Clinical Medicine

Download A Clinical Guide to Sleep Disorders in Children and by Gregory Stores PDF

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By Gregory Stores

Sleep disturbances are regular difficulties that reason nice misery to victims and their households. they're implicated in numerous difficulties, from terrible academic functionality or disturbed habit to injuries or different actual difficulties. but, there's no up to date, finished, one-stop resource of data for clinicians bearing on sleep problems in youngsters. generally, study into sleep issues has often happened inside of separate, unconnected scientific disciplines, quite often concerning adults. As sleep disturbances are linked to critical illnesses, selecting and treating the matter early is vital for sturdy long term overall healthiness and health. Gregory shops addresses this want with a cross-disciplinary evaluate of obtainable medical details and coverings, illustrated via genuine instances. This ebook may be crucial studying for all pros taken with baby healthcare from infancy to early life, and also will be important to normal readers trying to find updated details and references.

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Extra info for A Clinical Guide to Sleep Disorders in Children and Adolescents

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NREM/REM sleep cycles occur at intervals of 50–60 minutes in infants who often enter REM sleep at the start of their sleep period. This interval between sleep cycles continues until adolescence when the periodicity changes to 90–100 minutes which persists into adult life. The amounts of NREM and REM in each sleep cycle is about equal in early infancy; afterwards NREM sleep (especially SWS) predominates in the earlier cycles and REM sleep in the later cycles. Young children may have a period of SWS before Wnally waking in the morning.

Each REM period typically ends with a brief arousal or transition into light NREM sleep. In successive cycles, the amount of NREM sleep decreases and the amount of 28 Basic aspects of sleep and its disorders Figure 1 Hypnogram of healthy young adult. REM sleep increases. SWS is usually conWned to the Wrst two sleep cycles. The diagrammatic representation of overnight sleep architecture is known as a ‘hypnogram’, a simpliWed form of which is shown in Figure 1. Sleep microstructure and sleep fragmentation The conventional sleep staging just described is concerned with the ‘macrostructure’ of sleep, but there is increasing interest in the microstructural disruption of sleep by frequent, brief arousals (seen mainly as changes in the EEG) lasting a matter of seconds without obvious clinical accompaniments.

This period has been called the ‘forbidden zone’ when sleep is particularly diYcult to attain (Lavie, 1986). However, individual diVerences are seen in the precise timing of this pattern. Even from an early age, some people wake early and are especially alert and active in the morning then tire in the evening and are soon asleep (‘morning types’ or ‘larks’). Others are at their best in the evening and Wnd it particularly diYcult to get up and function in the morning (‘evening types’ or ‘owls’) (Horne & Ostberg, 1979).

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