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Sleep and The Developing Brain: Mechanistic and Clinical Constructs

Administrator: Lalitha Sivaswamy

Pediatric Headache Disorders and Sleep: Case Based Discussion
Mitch Williams

Dr. Sivaswamy will use a series of illustrative cases to highlight the relationship between headache disorders and sleep. The audience will understand the importance of addressing each component of this dyad to optimize clinical outcomes and quality of life. The role of CGRP blockers will be discussed as applies to headache and sleep medicine. If possible, audience participation will be encouraged at this talk, through electronic means (depending on the availability at the venue). This will enable the participants to engage with the presentation. At the conclusion of the session, she will participate in the Q and A session. 
These are some recent papers co-authored by this speaker:
1. Headaches in Children. Sivaswamy L, Kamat D.
Pediatr Ann. 2018 Feb 1;47(2):e48-e49.
2. Management of Childhood Migraine by Headache Specialist vs Non-Headache Specialists. Gutta R, Valentini KJ, Kaur G, Farooqi AA, Sivaswamy L. Headache. 2019 Oct;59(9):1537-1546.
3.Factors Predisposing to Post Dural Puncture Headache in Children.
Bandatmakur M, Bench C, Ngwa N, Osman H, Dave P, Farooqi A, Sivaswamy L. J Child Neurol. 2021 Sep;36(10):831-840

 

Sleep and Epilepsy in the Pediatric Population: What is New?
Sanjeev Kothare

Up to 70% of patients with epilepsy have sleep disordered breathing, daytime sleepiness and fragmented nocturnal sleep, often unrecognized by the treating pediatric neurologist. This lecture will emphasize means to detect and treat these underlying sleep disorders. This may also help to reduce SUDEP in the pediatric population. Further, recent studies have highlighted the role of functional network systems underlying epileptiform activation in sleep in certain epilepsy syndromes, including absence epilepsy, benign focal childhood epilepsy, and epileptic encephalopathy with spike-wave activation in sleep. Adenosine kinase and orexin receptor antagonists are promising new potential drug targets that could be used to treat epilepsy. Sleep and epilepsy have a bidirectional relationship that intersects in the clinical realm. In this talk, Dr. Kothare will outline current concepts and discuss potential therapeutic opportunities in the field of epilepsy and sleep disorders.
References:
1. Effects of anti-seizure medications on sleep architecture and daytime sleepiness in patients with epilepsy: A literature review. Liguori C, Toledo M, Kothare S. Sleep Med Rev. 2021
2.The Interaction Between Sleep and Epilepsy.
Roliz AH, Kothare S. Curr Neurol Neurosci Rep. 2022

 

Autoimmune Encephalitis, COVID 19 and Sleep-Disorders in Children
Rachna Dube

We are gradually recognizing the existence of co-morbid sleep disorders in autoimmune encephalitis and in the recent COVID 19 pandemic, including MISC. This lecture will emphasize the range of sleep disorders that may be encountered by clinicians and tips to early detection and management. The neurological aspects of COVID-19 have been noted early in the pandemic but some of the subtleties and nuances are only now being discovered. The effects of CNS COVID-19 and especially MISC on sleep physiology will be discussed. 
Autoimmune encephalitis (AE) is a heterogeneous class of inflammatory diseases of the brain that can present with a wide spectrum of neuropsychiatric symptoms. Pediatric patients with AE are more likely to present with psychiatric symptoms and sleep disturbances compared to adults. Insomnia and hypersomnia are common sleep problems associated with AE that should be screened early in the diagnostic evaluation. This is a facet that is often overlooked in day-to-day clinical practice but is important from perspective of quality of life of the child. This lecture will focus on these specific scenarios.
 

Sleep Physiology and Traumatic Brain Injury
Joseph Kaleyias

Improving sleep can improve athletic performance. In addition, sleep disorders often emerge after even mild TBI and concussion. This lecture will emphasize how sleep disruption contributes to morbidity, such as the development of neurocognitive and neurobehavioral deficits, and prolongs the recovery phase after injury. The speaker will provide the audience with tips to improve sleep hygiene and schedules and make children, parents and coaches more aware of sleep disorders that can develop after brain injury. He will discuss management options. The shift from complete rest in the immediate aftermath to a more moderate schedule before return to full play and the impact of sleep on this new directive will be discussed. Evaluating sleep disorders in traumatic brain injury should be an important component of post-traumatic brain injury assessment and management, and this lecture will give participants greater insight into this aspect of concussion and traumatic brain injury. Finally, newer research techniques for early diagnosis, prognosis, and improved outcomes after TBI will also be addressed.
Refs:
1. Narcolepsy and other hypersomnias in children.
Kothare SV, Kaleyias J. Curr Opin Pediatr. 2008
2.Sleep disorders in children with cancer.
Kaleyias J, Manley P, Kothare SV. Semin Pediatr Neurol. 2012