Sleep and Breathing in Children: Developmental Changes in Breathing During Sleep, Second Edition

by Marcus; Carole

• ISBN13: 9781420060829
• ISBN10: 1420060821
• Edition: 2nd
• Format: Hardcover
• Copyright: 2008-02-19
• Publisher: CRC Press

Summary

Infants and children spend one- to two-thirds of their life asleep. Despite this, very little attention has been paid to understanding both normal sleep and sleep-related abnormalities during child development. This volume is devoted to breathing during sleep, its changes with development (from the fetus onwards), and the pathophysiology of sleep-related breathing disorders.

Table of Contents

Introduction	p. iii
Foreword	p. v
Preface	p. ix
Contributors	p. xi
Breathing and Sleep States in the Fetus and at Birth	p. 1
Introduction	p. 1
Animal Studies	p. 1
Human Studies	p. 8
Transition to Postnatal Respiration	p. 10
Summary	p. 12
References	p. 12
Laryngeal Function and Neonatal Respiration	p. 19
Introduction	p. 19
Overview of Laryngeal Function	p. 20
Perinatal "Respiratory" Function of the Larynx	p. 20
The Larynx and Apneas in the Newborn	p. 23
Laryngeal Chemoreflexes	p. 29
Swallowing and Respiration in the Newborn	p. 32
Laryngeal Function and Nasal Ventilatory Support	p. 39
Conclusion	p. 41
References	p. 41
Postnatal Development of Carotid Chemoreceptor Function	p. 47
Overview	p. 47
The Carotid Chemoreceptors in Normal Breathing Control in Childhood	p. 48
Developmental Changes in O[subscript 2] Chemoreflexes	p. 56
Developmental Changes in Afferent Chemoreceptor Nerve Activity	p. 58
Mechanisms of Developmental Changes	p. 61
The Carotid Chemoreceptors and Abnormal Breathing Control in Children	p. 71
Summary	p. 72
References	p. 73
Maturation and Plasticity of Central Components in Cardiovascular and Respiratory Control	p. 83
Introduction	p. 83
Plasticity of Respiratory Control	p. 84
Central Chemosensitivity	p. 94
Autonomic Development: Interactions with Breathing and Sleep	p. 95
Developmental Trends in Cardiovascular and Respiratory Measures	p. 96
Neural Structures Involved in Autonomic and Respiratory Regulation: Cerebellum and Vestibular Regions	p. 97
Sleep State Effects	p. 98
VMS Activity	p. 99
Rostral Brain Influences	p. 100
Potential Implications to SIDS	p. 102
Summary	p. 103
References	p. 104
Maturation of Breathing During Sleep	p. 117
Introduction	p. 117
Normal Respiration During Sleep: An Overview	p. 118
Ventilation, Respiratory Patterns, and Apneas	p. 118
Gas Exchange	p. 122
Summary	p. 126
References	p. 126
Interaction Between Upper Airway Muscles and Structures During Sleep	p. 131
Introduction	p. 131
Pharyngeal Maintenance Mechanisms	p. 131
Methodology of Pharyngeal Airway Maintenance Mechanisms	p. 137
Developmental Changes in Pharyngeal Airway Patency	p. 141
Mechanical Influences on Pharyngeal Airway Patency	p. 147
References	p. 152
Craniofacial Development and the Airway During Sleep	p. 157
Introduction	p. 157
Principles of Craniofacial Growth	p. 162
Craniofacial Pattern and OSAS	p. 164
Abnormal Patterns of Craniofacial Growth	p. 167
Conclusion	p. 171
References	p. 172
Breathing and Sleep in Preterm Infants	p. 177
Introduction	p. 177
History	p. 178
Classification and Development of Sleep in Preterm Infants	p. 179
Sleep States and Arousal from Sleep	p. 179
The Effects of Sleep on the Functional and Mechanical Properties of the Respiratory System in Preterm Infants	p. 181
