shabnam jalilolghadr

After going through the alpha wave before waking, a person usually enters the conscious phase physiologically by opening the eyes and communicating with the environment. We conducted the present study to investigate the brain rhythm wave pattern before waking up among the children admitted to the sleep clinic at Ghods Children's Hospital, Qazvin, Iran.

In this cross-sectional study, we investigated 42 children without physical or acute respiratory diseases for brain rhythm wave patterns, 15 seconds before waking up. Data were analyzed manually from the poly-somnography (PSG) recorded during sleep. Then, we divided the children into two groups based on the results of the apnea-hypopnea index (AHI), i.e., mild to moderate and severe AHI. The frequency of brain waves before waking up on epochs 30s, 10s, and 1s were checked between the two groups statistically.

Alpha waves appeared before waking up as the principal brain waves. The frequency of alpha waves went through a decreasing rate until they reached 10 Hz, and then the child woke up. We observed three repetitions of 10 Hz frequencies before waking up for both groups of low-moderate and high AHI.

Awakening happens with a specific trigger of alpha waves in the occipital lobe in the N2 phase at a 10 Hz frequency.

The concurrence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The obstruction of the upper airway leads to OSA and the obstruction of the lower airway leads to COPD. The aim of this study was to compare polysomnographic findings of patients with OS according to severity of lower airway obstruction.

Seventy‑two patients were included in this cross‑sectional study. Patients with COPD referred to a sleep clinic with suspicion of OSA were evaluated by polysomnography (PSG). PSG findings were interpreted based on the American Academy of Sleep Association criteria (2012). COPD severity was categorized into four groups based on GOLD criteria using forced expiratory volume in the first second (FEV1 ). PSG findings also were compared between patients regarding severity of lower airway obstruction (FEV1 ≥50% and FEV1 <50%).

Sixty‑eight of the patients had OS. Twenty‑nine (42.6%) were male. The mean age was 62.3 ± 6.88 years. Thirty‑two (54.4%) of the patients were in GOLD 2. The mean apnea/hypopnea index was 57.41 ± 36.16. Seventy‑two percent of patients had severe OSA. Severe OSA was more prevalent in patients of GOLD 2 and 3 groups compared to the other groups. Among PSG findings, only N2 sleep stage was significantly longer in patients with FEV1 < 50% than in patients with FEV1 ≥50% (61.5 ± 11.2, 55.3 ± 13.4, P = 0.039).

Polysomnographic findings (except N2 stage) are not different in patients with OS with respect to severity of lower airway obstruction.

Obstructive sleep apnea (OSA) has become a highly prevalent condition in pediatric care. OSA in children might considerably impact children’s quality of life. We aimed to evaluate sleep disorders in children with adenotonsillar hypertrophy.

This was a descriptive-analytical and questionnaire-based study of children with adenotonsil-lar hypertrophy referring to otolaryngology clinic at Qazvin Children Hospital, Iran, in 2018-2019. 181 children who were randomly selected from the referral hospitals were evaluated using the validated Persian version of the Children's Sleep Habits Questionnaire (CSHQ). Eight main branches were also completed by the parents and how they evaluated the last week sleep patterns of their children.

A total of 120 completed questionnaires were collected from children aged 1 to 15 years. 52.5% were male and 76.7% were urban residents. 88.8% had snoring and 90.0% had no family history of insomnia. 76.3% fell asleep in the morning, 74.3% had moderate to severe bedtime resistance according to the parents’ reports, and 60.0% had mild and 22.5% had severe sleep onset delay. Finally, 107 children had confirmed sleep disorder that figures 89.2% of the cases included in the study.

Our study showed a high prevalence of sleep disorders in our cases and its effects on behavioral disorders. Children with adenotonsillar hypertrophy had less sleep duration and more sleep disorder as parents reported in present study. Further studies are highly recommended to understand the etiology of sleep disorders in studied population.

Apert syndrome is a rare kind of craniosynostosis which is identified with fusion of cranial sutures during prematurity period and causes physical and intellectual disorders in younger ages. These patients may show symptoms of obstructive sleep apnea due to abnormal craniofacial shape. This article introduces a patient with Apert syndrome, with apnea symptoms, cyanosis, snoring, restlessness, night sweating, repeated sleep interrupts, and daytime irritability. Polysomnography was used due to a suspicious obstructive sleep apnea. The results were as follows: Arousal index: 3.27/h, RDI: 6.51/h, and Lowest oxygen saturation: 46%. CPAP with EPAP: 8cmH2o was used for the patient in sleeping time. Later test results and symptoms of the condition improved remarkably. Approximately 40% of patients with Apert syndrome have the symptoms of obstructive sleep apnea mainly because of mid face hypoplasia, but it can be related to changes of laryngopharynx, larynx, tracheobronchomalacia, and other abnormalities. If the condition is left untreated, obstructive sleep apnea can cause interruptive sleeping, repeated infections, delay in growth and cognition, and more importantly Cor pulmonale and sudden death in sleeping. Therefore, polysomnography must be considered and the patient should be under supervision.