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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the submitted paper the author gives an account of different affection associated with the syndrome of hypersomnia with sleep apnea. They include diseases and malformations with stenosis of the upper airways in the oropharyngeal area, particularly marked during sleep. They comprise also affections of nervous structures which innervate muscles in this area. The author pays attention to the frequent incidence of this syndrome in children with hypertrophic tonsils and adenoid vegetations. In this connection he mentions the cot death syndrome where very often death occurs during the apnoic interval as a result of immaturity of nervous structures which regulate respiration during sleep. The author describes also pathophysiological mechanisms of development of HSA and the diagnosis of this affection where examination by sleep polygraphy is essential. In the subsequent part of the work the author reviews contemporary conservative and surgical treatment of HSA.
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PMID:[Hypersomnia with sleep apnea. II]. 233 39

We have examined in a group of normal infants and in an "at-risk" group with clinical sleep apnea syndrome the duration and frequency distribution of apneas during sleep. In order to improve the estimation of an apnea factor, we introduced a weighting function which is based on the expected frequency distribution of apnea durations of normal infants. We were able to observe a good agreement between clinical rating, based on anamnestic symptoms, and numerical scoring. All infants of the at-risk group were treated with aminophylline, and the respiratory state improved significantly in nearly all cases. Breathing hypoxic gas mixtures tended to depress respiration, especially in the at-risk group, with a pronounced drop of pO2-values. Investigations on the coordination of respiration, sucking, and swallowing during nutritive sucking demonstrated a correspondence between disturbed coordination ability and the sleep apnea syndrome (SAS). This relationship is interpreted to be a result of an immaturity of the autonomic nervous system. In order to evaluate possible hereditary components in conjunction with respiratory disorders and, possibly, SIDS, we studied siblings of SIDS victims, of near-miss infants, and of infants with SAS. Only siblings of SAS and near-miss infants showed clinical signs of respiratory disorders with a rather high prevalence, whereas most of the siblings of SIDS victims were completely lacking conspicuous respiratory symptoms. Our results suggest that not all infants with sleep apnea syndrome are necessarily at increased risk for SIDS.
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PMID:Physiological approaches to respiratory control mechanisms in infants. Assessing the risk for SIDS. 342 35

SIDS is almost invariably sleep-related. Viable syndrome aetiology must be compatible with its many epidemiologically diverse risk factors, each of which directly or indirectly associates with the creation of psychological and/or physiological infant stress, and the subsequent disruption of normal, contented sleep. During essential deep 'rebound' recovery sleep, arousal ability and upper airway muscle tone decrease further to that in normal sleep, with subsequent upper airway obstruction. When stress impact causes sufficient sleep disruption and physiological fatigue, a failure to arouse and so restore sufficient tone to overcome such obstruction results in sudden, unexpected death. SIDS has therefore many causes which share a final lethal mechanical pathway. Evidence is presented for obstructive apnoea during sleep as being the primary syndrome death mode, for sleep disruption, reduced arousal ability, and infant stress in SIDS, and for risk factor association with the creation of this stress. Specific infant vulnerability in the first 6 months of life to stress predominantly related to total dependency on a carer for gratification of need, and to obstructive sleep apnoea due to normal anatomical, physical, and respiratory immaturity, including rapid physiological fatigue, and peaks in sleep and thermal stress vulnerability, are discussed. Further reasons for the limited age period of SIDS, and for reduced neonatal risk, are given. Prone sleeping risk can relate to positional airway obstruction during normal sleep without prior infant stress. Much of SIDS aetiology appears to concern factors related to socio-economic deprivation and subsequent sub-optimal infant care.
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PMID:Infant stress and sleep deprivation as an aetiological basis for the sudden infant death syndrome. 1117 74

Sleep problems are common in childhood. A distinction is made between problems in which polysomnography is abnormal (i.e., the parasomnias, sleep apnea and narcolepsy) and problems that are behavioral in origin and have normal polysomnography. The parasomnias--sleep terrors, somnambulism and enuresis--appear to be related to central nervous system immaturity and are often outgrown. Obstructive sleep apnea syndrome (OSAS) is frequently missed in children and can often be cured through surgery. Behavioral sleep problems may be overcome after parents make interventions. Physicians can be of great assistance to these families by recommending techniques to parents that have been shown to be effective.
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PMID:Sleep disorders and sleep problems in childhood. 1120 93

Sleep-disordered breathing includes disorders of breathing that affect airway patency, e.g. obstructive sleep apnoea syndrome, and also conditions that affect respiratory drive (central sleep disorders) or cause hypoventilation, either as a direct central effect or due to peripheral muscle weakness. Obstructive sleep apnoea syndrome (OSAS) is an increasingly-recognised clinical entity affecting up to 5.7% of children, which, if left untreated, is associated with adverse effects on growth and development including deleterious cognitive and behavioural outcomes. Evidence exists also that untreated OSAS impacts on cardiovascular risk. Close attention should be paid to assessment and investigation of this relatively common condition, instigating early and appropriate treatment to children with OSAS. First-line treatment in younger children is adenotonsillectomy, although other treatment options available include continuous positive airways pressure (CPAP), anti-inflammatory therapies (nasal corticosteroids and anti-leukotrienes), airway adjuncts and orthodontic appliances. Central sleep-disordered breathing may be related to immaturity of respiratory control and can be associated with prematurity as well as disorders such as Prader-Willi syndrome. In some cases, central apnoeas occur as part of a central hypoventilation disorder, which may be inherited, e.g. Congenital Central hypoventilation Syndrome, or acquired, e.g. Arnold-Chiari malformation, brain tumour, or spinal injury. The treatments of central breathing problems depend upon the underlying aetiology.
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PMID:Investigation and management of childhood sleep apnoea. 2447 Jul 27

Sudden demise of a healthy fetus or a neonate is a very tragic episode in the life of parents. These deaths have been a mystery since ages but still remain unexplained. This review proposes the involvement of trigeminal nerve, neurotransmitter substance P (SP), and its receptor neurokinin 1 (NK-1R) in regulation of cardiorespiratory control in fetuses and newborns. Anomalies and immaturity of neuroregulatory systems such as trigeminal system in medulla oblongata of brainstem may provide a possible mechanism of sudden perinatal deaths. Vulnerable infants are born with respiratory center immaturity which in combination with any stressor such as cold, hypoxia, and smoking may lead to cessation of breathing and ventilatory response. SP/NK-1R may be involved in regulating the ventilatory control in neonates while it is decreased in fetal and adult life in humans, and any alterations from these may lead to irreversible sleep apnea and fatal breathing, ultimately sudden death. This review summarizes the studies performed to highlight the expression of SP or NK-1R in sudden perinatal deaths and proposes the involvement of trigeminal ganglion along with its nerve and SP/NK-1R expression alteration as one of the possible pathophysiological underlying mechanism. However, further studies are required to explore the role of SP, NK-1R, and trigeminal system in the pathogenesis of sudden infant deaths, sudden intrauterine deaths, stillbirths, and sudden deaths later in human life.
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PMID:Substance P/Neurokinin 1 and Trigeminal System: A Possible Link to the Pathogenesis in Sudden Perinatal Deaths. 2834 44