What is Polysomnography (PSG)?
Polysomnography (PSG) is a comprehensive sleep study used to diagnose various sleep disorders in children. It involves recording a range of physiological parameters during sleep, such as brain activity (EEG), eye movements (EOG), muscle activity (EMG), heart rate, respiratory effort, airflow, and oxygen saturation levels.
Why is PSG Important in Pediatrics?
PSG is crucial in pediatrics because sleep disorders can significantly impact a child's development, behavior, and overall health. Conditions like obstructive sleep apnea (OSA), narcolepsy, periodic limb movement disorder, and parasomnias can be accurately diagnosed with PSG, allowing for targeted and effective treatment.
When Should a Child Undergo PSG?
PSG is recommended for children exhibiting symptoms of sleep disorders, such as loud snoring,
pauses in breathing during sleep, restless sleep, daytime sleepiness, hyperactivity,
learning difficulties, and
poor growth. It is also indicated when there is a suspicion of OSA, especially in children with conditions like Down syndrome, obesity, or craniofacial abnormalities.
How is PSG Conducted in Children?
Conducting PSG in children involves preparing the child and family for the study, often performed in a sleep laboratory. The child is monitored overnight using a variety of sensors and electrodes attached to the body. The environment is made as comfortable as possible to mimic the child's home sleep setting. Parents are usually allowed to stay with their child during the study.
What Parameters are Monitored During PSG?
Several parameters are monitored during a pediatric PSG:
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Electroencephalogram (EEG): Measures brain wave activity.
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Electrooculogram (EOG): Tracks eye movements.
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Electromyogram (EMG): Records muscle activity.
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Electrocardiogram (ECG): Monitors heart rate and rhythm.
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Respiratory effort: Assessed with chest and abdominal belts.
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Airflow: Measured using nasal and oral thermistors.
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Oxygen saturation: Monitored with a pulse oximeter.
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Carbon dioxide levels: Assessed using a capnometer.
What are the Common Pediatric Sleep Disorders Diagnosed with PSG?
PSG helps diagnose various sleep disorders in children, including:
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Obstructive Sleep Apnea (OSA): Characterized by repeated episodes of partial or complete blockage of the airway during sleep.
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Central Sleep Apnea: Where breathing repeatedly stops and starts due to lack of respiratory effort.
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Narcolepsy: A chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep.
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Periodic Limb Movement Disorder (PLMD): Involves repetitive movements of the limbs during sleep.
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Parasomnias: Such as night terrors, sleepwalking, and sleep talking.
What are the Treatment Options Post-PSG Diagnosis?
Treatment depends on the specific sleep disorder diagnosed:
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OSA: Often treated with continuous positive airway pressure (CPAP) therapy, weight management, adenotonsillectomy, or orthodontic treatments.
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Central Sleep Apnea: May require medication, CPAP, or addressing underlying conditions.
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Narcolepsy: Managed with medications to promote wakefulness and regulate sleep cycles.
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PLMD: Treated with medications that reduce limb movements.
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Parasomnias: Managed through behavioral strategies and ensuring a safe sleep environment.
Are there any Risks Associated with PSG in Children?
PSG is a safe and non-invasive procedure. The primary risks are minor and include discomfort from the sensors and potential difficulty sleeping in the laboratory setting. However, the benefits of accurately diagnosing and treating sleep disorders far outweigh these minimal risks.
How Can Parents Prepare Their Child for PSG?
Parents can help prepare their child by explaining the procedure in simple terms, ensuring a favorite blanket or toy is brought along for comfort, and maintaining a positive and calm demeanor. It can also be helpful to visit the sleep lab beforehand to familiarize the child with the environment.
