Report of the European Pediatric Sleep Club Meeting

BLED (SLOVENIA) 30 September – 1^st October 2001

The Congress was held in the wonderful scenery of Bled with a nice lake-view directly from the Congress room. It has been organized by Dr.Neubauer and Dr. Ravnik with friendliness and excellent hospitality.

The state of the art lecture from Prof. Kahn was about the factors implicated in the pathogenesis of SIDS. Specila attention has been given to risk factors such as prone position, increase of environmental temperature and prenatal maternal smoking. A complete and exhaustive picture of the syndrome has been made based on personal contributions and the review of the latest literature.

Linking the scientific data with several reports of social health organizations it has been pointed out the impact of maternal smoking as contributing factor for SIDS.

A new approach to the evaluation of sleep microstructure has been presented by Dr. Bruni. The Cyclic Alternating Pattern has been recently recognized by the scientific communutiy and an Atlas is going to be published. The report of Dr. Bruni was the first application of this approach in pediatrics. This kind of analysis could lead to an innovative interpretation of different sleep pathologies in childhood as researcher has been made in adult population.

A comprehensive review of effect of medications used for different pathologies and even of medications used for sleep has been presented by Dr. Groswasser. Starting from vaccinations and mentioning antiepileptic drugs, anti-asthma, antidepressants, corticoids, etc. it has been reported the disrupting effects on sleep of each drug. Finally it has been reported a case of blind child whose slep-wake rhythm was reset by graduated administration of melatonin, rising the problem of the correct administration of this hormone in children.

Dr. Dolenc reported three cases of adult somnambulism rising diagnostic issues and treatment problems. Differential diagnosis with depression, REM behavior disorders, sleep terrors  and obstructive sleep apneas has been considered and the discussion was on the best treatment for each case.

The evening session presented epidemiological data on sleep disorders in developmental age in Slovenia. Dr. Ravnik and his collaborators showed data that included infants, children and adolescents, reporting data similar to other european countries. However, the recent events lead the Slovenian researchers to evaluate the sleep in refugee children and adolescents, showing the disruptive effects of adverse events on sleep of children and adolescents.

Dr. Cvetko presented a wonderful description of the traditional slovenian lullabies with an accurate analysis of melodies and of semantic structure fascinating the sleep researchers.

Dr. Sitar showed us an alternative approach to distressed children and the method to involve them in activities that can  ameliorate their quality of life.

The next morning a comprehensive description of arousal in infants and children was made by Dr. Groswasser. The report highlighted the tremendous efforts of several authors in order to make a consensus on this interesting topic.

Dr. Franco analyzed arousals in infants evaluating the concordance between raters, the differences between cortical and subcortical arousals and the relationships with sleep stages, with modification of heart rate and breathing patterns and with movements.

Dr. Challamel presented preliminary data on arousals in obstructive sleep apnea children showing that, while sleep macrostructure was similar to control children, major differences has been found for microstructure and highlighted the correlation of apneas with arousals.

Dr De Villa presented data on sleep in children with myopathies, stressing that polysomnographic evaluation as a large proportion of them present signs of impaired sleep. For some of them those signs precede any complaint. She indicated also that research was needed in order to determine whether respiratory help during sleep improves life quality and life expectancy in those patients.

Doctor Milanic presented a study of infants with ALTE, in order to determine risk factors for subsequent SIDS.

Dr Gnidovec presented her experience in actimetric studies in infants fopr the study of the development of sleep/wake rhythms. She stressed the importance of using lightweight actimètres and the necessity to validate the data obtained from actimetry.

Dr Groswasser presented a study showing that autonomic balance is modified by the occurrence of sighs. He presented also a study showing that obstructive apneas disappear spontaneously before the age of 20 months. The speed of disappearance is negatively influenced by the number and the duration of apnea at the age of 3 months and positively by the presence of startles.

Dr Challamell presented a lecture on parasomnias in children (mostly arousal disorders) stressing on the differential diagnosis of these disorders and the respective places of reassurance about the benignity of the disorder (though those children may present dangerous behavior) and of psychological and rarely medication treatment.

Some photos of the Congress are here: http://animus.mf.uni-lj.si/neurology/