Can anyone tell me what this is and what symptoms it can cause in a child??  My daughter (7) just got the results from her sleep study this week, and while her problems weren't as severe as her brothers, she did still have an AHI index of 2 and her sleep was pretty fragmented.  At this point we are playing the wait and see game.  Her sleep wasn't normal (although she said she slept really good during the study) but it wasn't too bad either.  ??

Sleep fragmentation is defined as the interruption of sleep with frequent, brief arousals characterized by increases in EEG activity and occasionally, temporary increases in muscle tone.

Several studies have shown that fragmentation without overall sleep loss is associated with reduced daytime function similar to that seen in sleep deprived patients.

The arousals can be caused by apneas, hypopneas, limb movements, pain, etc) although there are times when no arousing stimulus can be identified.

Hi Shelee

I don't know much about sleep fragmentation.  I do know that Chris had 50 or more arousals an hour  due to apnea/hypopnea/periodic leg movement disorder....and all that fun stuff.  She was 7 and in 1st grade and we watched as her reading and math improved when she was put on cpap.  Then due to a doc "oops" she was off cpap for 9 months and her reading and math went down dramatically.....put her back on cpap and she was back where she should be or better.   Without her cpap she just can't learn.

Don't let them wait too long before deciding on a treatment for her.  Cpap can really make a difference even with an AHI of 2 (Chris was 1.8 the night she was tested but would probably have been at least 5 or 6 if it had been a normal night).

Anything I can do to help?

Susanne and her mini-hose head Chris

I'm going to talk to her pulmo tomorrow and ask if we can do a trial at home using my dh's cpap machine.  It's a c-flex (or something like that)....??  Can you tell that I'm very unfamiliar with these things??  My dh and ds both use a vpap so I know quite a bit more about those.  

I finally got a copy of her sleep study (just the summary) and it's rather interesting.  It took her nearly 5 hours to get into REM sleep and then she only had 3 periods of REM sleep during the night.  The total # of arousals was 54, with an index of 7.  Her oxygen saturation was normal (mean, 95% - low, 91%), she did have light snoring, but it was primary snoring, not due to a sleep disorder.  The only other thing that stands out to me is that she had episodic limb movements (index of 6).  ??  The funny thing (or frustrating thing depending on how you look at it) was that when she woke up, she said that she'd slept really good that night and that she wasn't tired (which she usually is).  So we really don't know how accurate these results are, and if there's more to her sleep than this particular study captured or not.  ??

I really don't know if a cpap will help her, but I figured that it was at least worth a try.  It's nearly time for school to start and I really don't want her to have to struggle again this year.  She missed close to 30 days last year due to illness (possibly cyclic neutropenia) and I want to do everything I can to make sure that she feels as good as possible so that she doesn't get farther behind.  If you have any thoughts, I would love to hear them.  Thanks!!

Hi Shelee,

Your daughter sounds a lot like Chris.  Her study summary is very close to Chris' last one.......except it took Chris 81 min to get to REM and she was there 5 times and her leg movements were 10.4/hr.  I also wondered how close the study was to reality, Chris was very well behaved and quiet that night.  Normally she is a wild thing in her sleep.  The way I see it, even if it was not a typical night's sleep it was still abnormal enough to get her treated and that is the most important thing.

I can tell you that the normal leg movement number is 5 or less/hr.  So 6 is not that far off normal.  I believe that what they are measuring are things like flexing her foot and big toe wiggling.........not necessarily a big kick and not rolling over.  I believe that there have to be 3 movements within a short span of time (seconds) to count as a periodic leg movement.  

I don't know what her pulmo will say, I hope that he will agree to let her try cpap and see how thing go.  I am glad that you are willing to ask and see, your daughter is very lucky to have such a concerned mom.  I hope that you can get everything straightened out before school starts.  I can totally understand about kids missing school, Chris missed a day or part of a day each week all year in 1st grade.....

Good Luck tomorrow    Let me know what he says.

Susanne and her mini-hosehead Chris......who just saw her old nasal mask and wants to wear it tonight .........There goes her low leak rate......