A 15-year-old girl was referred to us for sleep difficulties and restless sleep. The parent stated that she was always a poor sleeper, having difficulty falling asleep and frequent nocturnal awakenings since she was a very young child, but in the past 6 months the symptoms had worsened. She slept in her own room and in her own bed. Her bedtime was 10:30 PM, staying in bed anywhere from 2 to 5 h before she could fall asleep. During this time, she felt discomfort in her legs with the urge to move her legs and relief after movement. This sensation was worse at night or when sitting for prolonged periods of time. Once she fell asleep, she woke up 2 to 3 times a night. She started her day at 7 AM but felt very sleepy and often would fall asleep again until 10 AM. During the day she was exhausted and often took a nap from 3 to 5 PM. There was soft snoring and no parasomnias. Her medical history was significant for beta-thalassemia trait. She was not on any medications. Social history included no dietary restrictions and no caffeine use.
The patient was a 14-month-old male with a history of 22q11.2 deletion with a large ventricular septal defect and right aortic arch status post repair at age 4 months. He had dysphagia and gastroesophageal reflux for which he took 2 mL ranitidine (15 mg/mL) twice a day. The patient was referred to the sleep clinic by his gastroenterologist for concerns of snoring and noisy breathing. The patient was born at full term and is dependent on a nasogastric feeding tube but has had no difficulty with growth or weight gain. At the time of the study he was bolus-fed formula via nasogastric tube and only took purees by mouth due to dysphagia with high risk for aspiration (determined by a swallow study in November 2017). He did not have any overnight feedings. The patient's parents positioned him to sleep in a bassinet at a 30° incline per recommendations from their gastroenterologist to help prevent reflux. The patient typically slept from 10:00 pm to 10:30 am and woke up at least
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.