The Effects of Sleep on the Breathing Pattern	p. 185
The Effects of Sleep on Ventilation	p. 191
Clinical Conditions Affected by Sleep	p. 197
Conclusions	p. 200
References	p. 201
Apnea During Infancy	p. 211
Introduction	p. 211
Normative Data in Healthy Term Infants	p. 212
Idiopathic ALTE	p. 217
Summary	p. 223
References	p. 224
Apparent Life-Threatening Events: Pathogenesis and Management	p. 229
Introduction	p. 229
Relationship to Sudden Infant Death	p. 230
Definition	p. 230
The Evidence Base	p. 231
Epidemiology	p. 232
Causes	p. 232
History and Examination	p. 234
Initial Management and Investigations	p. 235
Physiology	p. 237
Multichannel Recordings	p. 238
Medical Causes	p. 238
Psychological Assessment	p. 243
Discharge Planning and Home Monitoring	p. 243
Specific Management for Recurrent ALTE	p. 245
Outcome	p. 246
References	p. 246
Pathophysiology of Sudden Infant Death Syndrome	p. 255
Pathophysiology of Sudden Infant Death Syndrome	p. 255
Failure to Autoresuscitate from Severe Hypoxia	p. 256
Abnormal Chemoreceptor Function Hypothesis	p. 256
Obstructive Sleep Apnea and Apnea of Prematurity as a Cause of SIDS and the Potential Role of Viral Infection	p. 257
OSA, A Cause of SIDS	p. 259
Cardiac Hypothesis for SIDS	p. 260
Accidental Suffocation and Thermal Stress Theories	p. 261
Metabolic Deficiencies Presenting as SIDS	p. 263
Brain Stem Pathology and SIDS	p. 263
References	p. 264
Sudden Infant Deaths: Risk Factors, Contributory Factors, and Causal Factors	p. 269
Introduction	p. 269
Investigation and Classification of Unexpected Infant Deaths	p. 269
The Epidemiology of Unexpected Infant Deaths: Modifiable and Nonmodifiable Risk Factors	p. 272
Infant Physiology and the Pathophysiology of Unexpected Death	p. 280
The "Triple Risk" Hypotheses and Prospects for Prevention of SUDI	p. 282
Current Recommendations	p. 283
References	p. 283
Sudden Infant Death Syndrome: Genetic Studies in Cardiorespiratory and Autonomic Regulation	p. 293
Introduction	p. 293
Cardiac Channelopathy Genes in SIDS	p. 293
Serotonergic System Genes in SIDS	p. 295
Autonomic Nervous System Genes in SIDS	p. 298
Nicotine Metabolizing Genes in SIDS	p. 303
Summary and Clinical Significance	p. 304
Future Directions	p. 307
References	p. 308
Effects of Intermittent Hypoxia on the Developing Organism	p. 315
Background and Introduction	p. 315
Clinical Context (Diseases Producing Intermittent Hypoxia)	p. 317
Risk Factors for Sudden Infant Death Syndrome	p. 318
Responses to Hypoxia	p. 319
Responses to Reoxygenation	p. 321
Effects of Intermittent Hypoxia and Reoxygenation	p. 324
Specific Effects of Intermittent Hypoxia and Reoxygenation Cycle During Early Development	p. 325
Plasticity	p. 329
Models of Intermittent Hypoxia	p. 331
Implications of Current Research and Future Directions	p. 331
References	p. 332
Influence of Prenatal Nicotine Exposure on Development of Neurotransmission in Central Respiratory Neurons	p. 341
Introduction	p. 341
Prenatal Nicotine Exposure and Cholinergic Neurotransmission	p. 342
Prenatal Nicotine Exposure and Fast Inhibitory Neurotransmission	p. 345
Prenatal Nicotine Exposure and Fast Excitatory Neurotransmission	p. 349
Prenatal Nicotine Exposure and Modulatory Neurotransmission: Serotonin	p. 351
Prenatal Nicotine Exposure and Modulatory Neurotransmission: Catecholamines	p. 354
Translational Physiology	p. 354
References	p. 355
Central Hypoventilation Syndromes	p. 363
Introduction	p. 363
