Learning objectives: • Understand the role of the sleep laboratory for diagnosis and management of a spectrum of pediatric sleep disorders. • Learn about the special equipment and techniques important in studying pediatric patients. • Understand recent advances and newer techniques in monitoring pediatric sleep.

Background- Oral appliances are increasingly being used now a day as one of the important treatment strategies for sleep disorders. Most of the treating physicians are unaware of their role in treatment for sleep disorders. Objective- The authors reviewed medical and dental literature dealing with available oral appliances and their role in treatment for sleep disorders Results-The authors found that oral appliances are indicated for use in following cases5: 1. Patients with primary snoring or mild OSA who do not respond or are not appropriate candidates for treatment with behavioural measures such as weight loss or sleep position change 2. Patients with moderate to severe OSA who are intolerant of, or refuse treatment with nasal CPAP 3. Patients who refuse or who are not candidates for tonsillectomy and adenoidectomy, cranial facial operations or tracheostomy

Introduction: Persons with neck injuries often have lasting psychosocial effects. One symptom that occurs in a significant number of persons is problems with sleep. Until recently, it was unclear about the predictors of sleep disturbances after a neck injury that does not tend to resolve within six months post injury. In addition, very little is known about how sleep affects overall self reported quality of life, controlling for other relevant predictors. The study aims to examine predictors of sleep disturbances after a neck injury that does not tend to resolve within six months of post injury and how sleep disturbance affects overall quality of life to those having six months post injuries. Methods: Data from a retrospective cohort study of adults have been used to investigate the study. The study population were 258 adults aged (at least 14 years) suffering from moderate to severe neck injury at an acute care Hospital in Toronto, Canada. Both exploratory as well as advanced logistic regression analyses were used in the study. Results: The study shows that participants who had alcohol problem are experiencing about two times higher sleep disturbance and participants with lower education are approximately 3 times more likely of having trouble with sleep than those with higher education. The injury severity and marital status are also found to be important determinant for sleep disturbances. Again, as expected, sleep disturbance and mental health are associated with defining quality of life. Conclusion: This study reveals that marriage, alcohol problem, education, mental health and injury severity are significantly associated with sleep disturbance. On the other hand, strong associations are observed among sleep, mental health and quality of life. These finding helps in understanding risk factors related to sleep disturbance and their consequences on the quality of life.

Background: Recently Distraction Osteogenesis (DO) has been used successfully for advancing maxilla and mandible to treat sleep disordered breathing like Obstructive sleep apnea and non apneic snoring. Prime advantage of DO is slow stretching of soft tissues and bone formation allowing greater advancement and enhancement of airway volume. Patients and Methods: 10 cases with sleep disordered breathing due to maxillo-mandibular discrepancy of varying age groups were treated by various DO techniques.. All the cases showed gross improvement not only in facial and dental aesthetics but also respiratory symptoms. A mean increase of 5.14 mm and 1.85mm with respect to posterior airway space and retro palatal space was observed in mandibular corpus lengthening cases. All the cases showed improvement subjectively and objectively. Conclusion: DO has been found to be valuable and gives us the ability to both prevent and correct the development of sleep disordered breathing.

A 15 year old boy presented with complaints of episodic hypersomnolence, sleeping for 16 to 18 hours a day which would happen for continuously 7 to 8 days, seven to eight times a year for the past 10 years. There was also history of voracious eating during such episodes. There was no history of trauma, seizure -like activity and no significant family history or psychosocial history. His blood sugar, growth hormone, prolactin levels were all normal. MRI brain with contrast done was also normal. Sixteen channel overnight polysomnography and Multiple Sleep Latency Test (MSLT) were done and found to be normal. Clinical features and significant negative tests led to a diagnosis of Kleine-Levin syndrome. He was started on Lithium and being monitored for reduction in frequency of symptoms.