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Sleep-related obstructive respiratory disturbances in childhood differ significantly from the adult's obstructive sleep apnea syndrome (OSAS). In contrast to adults, in children with OSAS the disturbance of the macrostructure of sleep, the increase of the number of apneas and hypopneas, and the diminution of oxygen saturation are not so prominent. Restlessness of the sleep, as reflected by movement arousals together with cortical (electroencephalograph-recorded) arousals, is important. The combination of clinical symptoms and polysomnographic parameters is necessary to diagnose OSAS in children.

Zusammenfassung15 Kinder im Alter von 4,0-16,2 Jahren (8,7/6,4 Jahre -Median / Interquartilabstand) wurden polysomnographisch zum AusschluB schlafbezogener Atmungsst6rungen untersucht und die Anzahl von Aktivit/itserh6hungen des EMG 1"/1 brachioradialis und EMG r/l tibialis anterior sowie von EEG-Arousals wShrend der Schlafzeit erfaBt. Es lieBen sich 9,7/3,9 EEG-Arousals/h Gesamtschlafzeit (TST) nachweisen. Sie traten insbesondere in Kombination mit Bewegungen (88,4%) auf. 44,6% aller Bewegungen waren kombinierte Arm-, Beinbewegungen (Ganzk6rperbewegungen), wobei diese zu 90,6% von EEG-Arousals begleitct waren. Alleinige Aktivitatssteigerungen des EMG brachioradialis waren seltener (4,7% aller Bewegungen) als alleinige Beinbewegungen (50,4% aller Bewegungen). Es bestand eine signifikante Korrelation zwischen der H~iufigkeit von Beinbewegungen und EEG-Arousals zu den Schlafstadien. Die Anzahl der Beinbewegungen nahm in folgender Weise in den Schlafstadien ab S1 > REM > $2 > $3/4. In 150 Untersuchungen an 60 unselektierten Patienten konnte kein Altersgang der H~iufigkeit von Beinbewegungen, Beinbewegungen in Kombination mit EEG-Arousals und EEG-Arousals festgestellt werden. SchliisselwOrterP~idiatrie -Schlaf-unruhiger Schlaf-schlafbezogene Atmungsst6rungen. Summary15 children in the age range of 4.0 to 16.2 years ((8.7/6.4 years -median / quartile range) were investigated by nocturnal polygraphy to evaluate disturbances of breathing during one night. To show which limb movements are representative for a restless sleep we quantified the number of arm-and leg-movements (EMG r/l brachioradialis, EMG r/1 tibialis anterior) and EEG-arousals. There were 9.7/3.9 EEG-arousals/h TST (total sleep time). Most arousals were accompanied by movements (88.4%). 44.6% of all movements were combined arm/leg-movements and 90.6% of these movements were accompanied by an EEG-arousal. Only 4.7% of all movements were isolated arm movements and 50.4% were isolated leg movements. There was a significant correlation between the number of leg-movements and EEG-arousals with sleep states. The rate of body movements decreases along the sequence of sleep states NREM 1 > REM > NREM 2 > NREM 3/4. In 150 investigations of 60 children (age 9.2/5.4 years, range 3.7-17.3) with the same procedure there was no age dependence of leg-movements, leg-movements in combination with EEG-arousals and EEG-arousals.

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