Movement/arousals. Description, classification, and relationship to sleep apnea in children.

Abstract

Movement/arousal has been described as a characteristic of adult obstructive sleep apnea syndrome (OSAS), but opinions differ as to whether or not OSAS in children increases the frequency of movement/arousal. The problem that we decided to address was the lack of a comprehensive definition and characterization of movement/arousals in children. We therefore quantified and classified movement/arousals during nocturnal polysomnography in 15 children 5.2 +/- 2.7 SD yr of age being evaluated for OSAS. Movement/arousals were defined by modifying the standard criteria for scoring arousals in adults. Median respiratory disturbance index was 4.4/h, with a range of 1 to 28/h. Videotape review was required to adequately distinguish technician-induced from spontaneous movement/arousals. Although movement/arousal durations varied from 1 s to prolonged awakenings, a high frequency of brief, 1- to 3-s movement/arousals occurred in all classification categories: respiratory, 44%; technician-induced, 33%; spontaneous, 36%. When comparing a 16-channel PSG montage with that of a seven-channel cardiorespiratory montage, we found that 84% of all movement/arousals could be detected using the abbreviated montage. In conclusion, we propose a simple classification system that distinguishes three types of movement/arousals: respiratory, technician-induced, and spontaneous. Our results further suggest that a simple montage using cardiorespiratory channels and videotaping would be suitable for home study and sensitive for identifying movement/arousals.

Sleep and Periodic Limb Movement in Sleep in Juvenile Fibromyalgia

“…4 Obstructive sleep apnea should be excluded in any polysomnographic assessment of JF, because it has also been shown to be associated with excessive motor activity during sleep in children. 14 Our polysomnographic data confirm the finding of decreased sleep efficiency reported by Roizenblatt et al 3 However, sleep efficiency could be reduced by several factors such as prolonged sleep latency, reduced total sleep time, and increased wakefulness periods during sleep. We found alterations in all of these domains in our study.…”

Influence of Airway Pressure on Genioglossus Activity during Sleep in Normal Children

“…However, Younes demonstrated that adults with OSAS may on occasion have an increase in flow during induced obstructions sufficient to sustain minute ventilation without arousal (10). In children with OSAS, obstructive events frequently end without a visible electrocortical arousal (11,12), and the sleep architecture remains intact (7). Mechanisms other than frank arousal therefore must also be operative in children, including reflex increases in pharyngeal dilator activity, as discussed above, and alterations in respiratory timing.…”

Obesity Rather Than Severity of Sleep-Disordered Breathing as the Major Determinant of Insulin Resistance and Altered Lipidemia in Snoring Children

“…Because criteria for arousals have not yet been developed for children, arousals were defined as recommended by the American Sleep Disorders Association Task Force report 45 using the 3-second rule and/or the presence of movement arousal. 46,47 Height and weight were obtained using standard techniques from each child. BMI then was calculated (body mass/height 2 ) and was expressed as relative BMI (relBMI), using the following formula: (BMI/BMI of the 50th percentile for age and gender) ϫ 100, based on standardized percentile curves.…”