Question

A nine-year-old girl is brought to the pediatrician. Her parents describe that any time she is startled, she appears to collapse and fall asleep. She also complains of waking up in the morning unable to move. Which sleep disorder should be suspected? (A) Insomnia (B) Sleep deprivation (C) Narcolepsy (D) Sleep apnea

Short answer

Narcolepsy (C).

Step-by-step solution

- Identify key symptoms

The girl collapses and appears to fall asleep when startled and is unable to move upon waking up in the morning. These are the key symptoms.

- Match symptoms with disorders

Compare the symptoms to common sleep disorders. Learn that sudden collapses and inability to move upon waking are characteristic of narcolepsy.

- Evaluate each option

Assess options: Insomnia (difficulty falling/staying asleep), Sleep deprivation (not getting enough sleep), Narcolepsy (sudden sleep attacks, sleep paralysis), Sleep apnea (breathing interruptions). Only narcolepsy matches the symptoms.

- Confirm the answer

Since narcolepsy matches the girl’s symptoms of collapsing when startled and waking up unable to move, it is the most probable disorder.

Key concepts

narcolepsy

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden sleep attacks. It can cause significant disruptions to daily life.
One of the most notable symptoms is cataplexy, which is the sudden loss of muscle tone triggered by strong emotions such as laughter or fear. This can make the person collapse, as seen in the nine-year-old girl in the exercise.
Another frequent symptom is sleep paralysis. This is the temporary inability to move or speak while falling asleep or waking up, often accompanied by hallucinations.
Managing narcolepsy often involves a combination of medication and lifestyle adjustments to help regulate sleep patterns and reduce symptoms.

sleep paralysis

Sleep paralysis is a condition where a person is aware but unable to move or speak while falling asleep or waking up. It is often accompanied by vivid hallucinations and a sensation of pressure on the chest.
This can be a frightening experience, but it is generally harmless. Episodes typically last a few seconds to a couple of minutes.
Causes of sleep paralysis can include sleep deprivation, irregular sleep schedules, stress, and other sleep disorders like narcolepsy.
To help manage sleep paralysis, improving sleep hygiene is important. This includes maintaining a regular sleep schedule, creating a comfortable sleep environment, and reducing stress.

pediatric sleep issues

Pediatric sleep issues are common and can greatly impact a child's health, behavior, and overall development. They range from difficulties falling asleep and staying asleep to more severe disorders like narcolepsy.
Common causes of sleep problems in children include irregular sleep schedules, poor sleep environment, medical conditions, and psychological factors such as anxiety.
Symptoms of sleep issues in children can include excessive daytime sleepiness, irritability, difficulty concentrating, and behavioral problems.
Addressing pediatric sleep issues often involves a holistic approach. This can include establishing healthy sleep routines, creating a conducive sleep environment, and consulting healthcare professionals for underlying medical or psychological conditions.

sleep disorder diagnosis

Diagnosing sleep disorders involves a thorough evaluation by a healthcare professional. This can include medical history, physical exams, and specific tests.
One common diagnostic tool is a sleep study or polysomnography, which records brain waves, oxygen levels, heart rate, and breathing during sleep.
In cases of suspected narcolepsy, multiple sleep latency tests might be conducted. These measure how quickly a person falls asleep in a quiet environment during the day.
Questionnaires and sleep diaries are also used to gather detailed information about sleep patterns and daytime symptoms.
Early diagnosis and treatment of sleep disorders are crucial for managing symptoms and improving quality of life. Effective management plans often include medication, lifestyle changes, and sometimes behavioral therapy.