Familial Childhood Sleep Apnea

We report four siblings who had polysomnographically documented sleep apnea. Two presented with the typical clinical picture of sleep apnea syndrome including daytime somnolence and snoring, had repetitive obstructive apneic episodes during sleep, and were effectively treated with upper airway surgery. The other two were asymptomatic and showed infrequent apneic episodes during sleep. This family illustrates the distinction between the sleep apnea syndrome and infrequent apneic episodes during sleep. The sleep apnea syndrome is associated with daytime symptomatology and requires treatment. The presence of apneic episodes during sleep in all four siblings has implications regarding the predisposing factors (eg, upper airway anatomy and central nervous system dysfunction) versus precipitating factors (eg, obesity, upper airway infection, and central nervous system depressants) in sleep apnea

Sleep-Wake Complaints and Their Relation to Sleep Disturbance

This report is a comparison of patients presenting with 1) an insomnia complaint diagnosed as no objective findings. 2) insomnia diagnosed as being associated with a psychiatric disorder, and 3) daytime sleepiness diagnosed as no objective findings. The sleep of patients with insomnia diagnosed as no objective findings is comparable to that of patients with daytime sleepiness diagnosed as no objective findings and is significantly better than that of patients with insomnia associated with a psychiatric disorder. Significant differences were found in sleep induction, sleep maintenance, and overall sleep efficiency. No major differences were found among any of the groups in terms of sleep staging. All groups showed signs of psychological distress, but as expected this was significantly higher in the patients with insomnia associated with a psychiatric disorder. The fact that patients may present with sleep complaints (either insomnia or daytime somnolence) despite essentially normal sleep has clinical implications. Adequate evaluation of sleep complaints and symptomatic treatment plans are discussed

Isolated Cataplexy: A Familial Study

Four members of a family, a mother, her two sons, and the mother\u27s second cousin, presented with a history of isolated cataplexy without excessive daytime sleepiness or other symptoms typical of narcolepsy. They were polygraphically monitored during one night followed by a day of multiple nap tests. No subject manifested objective daytime sleepiness as measured by short latencies to sleep onset during daytime naps, and no subject exhibited periods of sleep onset rapid eye movement sleep in either the night or nap recordings. The incidence of isolated cataplexy in this family was traced by history through six generations. We conclude that isolated cataplexy in this family is a genetically transmitted dominant trait with incomplete penetrance which occurs independently of daytime sleepiness and the full-blown narcolepsy syndrome