Paeds Vivas · adolescent-and-young-adult-medicine
Sleep, fatigue and circadian disorders in adolescents — branching viva
Branching viva on adolescent sleep physiology, the differential of the tired teenager, delayed sleep-wake phase disorder, insomnia, and the recognition of narcolepsy and other red flags.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are the paediatric registrar in adolescent clinic. The examiner will move from adolescent sleep physiology to the differential of the tired teenager, then to a delayed-phase stem, an insomnia stem and a hypersomnolence red-flag stem.
Stem
The examiner will test whether you understand adolescent sleep physiology well enough to separate the common mechanisms, distinguish sleepiness from fatigue, build a stepped-care plan, and recognise the red flags that mandate referral. [10]
References10ShowHide
- [1]Carskadon MA, Wolfson AR, Acebo C, Tzischinsky O, Seifer R Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep, 1998.PMID 9871949
- [4]Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. Journal of clinical sleep medicine : JCSM, 2016.PMID 27250809
- [7]Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of clinical sleep medicine : JCSM, 2015.PMID 26414986
- [8]Hagenauer MH, Perryman JI, Lee TM, Carskadon MA Adolescent changes in the homeostatic and circadian regulation of sleep. Developmental neuroscience, 2009.PMID 19546564
- [9]Crowley SJ, Acebo C, Carskadon MA Sleep, circadian rhythms, and delayed phase in adolescence. Sleep medicine, 2007.PMID 17383934
- [10]Carskadon MA Sleep in adolescents: the perfect storm. Pediatric clinics of North America, 2011.PMID 21600346
- [11]Beebe DW Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatric clinics of North America, 2011.PMID 21600347
- [13]Blake M, Waloszek JM, Schwartz O, et al. The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive-behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents. Journal of consulting and clinical psychology, 2016.PMID 27775416
- [15]Salanitro M, Wrigley T, Ghabra H, et al. Efficacy on sleep parameters and tolerability of melatonin in individuals with sleep or mental disorders: A systematic review and meta-analysis. Neuroscience and biobehavioral reviews, 2022.PMID 35691474
- [16]Maski K, Trotti LM, Kotagal S, et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine clinical practice guideline. Journal of clinical sleep medicine : JCSM, 2021.PMID 34743789