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  • Print publication year: 2010
  • Online publication date: November 2010

Case 11 - Paralyzed and unable to breathe

from Part IV - Parasomnias

Summary

This chapter describes the case of a 7.5-month-old Caucasian infant with a birthweight of 3.9 kg, born full term to a 35-year-old mother. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. The patient's pediatrician suspected an upper respiratory tract infection and treated her with "Infants' Cold Formula" with no relief. A soft-tissue X-ray of her neck revealed hypertrophy of her adenoids, which were obstructing the nasal airway. There was paradoxical inward rib-cage motion during inspiration throughout much of the study. Tachypnea was present, particularly during REM sleep. The diagnosis based on the polysomnography (PSG) results was severe obstructive sleep apnea (OSA), pediatric. The patient's symptoms and O2 saturation improved immediately thereafter. A follow-up sleep study 2 months later revealed that the patient no longer demonstrated an obstructive breathing pattern or impairment in gas exchange.

Suggested reading

Historical
MitchellSW.On some of the disorders of sleep. Virginia Med Monthly 1876; 2: 769–81.
Review
SandykR.Resolution of sleep paralysis by weak electromagnetic fields in a patient with multiple sclerosis. Int J Neurosci 1997; 90: 145–57.
General
AASM (American Academy of Sleep Medicine). International Classification of Sleep Disorders, 2nd edn.: Diagnostic and Coding Manual. Westchester, Illinois: American Academy of Sleep Medicine, 2005.
AwadallaA, Al-FayezG, HarvilleM, et al. Comparative prevalence of isolated sleep paralysis in Kuwaiti, Sudanese, and American college students. Psychol Rep 2004; 95: 317–22.
CheyneJA.Sleep paralysis episode frequency and number, types, and structure of associated hallucinations. J Sleep Res 2005; 14: 319–24.
de JongJT.Cultural variation in the clinical presentation of sleep paralysis. Transcult Psychiatry 2005; 42: 78–92.
GirardTA, CheyneJA.Timing of spontaneous sleep-paralysis episodes. J Sleep Res 2006; 15: 222–9.
MitlerMM, HajdukovicR, ErmanM, KoziolJA.Narcolepsy. J Clin Neurophysiol 1990; 7: 93–118.
OhaeriJU, AwadallaA, MakanjuolaVA, OhaeriBM.Features of isolated sleep paralysis among Nigerians. East Afr Med J 2004; 81: 509–19.

Historical

MitchellSW.On some of the disorders of sleep. Virginia Med Monthly 1876; 2: 769–81.

Review

SandykR.Resolution of sleep paralysis by weak electromagnetic fields in a patient with multiple sclerosis. Int J Neurosci 1997; 90: 145–57.

General

AASM (American Academy of Sleep Medicine). International Classification of Sleep Disorders, 2nd edn.: Diagnostic and Coding Manual. Westchester, Illinois: American Academy of Sleep Medicine, 2005.
AwadallaA, Al-FayezG, HarvilleM, et al. Comparative prevalence of isolated sleep paralysis in Kuwaiti, Sudanese, and American college students. Psychol Rep 2004; 95: 317–22.
CheyneJA.Sleep paralysis episode frequency and number, types, and structure of associated hallucinations. J Sleep Res 2005; 14: 319–24.
de JongJT.Cultural variation in the clinical presentation of sleep paralysis. Transcult Psychiatry 2005; 42: 78–92.
GirardTA, CheyneJA.Timing of spontaneous sleep-paralysis episodes. J Sleep Res 2006; 15: 222–9.
MitlerMM, HajdukovicR, ErmanM, KoziolJA.Narcolepsy. J Clin Neurophysiol 1990; 7: 93–118.
OhaeriJU, AwadallaA, MakanjuolaVA, OhaeriBM.Features of isolated sleep paralysis among Nigerians. East Afr Med J 2004; 81: 509–19.