End-tidal and transcutaneous CO2 monitoring during sleep in children aged under three with suspected sleep apnea

Monitorización transcutánea de CO2; Niños; Apnea del sueñoTranscutaneous CO2 monitoring; Children; Sleep apneaMonitorització transcutània de CO2; Nens; Apnea del so

Nasal cannula use during polysomnography in children aged under three with suspected sleep apnea

Nasal cannula; Pediatric sleep apnea; PolysomnographyCánula nasal; Apnea del sueño pediátrica; PolisomnografíaCànula nasal; Apnea del son pediàtrica; PolisomnografiaObjective Early diagnosis of obstructive sleep apnea (OSA) in children is important. The use of a nasal cannula as an airflow sensor during polysomnography has not been evaluated in younger children. The study aims to evaluate the use of nasal cannula in detecting respiratory events in children under three with suspected OSA during daytime nap studies. Methods A total of 185 patients were prospectively included. Respiratory events were scored using nasal cannula alone, thermistor alone, and both methods simultaneously as the airflow sensor. Agreement and diagnostic accuracy were assessed. Results One hundred and seventy-two children were finally analyzed and 110 (64.0%) presented OSA. Total sleep time with an uninterpretable signal was longer with the nasal cannula than with the thermistor (17.8% vs 1.9%; p < 0.001), and was associated with poor sensor tolerance and adenotonsillar hypertrophy. In the estimation of the apnea-hypopnea index, the nasal cannula showed lower agreement than the thermistor with the joint use of the two sensors (intraclass correlation coefficient: 0.79 vs 0.996 with thermistor). Compared with the thermistor, the nasal cannula presented lower sensitivity for detecting OSA (82.7% vs 95.5%) and a lower negative predictive value (76.5% vs 92.4%). Overall, fewer children were diagnosed with severe OSA with the nasal cannula (19.8% vs 30.8% with the thermistor, and 32.6% with both). Conclusions In children under the age of three, the ability of the nasal cannula to detect obstructive events was relatively low. Therefore, other non-invasive measurements for identifying respiratory events during sleep may be of additional value

Effect of adjunctive perampanel on the quality of sleep and daytime somnolence in patients with epilepsy

Epilèpsia; Somnolència diürna; Fàrmacs antiepilèpticsEpilepsia; Somnolencia diurna; Fármacos antiepilépticosEpilepsy; Daytime somnolence; Antiepileptic drugsThis prospective uncontrolled study evaluated the effect of low-dose adjunctive perampanel therapy (4 mg/day for 3 months) on the sleep-wake cycle and daytime somnolence in adult patients (n = 10) with focal seizures. A > 50% reduction in the number of seizures was reported in 80% of the study patients; treatment had no significant effect on any sleep parameters as evident by the Maintenance of Wakefulness Test, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale scores. Two patients reported dizziness with treatment. In conclusion, low-dose perampanel may improve seizure control without affecting the sleep characteristics or daytime somnolence in patients with epilepsy.This work was supported by Eisai Pharmaceuticals, Spain