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daniel erichsen md faap 10 25 2011 n.
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Pediatric Sleep 101 PowerPoint Presentation
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Pediatric Sleep 101

Pediatric Sleep 101

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Pediatric Sleep 101

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  1. Daniel Erichsen, MD, FAAP 10/25/2011 Pediatric Sleep 101

  2. 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?

  3. Clinic • Thursday AM session • Patients • 2 – 26 y • Sleep-disordered breathing • Insomnia • Hypersomnia • Restless legs • Parasomnias

  4. Clinic

  5. Clinic

  6. Clinic

  7. Clinic

  8. Clinic

  9. Clinic

  10. Clinic + Facesheet Plz

  11. Clinic • Pediatric Sleep Clinic • The function(s) of sleep • Consequences of sleep loss • OSA • Insufficient sleep

  12. Bronx

  13. Eksjö, Småland

  14. Sävsjö, Småland

  15. Jonas Bronck • Born • Sävsjö 1600 • 1620s • Captain Dutch West India Company • New Netherlands

  16. 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

  17. Bronx • South of 150th • Jonas Bronk’s land

  18. Bronx • South of 150th • Jonas Bronck’s land • -> Bronck’s land

  19. Bronx • South of 150th • Jonas Bronck’s land • -> Bronck’s land • -> Broncksland

  20. Bronx • South of 150th • Jonas Bronck’s land • -> Bronck’s land • -> Broncksland • -> Bronx

  21. Back to Sleep • 1/3 of your life

  22. Human behavior • Eating • Energy supply • Talking • Communication • Sex • Reproduction • Sleep • ???

  23. Disadvantageous state • Sleep • No food gathering • No reproduction • Easy pray

  24. Sleep • Why do we sleep? • How important is sleep?

  25. Evolutionary perspective • Important functions conserved • How conserved is sleep? • How important is sleep?

  26. Mammals

  27. Northern fur seal • Lungs • Max 7 minutes submerged • Lives in water • Emerges 4-6 weeks/year

  28. Implanted brain electrodes • Land • Synchronized slow EEG activity entire brain and eyes closed night. • Asynchronized fast EEG activity entire brain and eyes open day.

  29. Implanted brain electrodes • Sea • Right hemisphere synchronized slow activity with left eye closed. • Left hemisphere asynchronized fast activity with right eye open.

  30. Sleep is universal • All species studied have sleep or sleep equivalent • Fish • Insects • Bacteria

  31. Sleep deprivation

  32. Sleep deprivation • Complete sleep deprivation • Hyperphagia • Hyperthermia • Autonomic dysregulation • Loss of fur • Death

  33. Wagner - 2006

  34. 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”

  35. Wagner - 2006 • None gained “insight” after first 90 tasks

  36. Wagner - 2006 • % gained “insight” after 300 test tasks

  37. Functions of sleep • Consolidation of declarative memory

  38. Gais- 2002

  39. 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

  40. Gais- 2002 • Outcome • Improvement in speed of correct answer • Decrease in milliseconds

  41. Gais- 2002 • Results

  42. Functions of sleep • Consolidation of procedural memory

  43. Normal sleep architecture

  44. Memory consolidation

  45. Memory consolidation • Slow wave, “deep”, sleep • Consolidation of declarative memory • REM sleep • Consolidation of procedural memory

  46. Functions of sleep • Memory consolidation

  47. Margoliash - 2005 • Single neuron recording • Zebra Finch

  48. Margoliash - 2005 • Record singing

  49. Margoliash - 2005 • New song

  50. Functions of sleep • Memory consolidation may occur 2nd to reactivation of neural pathways in sleep