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In contrast, arousals are less frequent in infants and children, who are more likely to manifest prolonged episodes of partial obstruction and hypoventilation without an interruption in sleep. Perhaps this is the reason that hypersomnolence is not commonly seen in children. The leading predisposing factor for OSAS in children is adenotonsillar hypertrophy. Other etiologies include congenital anomalies, especially those involving midfacial hypoplasia or a small nasopharynx or micrognathia, obesity, laryngomalacia and neuromuscular disorders involving muscular hypotonia or hypertonia.

Her past medical history and family history was unremarkable. She was referred to a child neurologist who started a work-up for myasthenia gravis and an unsuccessful empiric treatment with acetylcholinesterase inhibitor. Twenty-four-hour EEG monitoring did not demonstrate any ictal events. A brain MRI was normal without any structural lesion, and electrodiagnostic studies were normal without findings for neuropathy, myopathy or myasthenia Case Studies in Sleep Neurology: Common and Uncommon Presentations, ed.

A putative flip–flop switch for control of REM sleep. Nature 2006; 441: 589–94. Morgenthaler TI, Kapur VK, Brown T, et al. Standards of Practice Committee of the American Academy of Sleep Medicine. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep 2007; 30: 1705–11. Nevsimalova S. Narcolepsy in childhood. Sleep Med Rev 2009; 13: 169–80. Case 6 A sleepy-head Antonio Culebras Clinical history Mr. X. remembered being a sleepy-head in high school. He would sleep through study hall and had great difficulty staying awake in morning classes.

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Grounding Cognition - Role of Perception and Action in Memory, Language etc by Pecher, Zwaan

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