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Daniel Erichsen, MD, FAAP 10/25/2011. Pediatric Sleep 101. PS 101. Pediatric Sleep Clinic The function(s) of sleep Consequences of sleep loss Obstructive sleep apnea Division of Peds Sleep What’s going on?. Clinic. Thursday AM session Patients 2 – 26 y Sleep-disordered breathing
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Daniel Erichsen, MD, FAAP 10/25/2011 Pediatric Sleep 101
PS 101 • Pediatric Sleep Clinic • The function(s) of sleep • Consequences of sleep loss • Obstructive sleep apnea • Division of Peds Sleep • What’s going on?
Clinic • Thursday AM session • Patients • 2 – 26 y • Sleep-disordered breathing • Insomnia • Hypersomnia • Restless legs • Parasomnias
Clinic + Facesheet Plz
Clinic • Pediatric Sleep Clinic • The function(s) of sleep • Consequences of sleep loss • OSA • Insufficient sleep
Jonas Bronck • Born • Sävsjö 1600 • 1620s • Captain Dutch West India Company • New Netherlands
June 1639 • Jonas Bronck • Navigates up East River in De Brant Van Troyen (The fire of Troy) • Purchases land north of Harlem River • South of 150th st
Bronx • South of 150th • Jonas Bronk’s land
Bronx • South of 150th • Jonas Bronck’s land • -> Bronck’s land
Bronx • South of 150th • Jonas Bronck’s land • -> Bronck’s land • -> Broncksland
Bronx • South of 150th • Jonas Bronck’s land • -> Bronck’s land • -> Broncksland • -> Bronx
Back to Sleep • 1/3 of your life
Human behavior • Eating • Energy supply • Talking • Communication • Sex • Reproduction • Sleep • ???
Disadvantageous state • Sleep • No food gathering • No reproduction • Easy pray
Sleep • Why do we sleep? • How important is sleep?
Evolutionary perspective • Important functions conserved • How conserved is sleep? • How important is sleep?
Northern fur seal • Lungs • Max 7 minutes submerged • Lives in water • Emerges 4-6 weeks/year
Implanted brain electrodes • Land • Synchronized slow EEG activity entire brain and eyes closed night. • Asynchronized fast EEG activity entire brain and eyes open day.
Implanted brain electrodes • Sea • Right hemisphere synchronized slow activity with left eye closed. • Left hemisphere asynchronized fast activity with right eye open.
Sleep is universal • All species studied have sleep or sleep equivalent • Fish • Insects • Bacteria
Sleep deprivation • Complete sleep deprivation • Hyperphagia • Hyperthermia • Autonomic dysregulation • Loss of fur • Death
Wagner - 2006 • 90 practice tasks-> 8 hr break -> 300 testing tasks • Group 1 – Awake 11 am -> 7 pm • Group 2 – Awake 11 pm -> 7 am • Group 3 – Sleep 11 pm -> 7 am • Outcome • % subjects gained “insight”
Wagner - 2006 • None gained “insight” after first 90 tasks
Wagner - 2006 • % gained “insight” after 300 test tasks
Functions of sleep • Consolidation of declarative memory
Gais- 2002 • 1 hr learning session -> 12 hr break -> 1 hr testing session • Group 1 – Slept 3 hrs • Group 2 – Slept 8 hrs • Group 3 – Awake daytime • Group 4 – Awake nighttime
Gais- 2002 • Outcome • Improvement in speed of correct answer • Decrease in milliseconds
Gais- 2002 • Results
Functions of sleep • Consolidation of procedural memory
Memory consolidation • Slow wave, “deep”, sleep • Consolidation of declarative memory • REM sleep • Consolidation of procedural memory
Functions of sleep • Memory consolidation
Margoliash - 2005 • Single neuron recording • Zebra Finch
Margoliash - 2005 • Record singing
Margoliash - 2005 • New song
Functions of sleep • Memory consolidation may occur 2nd to reactivation of neural pathways in sleep