiology
3.6 Critical Pressure for UAW Collapse (Pcrit)
3.7 Duration of Apnea and Arousal Threshold (Cortical, Autonomic)
3.8 Ventilatory Control Instability (Loop Gain) and Arousal Effects
3.9 Endothelial Function
3.10 Summary
References
4: Sleep Assessment
4.1 Introduction
4.2 Adult Questionnaires
Sleep Quality
Pittsburgh Sleep Quality Index (PSQI) [3]
Sleep Health Index [12]
Sleep-EVAL
Sleepiness
Epworth Sleepiness Scale (ESS)
Insomnia
The Insomnia Severity Index (ISI)
Athens Insomnia Scale (AIS)
Bergen Insomnia Scale (BIS)
Sleep Apnea
Berlin Questionnaire (BQ)
STOP (SQ) and STOP-BANG (SBQ) Questionnaires
Sleep Apnea Clinical Score (SACS)
Four-Variable Screening Tool (4VSC)
NoSAS Score
No-Apnea Instrument
GOAL Questionnaire
Other Aspects of Sleep
Sleep Duration and Timing
Sleep Hygiene
Psychological Factors of Sleep
Dysfunctional Beliefs and Attitudes About Sleep (DBAS)
Sleep Problem Acceptance Questionnaire (SPAQ)
Self-Efficacy for Sleep Scale (SE-S)
Metacognitive Processes of Sleep Scale (MPSS)
Pre-Sleep Arousal Scale (PSAS)
4.3 Assessment of Children’s Sleep
Sleep Disturbance Scale for Children (SDSC)
Pediatric Sleep Questionnaire (PSQ)
Children’s Sleep Habit Questionnaire (CSHQ)
Sleepiness
Cleveland Adolescent Sleepiness Questionnaire (CASQ) [128]
Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD)
OSA Screening Questionnaires
4.4 Polysomnography
Polysomnography in Adults
Polysomnography in Infants and Children
Appendix
References
5: Sleep-Disordered Breathing: Diagnosis
5.1 Diagnostic Procedures
History and Physical Examination
OSA Screening Questionnaires
Comprehensive Sleep Studies
Polysomnography
Home Sleep Apnea Testing
Blood Biomarkers
5.2 Diagnostic Strategy
Impact of COVID-19 Pandemic on Diagnostic Strategy for OSA
5.3 Decision Support Systems in OSA Diagnosis
Automated Sleep Staging from Polysomnography
Automated Diagnosis of Sleep Apnea
Digital Health Technologies in the Management of Sleep Apnea
Advantages and Limitations of Artificial Intelligence in the Management of OSA
References
6: Transitional Care of Sleep-Disordered Breathing: Management
6.1 Introduction
6.2 Overview of Management of OSA in Children and Adolescents
Adenotonsillectomy
Medications
PAP (Positive Airway Pressure) Therapy
Dental Appliance
High-Flow Nasal Cannula and Supplemental Oxygen
Other Treatments
6.3 Overview of Transition of Care
6.4 Structured Transition Care Program in OSA
6.5 Issues Related to Specific Treatment of OSA
Positive Airway Pressure Therapy
Medical Therapy
Surgery
6.6 Issues Related to Specific Conditions with High Prevalence of OSA
Obesity
Chromosomal Anomalies and Craniofacial Syndrome
References
7: Technology Approaches for Chronic Noninvasive Ventilatory Support in Chronic Respiratory Conditions
7.1 Introduction
7.2 Bilevel Positive Pressure Ventilation
Central Alveolar Hypoventilation: Congenital Central Hypoventilation Syndrome
Functional Decrease in Respiratory Muscle Capacity: Neuromuscular Diseases
Increased Respiratory Load: Cystic Fibrosis
Monitoring
7.3 Continuous Positive Airway Pressure
Obesity Hypoventilation Syndrome
7.4 New Modes of Ventilation
Hybrid Modes
VAPS in Neuromuscular Disease
VAPS in Congenital Central Hypoventilation Syndrome
Adaptive Servo-Ventilation
7.5 Telemonitoring
7.6 Active Patient Monitoring
7.7 Transition of Patients on Noninvasive Ventilatory Support
Barriers and Facilitators to Transition of Patients on Noninvasive Ventilatory Support
Examples of Good Practice
7.8 Conclusion
References
8: Chronic Noninvasive Ventilatory Support in Various Chronic Respiratory Conditions Including Protocols
8.1 Introduction
8.2 Noninvasive Ventilation Modes and Settings
8.3 Sleep-Related Hypoventilation and Central Sleep Apnea
8.4 Noninvasive Ventilation in Conditions Involving Neuromuscular Weakness
8.5 Noninvasive Ventilation and Transition of Care
References
9: Insomnia Across the Life Span
9.1 Infancy
9.2 Early Childhood
9.3 School Age
9.4 Adolescence
9.5 Early Adulthood
Pregnancy
Postpartum
9.6 Middle Age
Menopause
9.7 Older Adults
9.8 Conclusion and Future Directions
References
10: Parasomnias: Diagnosis and Management
10.1 Introduction
10.2 Epidemiology
10.3 Disorders of Arousals
10.4 Confusional Arousals
10.5 Sleep Terrors
10.6 Sleepwalking
10.7 Sleep-Related Eating Disorder
10.8 Sleep Talking
10.9 Exploding Head Syndrome
