Extreme pediatric obstructive sleep Apnea: Clinical Features, management, long-term outcomes and mortality.

Objectives: Extreme obstructive sleep apnea (OSA), defined by an obstructive apnea-hypopnea index (OAHI) ≥100 events/hr, presents management challenges in pediatric patients due to its severity and associated comorbidities. This study aims to review the clinical characteristics, management strategies, and outcomes in this population.

Methods: Retrospective reviewed patients aged ≤18 years with extreme OSA who underwent level 1 polysomnography (PSG) from 2010 to 2024.

Positional therapy for the treatment of positional obstructive sleep apnea in children: A randomized controlled crossover trial.

Background: Obstructive sleep apnea (OSA) is prevalent in children, but many children remain untreated. Up to one half of children with OSA have positional OSA, a phenotype characterized by the predominance of airway obstruction while supine. Positional devices that prevent sleeping supine may be beneficial for positional OSA.

14 and 6 Hz like spike wave activity is a common finding in young patients with Prader-Willi syndrome.

Study Objectives: Our aim was to characterize the 14 and 6 like spike wave activity seen on electroencephalograms (EEG) in children with Prader-Willi syndrome (PWS) undergoing polysomnograms.

Methods: We performed a retrospective review of children with PWS and healthy controls who underwent diagnostic polysomnograms between January 1, 2007, and December 31, 2020, at SickKids, Toronto, Canada. EEGs from the polysomnograms were reviewed for the presence of the 14 and 6 like spike wave activity and its characteristics.

Polysomnography in hospitalized children: Characteristics and clinical practice at a single tertiary care center.

Background: Polysomnography (PSG) is the gold standard for the diagnosis of pediatric sleep-disordered breathing (SDB). However, the literature characterizing the indications for inpatient PSGs and the impact on clinical decision-making is limited.

Objective: To determine the indications, results, and outcomes for children undergoing inpatient PSGs at our institution.

Characterization of sleep-disordered breathing in children with Duchenne muscular dystrophy by the American Academy of Sleep Medicine criteria vs disease-specific criteria: what are the differences?

Study Objectives: Individuals with Duchenne muscular dystrophy (DMD) frequently develop sleep-disordered breathing. Noninvasive ventilation is often prescribed for sleep-disordered breathing treatment based on the American Academy of Sleep Medicine (AASM) criteria. In 2018, DMD disease-specific criteria for sleep-disordered breathing were established.

Positional device therapy for the treatment of positional obstructive sleep apnea in children: a pilot study.

Background: There is a critical gap in identifying effective interventions for children with obstructive sleep apnea (OSA) who do not tolerate continuous positive airway pressure therapy. Positional OSA (POSA) is a common clinical phenotype whereby OSA occurs predominantly while sleeping in supine position. POSA may be amenable to treatment with a positional device, a belt worn around the chest with cushions on the back to prevent supine positioning, but no data exists in children.

Positional obstructive sleep apnea in an obese pediatric population.

Study Objectives: Positional obstructive sleep apnea (POSA) is a phenotype of obstructive sleep apnea (OSA) where sleep-related obstructive events occur predominantly in the supine position. Limited knowledge exists regarding the presence of POSA in children with obesity. The study objective was to determine the prevalence of POSA while identifying factors associated with POSA in children with obesity.

The Accuracy of an Ambulatory Level III Sleep Study Compared to a Level I Sleep Study for the Diagnosis of Sleep-Disordered Breathing in Children With Neuromuscular Disease.

Study Objectives: Polysomnography (PSG) surveillance recommendations are not being met for children with neuromuscular disease (NMD) because of limited diagnostic facilities. We evaluated the diagnostic accuracy of an ambulatory level III device as compared to a level I PSG.

Methods: A cross-sectional study was conducted at a tertiary pediatric institution.

Memory consolidation in children with epilepsy: does sleep matter?

Introduction: Children with epilepsy have frequent sleep disturbance and challenges in learning and memory. There is little research on the consolidation of memory during sleep in this population. The goal of this pilot study was to determine whether children with epilepsy are able to consolidate memories better after a sleep versus wake period as has been demonstrated in typically developing children.

The utility of a portable sleep monitor to diagnose sleep-disordered breathing in a pediatric population.

Background: Central and⁄or obstructive sleep-disordered breathing (SDB) in children represents a spectrum of abnormal breathing during sleep. SDB is diagnosed using the gold standard, overnight polysomnography (PSG). The limited availability and access to PSG prevents its widespread use, resulting in significant delays in diagnosis and treatment of SDB.

Presentation and treatment of monozygotic twins with congenital central hypoventilation syndrome.

Congenital central hypoventilation syndrome is a rare genetic disorder characterized by hypoventilation during sleep secondary to a blunted response to hypercapnia and hypoxia. The current case report describes developmentally normal four-year-old monozygotic twin boys who presented in infancy with variable presentations and clinical severity of congenital central hypoventilation syndrome. Both were managed with noninvasive positive pressure ventilation.