Report of the European Pediatric Sleep Club Meeting

15^th European Sleep Research Society Congress

The club held a satellite meeting on Tuesday, September 12, 2000; its subject was « Sleep in neurologically impaired children ». It was moderated by S Nevsimalova and MJ Challamel and sponsored by the laboratoire Lafon. Sonia Nevsimalova reviewed the literature and presented own data on « Neuroimaging and sleep disturbances in some neuropsychiatric disorders in children ». The importance of functional neuroimaging methods in clarifying the level of dysfunction in neurological diseases associated with sleep disorders was shown. The presentation was focused on autism, Attention Deficit Hyperactivity Disorders (ADHD) and Tourette syndrome. L. Wiggs spoke about "Sleep quality and its psychological significance in chronically ill children" concerning case‑control studies, using home PSG, on the effects of nocturnal asthma, atopic dermatitis and chronic fatigue on sleep organization. She emphasised the beneficial effects, on both the child and the family, when correcting these sleep disturbances. H. Trang reviewed "Breathing problems and support in neurologically impaired children". The main dysfunctions in the regulation of respiration: abnormal cortical influence, deficiency in the brainstem chemosensitive control pathways, dysfunction in the diaphragm and accessory respiratory muscles, dysfunction in the muscles controlling the upper airway diameter during sleep, and the main neurological syndromes associated with an anomaly of the regulation of respiration: Rett and Joubert syndromes, Prader‑Willi syndrome and the Central Congenital Hypoventilation Syndrome were reviewed. Recommendations were made to include assessment of sleep‑related respiration in the follow‑up of neurologically impaired children and on treatments (adenotonsillectomy and or home nasal ventilation) which improve the quality of life of these children.

The second part involved sleep disturbances in specific syndromes or diseases. MJ Challamel presented sleep and respiratory disturbances in two genetic disorders: Rett and  Prader‑Willi syndromes, based on personal data and literature. Concerning Rett syndrome they insisted on the complexity of the respiratory dysfunction which is not only to be seen during waking states but also during sleep in some children. In a personal study based on actimetry, sleep logs and 12‑24 polygraphic recordings, they showed a progressive deterioration of sleep with age, its microstructure and circadian organization. H de Leersnyder presented results of a study in 20 children with Smith‑Magenis syndrome based on sleep log and ambulatory actigraphy associated with ambulatory PSG monitoring in 8 of these children. Biological measurements of melatonin, cortisol and GH were made. This study showed very interesting specific results with clinical evidence of severe insomnia associated to an advanced sleep phase syndrome. It was hypothesized, that the abnormal secretion of melatonin accounts for sleep behaviour disturbances and behaviour problems which are very specific in this syndrome.

M.J. Challamel