10.10 Sleep-Related Hallucinations
10.11 REM Sleep Disorders
10.12 Nightmares/Nightmare Disorder
10.13 Sleep Paralysis
10.14 REM Sleep Behavior Disorder (RBD)
10.15 Enuresis
10.16 Transition of Care for Patients with Parasomnias
References
11: Movement Disorders: Diagnosis and Management
11.1 Restless Legs Syndrome
Patient Report of RLS Journey
Epidemiology and Pathophysiology
Diagnostic Features
Management and Treatment Options
Summary
11.2 Periodic Limb Movement Disorder
Diagnostic Features
Management and Treatment Options
Summary
11.3 Sleep-Related Bruxism
Diagnostic Features
Treatment Options
Summary
11.4 Sleep-Related Rhythmic Movement Disorder
Diagnostic Features
Treatment Options
Summary
11.5 Restless Sleep Disorder
Diagnostic Features
Treatment Options
Summary
References
12: Circadian Rhythm Disorders in Children and Adults
12.1 Circadian Rhythm Across the Life Span
12.2 Influence of the Circadian Rhythm on Sleep
12.3 Circadian Rhythm Through the Life Span
12.4 Pediatric Sleep and Rhythm
12.5 Sleep During Adolescence
12.6 Sleep During Adulthood and Later Life
12.7 Circadian Rhythm Disorders
12.8 Specific Circadian Rhythm Disorders
Delayed Sleep Phase Disorder
Advanced Sleep Phase Disorder
Irregular Sleep Phase Disorder
Free-Running (Non-24 h) Sleep Wake Disorder
12.9 Circadian Rhythm Disorders in Neurodevelopmental Disorders
12.10 Circadian Rhythm Disorders in Neurodegenerative Disorders
12.11 Diagnostic Testing for Circadian Rhythm Disorders in Children and Adults
12.12 Management of Circadian Rhythm Sleep Disorders in Children and Adults
Sleep Hygiene
Light Therapy
Melatonin and Agonists
Delayed Sleep Phase Syndrome
Advanced Sleep Phase Syndrome
Irregular Sleep-Wake Rhythm (ISWR)
Free-Running (Non-24 h) Disorder (FRD)
12.13 Conclusion
References
13: Transitional Care Aspects of the Diagnosis and Management of Narcolepsy and Other Primary Disorders of Hypersomnia
13.1 Introduction
Narcolepsy
Other Primary Hypersomnia Conditions
Transitional Care
13.2 Diagnosis
Clinical Aspects
Neurophysiological Measures
Difficulties with Pediatric Normative Values for Neurophysiological Tests
Laboratory Testing
Opportunities for Refining the Diagnosis in Transitional Care
13.3 Management
Medications
Behavioral Management
General Management Issues in Transitional Care
Life Stage Considerations
Housing
Driving
Education
Work
Substance Use
Comorbid Conditions
13.4 How Transitional Care Works in Toronto, Canada
13.5 Strategies to Improve Transitional Care
13.6 Future Directions
Narcolepsy and Other Primary Hypersomnia Conditions
Transitional Care in Central Hypersomnolence
13.7 Summary
References
14: Transition of Sleep Care in Patients with Neuromuscular and Neurodegenerative Disorders
14.1 Neurodegenerative Disease
Down Syndrome (DS)
Cerebral Palsy
Neuromuscular Disease
Disorders of the Anterior Horn: Spinal Muscular Atrophy (SMA), Types 1–4
14.2 Neuromuscular Junction Disease
Neonatal Myasthenia Gravis
Congenital Myasthenic Syndrome
14.3 Disorders of the Muscle
Muscular Dystrophy
Congenital Muscular Dystrophy
Duchenne’s and Becker’s Muscular Dystrophy
Duchenne’s Muscular Dystrophy
Myotonic Dystrophy
Myotonic Dystrophy Type 2
Congenital Myopathy
Nemaline Myopathy
X-Linked Myotubular Myopathy
Mitochondrial Disease
14.4 Conclusion
References
15: Cystic Fibrosis: A Successful Model of Transition of Care and Lessons Learned
15.1 Introduction
15.2 Epidemiology
15.3 Genetics
15.4 Pathophysiology
Pulmonary System
Gastrointestinal System
Pancreas
Hepatobiliary
Bowel
15.5 Reproductive Health
15.6 Cystic Fibrosis Transitions of Care
Transition Concepts
Why Is Transition Medicine Important to Cystic Fibrosis?
Models of Transition
Challenges During Transition
Complexity of Health History
Unclear Responsibilities of Co-managing Providers
Time and Financial Burden of Treatment Regimens
Financial Stressors
Social Impact of Illness
Sexual Health Disparity
Peer Group Limitations
Additional Resources
Cystic Fibrosis Foundation
Got Transition/Center for Health Care Transition Improvement
References
16: Sickle Cell Disease: Lessons Learned
16.1 Introduction
16.2 Sickle Cell Disease Overview
16.3 Phase 1: Pre-program Development
16.4 Phase 2: Program Development and Evaluation
16.5 Phase 3: Program Dissemination and Implementation
16.6 Future Directions, Opportunities, and Lessons Learned
References
Index
