Periodic breathing events during sleep such as apneas and hypopneas contribute to a variety of clinical disorders, including the obstructive sleep apnea, central sleep apnea, and central alveolar hypoventilation syndromes. In addition, patients with pulmonary or cardiac dysfunction can experience sustained hypoventilation or periodic respiration during sleep. Sleep-related apneas, hypopneas, and sustained hypoventilation produce asphyxia and sleep disruption, the severity of which determines the systemic effects and clinical sequelae of the respiratory events.
This section focuses on obstructive sleep apnea (OSA), a disorder with serious medical, social, and economic consequences. Although described for centuries, OSA has only recently received widespread recognition, since symptoms develop slowly over years and the breathing abnormality is evident only during sleep in most patients. In the past, we have also neglected the importance of routinely taking a good sleep history to identify these patients in general clinical practice. Well-designed epidemiologic studies are beginning to define just how common the problem is. For example, the Wisconsin Sleep Cohort Study recently demonstrated that 4% of men and 2% of women in a middle-aged working population have OSA.
In this section, We review some of the common sleep disorders of childhood and how they affect families. Developmental failures in achieving consolidated nighttime sleep and daytime wakefulness, in going to bed and falling asleep easily, in maintaining continuity of sleep, and in circadian regulation of sleep-wake cycles are significant risk factors for potential sleep disorders in infants, children, and adolescents. An understanding of childhood sleep disorders is facilitated by knowledge about the development of both sleep-state architecture and sleep-wake-state temporal organization. The maturation of sleep-wake states has been reviewed elsewhere, and only a summary is provided here.