What's new in paediatric sleep?
The major recent advance in our understanding of paediatric sleep is the publication of reference values for sleep in children aged 3.2-8.6 years. These data show developmental changes reflecting a subtle process of the maturation of the central nervous system with regard to sleep in childhood. In infants, a significant negative correlation has been observed between a snore-associated arousal index and an infant development scale, underlining that snoring is less innocent than has been suggested. A link between obstructive sleep apnoea (OSA) and airway inflammation has been demonstrated, with children with OSA having significantly higher expression of the leukotriene (LT) 1 and 2 receptors and higher concentrations of LT C4/D4/E4 and LT B4 in adenotonsillar tissues than children with recurrent rhinitis who have no OSA. This explains the efficacy of treatment for OSA with montelukast, a LT receptor antagonist, alone or in combination with corticosteroids. By using peripheral arterial tonometry, a noninvasive technique that allows the moment-to-moment measurement of sympathetic tone, persistent waking-associated autonomic nervous system dysfunction has been demonstrated in young children with sleep-disordered breathing (SDB). As such, SDB in childhood may represent a cardiovascular risk factor in adulthood.
Fauroux
Brigitte
B
AP-HP, Hôpital Armand Trousseau, Pediatric Pulmonary Department, Université Pierre et Marie Curie-Paris 6, INSERM UMR-S 719, Paris, France. brigitte.fauroux@trs.aphp.fr <brigitte.fauroux@trs.aphp.fr>
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D012913:Snoring / Q000209:etiology