Congenital Central Hypoventilation Syndrome	p. 363
Myelomeningocele with Arnold-Chiari Malformation	p. 368
Prader-Willi Syndrome	p. 370
Achondroplasia and Other Skeletal Dysplasias	p. 372
Leigh's Disease	p. 373
Joubert Syndrome	p. 374
Acquired Central Hypoventilation Syndromes	p. 374
Management of Respiratory Failure in Children with Respiratory Control Disorders	p. 375
Summary	p. 378
References	p. 378
Genetic Basis for Congenital Central Hypoventilation Syndrome	p. 383
Introduction	p. 383
Tentative Mutant Newborn Mouse Models of CCHS	p. 384
PHOX2B Gene Mutations in CCHS and LO-CHS Patients	p. 386
Mode of Inheritance	p. 387
Phenotype-Genotype Relationships	p. 388
Molecular Consequences of PHOX2B Gene Mutations	p. 389
Does the PHOX2B Gene Defect Fully Account for the Pathogenesis of CCHS?	p. 390
Conclusion and Perspectives	p. 391
References	p. 392
Epidemiology of Pediatric Obstructive Sleep Apnea	p. 397
Introduction	p. 397
Prevalence	p. 397
Distribution of OSAS Among Population Subgroups	p. 404
OSAS Risk Factors	p. 404
Natural History of OSAS	p. 410
Health Outcomes Associated with OSAS	p. 411
Research Needs	p. 412
References	p. 412
Pathophysiology of Childhood OSAS: Structural Factors	p. 419
Introduction	p. 419
The Role of Anatomic Factors in the Pathophysiology of OSAS	p. 421
Summary	p. 433
References	p. 434
Pathophysiology of Childhood OSAS: Neuromotor Factors	p. 441
Introduction	p. 441
Factors Affecting Neuromotor Function During Sleep	p. 442
Natural Course of Childhood OSAS	p. 452
References	p. 453
Cognitive and Behavioral Consequences of Childhood OSAS	p. 461
Introduction	p. 461
Behavioral Regulation in Children with OSAS	p. 461
Evidence for a Relationship Between OSAS and ADHD	p. 465
Cognitive Deficits in Children with OSAS	p. 466
Moving Beyond Associations: Does OSAS Directly Cause or Contribute to Neurobehavioral Morbidity?	p. 469
Summary and Future Directions	p. 477
References	p. 479
Inflammatory Association with Childhood Obstructive Sleep Apnea Syndrome	p. 489
Introduction	p. 489
Local Inflammation	p. 490
Systemic Inflammation	p. 494
Intermittent Hypoxia and Inflammation	p. 494
Summary	p. 501
References	p. 501
Metabolic Aspects of Sleep Apnea in Children	p. 507
Introduction	p. 507
OSAS	p. 508
Obesity as a Risk Factor for OSAS	p. 509
The Metabolic Consequences of OSAS	p. 509
Sleep Disruption and Glucose Homeostasis	p. 512
IH and Metabolic Abnormalities	p. 513
IGF-1-A Possible Link Between OSAS and Impaired Glucose Metabolism	p. 514
Inflammation	p. 514
Adipokines	p. 516
Summary	p. 518
References	p. 518
Cardiovascular Complications of Childhood OSAS	p. 529
Overview	p. 529
From Intermittent Upper Airway Obstruction to Cardiovascular Complications: Proposed Chain of Events	p. 530
Cardiovascular Complications of OSAS	p. 535
Conclusions and Unanswered Questions for Future Research	p. 543
References	p. 544
Acoustic Reflectance	p. 553
Introduction	p. 553
Basic Principles of the Technique	p. 553
Applications	p. 557
Summary	p. 560
References	p. 561
Pediatric Obstructive Sleep Apnea Syndrome: 30 Years of Progress	p. 565
Introduction	p. 565
Diagnosis	p. 568
Pathogenesis	p. 570
Sequelae: Failure to Thrive	p. 571
Sequelae: The Heart and Cardiovascular System	p. 572
Sequelae: Neurobehavioral Consequences of Sleep Apnea	p. 573
Obesity	p. 575
Surgical Treatment	p. 576
Medical Treatments	p. 576
References	p. 578
Index	p. 587
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