scholarly journals Introduction to Pediatric Sleep Clinic and Sleep Testing

2019 ◽  
pp. 81-106
Author(s):  
Madeleine Grigg-Damberger ◽  
Kathy M. Wolfe
Keyword(s):  
Decision Making ◽  
Children And Adolescents ◽  
Diagnostic Evaluation ◽  
Smartphone Apps ◽  
Child Friendly ◽  
Sleep Centers ◽  
Sleep Questionnaires ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing ◽  
Pediatric Sleep

This chapter covers the diagnostic evaluation of children and adolescents referred to sleep centers. Diagnosis of sleep disorders in children begins with a structured history. Pediatric sleep questionnaires can be useful. Polysomnography can be frightening for children, and child-friendly polysomnography techniques are discussed. The authors outline how sleep studies are scored in children. The use of actigraphy, nocturnal home oximetry, and multiple sleep latency testing is reviewed. Smartphone apps for monitoring sleep/wake are summarized. The authors believe that more evidence of the validity of smartphone apps is needed before we accept data from them and integrate this information into decision making and the electronic medical records.

scholarly journals Children’s Understanding of Depression

2019 ◽  
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Children And Adolescents ◽  
Health Professionals ◽  
Effective Communication ◽  
Active Involvement

Depression is a mental illness that affects children and especially adolescents, however little is known about how children and adolescents understand depression. Gaining an understanding of how children perceive illness can facilitate effective communication with health professionals and children’s active involvement in decision-making about their health.

scholarly journals But I Need Marijuana to Function as a Mother!

2019 ◽  
pp. 190-215
Author(s):  
Sasikanth Gorantla ◽  
Madeleine Grigg-Damberger
Keyword(s):  
Substance Abuse ◽  
False Negative ◽  
Recreational Drugs ◽  
Sleep Logs ◽  
Urine Drug ◽  
Adolescents And Adults ◽  
History Of ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Polysomnography and multiple sleep latency testing (MSLT), along with detailed history and sleep logs and actigraphy, are essential for the diagnosis of narcolepsy with cataplexy (narcolepsy type 1). Interpreting polysomnography and MSLT data is challenging in patients with substance abuse. This chapter presents the case of a young woman with a history of substance abuse and confounding MSLT results due to covert use of recreational drugs. Recreational drugs affect sleep architecture, and the results of urine drug screening become a critical part of diagnostic evaluation in patients with substance abuse. Patients undergoing MSLT to characterize and confirm central hypersomnia need proper preparation to reduce false-positive, false-negative, and confounding results. Unexpected positive urine toxicology results are common in adolescents and adults undergoing MSLT and maintenance of wakefulness testing.

Developmental Psycholegal Capacities

2018 ◽  
pp. 158-177 ◽  
Author(s):  
Thomas Grisso
Keyword(s):  
Decision Making ◽  
Children And Adolescents ◽  
Medical Patients ◽  
Psychology And Law ◽  
History Of ◽  
Legal Contexts ◽  
Criminal Culpability

This chapter provides a history of theory and research, beginning in the 1970s, on the abilities of children and adolescents to make decisions related to their civil and criminal rights. In this context, the author describes his entry into the field of psychology and law in the 1970s with his seminal studies of juveniles’ capacities to waive Miranda rights. The chapter then inventories the growth of research, to the present, on children’s decision-making capacities in legal contexts. Research has focused especially on youths’ competence to make decisions as medical patients and as defendants, as well as perspectives on their reduced criminal culpability due to developmental immaturity.

scholarly journals Practice Parameters for the Non-Respiratory Indications for Polysomnography and Multiple Sleep Latency Testing for Children

SLEEP ◽  
2012 ◽  
Vol 35 (11) ◽  
pp. 1467-1473 ◽  
Author(s):  
R. Nisha Aurora ◽  
Carin I. Lamm ◽  
Rochelle S. Zak ◽  
David A. Kristo ◽  
Sabin R. Bista ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Practice Parameters ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

scholarly journals 0738 Advance Taper of Antidepressants Prior to Multiple Sleep Latency Testing Increases the Number of Sleep-Onset Rapid Eye Movement Periods and Reduces Mean Sleep Latency

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A281-A281
Author(s):  
B Kolla ◽  
M Jahani Kondori ◽  
M Silber ◽  
H Samman ◽  
S Dhankikar ◽  
...  
Keyword(s):  
Eye Movement ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Initial Assessment ◽  
Rapid Eye Movement ◽  
Regression Analyses ◽  
Practice Parameters ◽  
The Impact ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Abstract Introduction Patients presenting with excessive sleepiness are frequently on antidepressant medication(s). While practice parameters recommend discontinuation of antidepressants prior to multiple sleep latency testing (MSLT), data examining the impact of tapering these medications on MSLT results are limited. Methods Adult patients who underwent MSLT at Mayo Clinic Rochester, Minnesota, between 2014-2018 were included. Clinical and demographic characteristics, medications, including use of rapid eye movement suppressing antidepressants (REMS-AD) at assessment and during testing, actigraphy and polysomnography data were manually abstracted. The difference in number of sleep-onset rapid eye movement periods (SOREMS), proportion with ≥2 SOREMS and mean sleep latency (MSL) in patients who were on REMS-AD and discontinued prior to testing versus those who remained on REMS-AD were examined. At our center, all antidepressants are discontinued 2 weeks prior to MSLT wherever feasible; fluoxetine is stopped 4 weeks prior. Regression analyses accounting for demographic, clinical and other medication-related confounders were performed. Results A total of 502 patients (age=38.18±15.90 years; 67% female) underwent MSLT; 178 (35%) were on REMS-AD at the time of assessment. REMS-AD were discontinued prior to testing in 121/178 (70%) patients. Patients tapered off REMS-AD were more likely to have ≥2 SOREMS (OR-12.20; 95%CI=1.60-92.94) compared to patients who remained on REMS-AD at the time of the MSLT. They also had shorter MSL (8.77±0.46 vs 10.21±0.28; p>0.009) and higher odds of having ≥2 SOREMS (OR=2.22; 95%CI=1.23-3.98) compared to patients not on REMS-AD at initial assessment. These differences persisted after regression analyses accounting for confounders. Conclusion Patients who taper off REMS-AD prior to MSLT are more likely to demonstrate ≥2SOREMs and have a shorter MSL. Pending further prospective investigations, clinicians should preferably withdraw REMs-AD before an MSLT. If this is not done, the test interpretation should include a statement regarding the potential effect of the drugs on the results. Support None

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