Case history
A 6-yr-old boy was admitted to our paediatric sleep lab because of witnessed apnoeas by his parents. There were no difficulties falling asleep, nocturnal awakenings nor excessive daytime sleepiness or tiredness.
He was a boy of nonconsanguine parents with normal developmental milestones. His past medical history included snoring which disappeared after adenotonsillectomy at the age of 4 yrs, asthma and allergic rhinitis for which he was on salmeterol and fluticason, cetirizine and mometason. He was also seen 6 months prior to admission because of headache after physical effort without vomiting. Blood pressure, EEG, dilated fundus examination and renal workup were all normal. A brain MRI was also performed in another hospital of which we had a written report stating that it was normal. The complaints of headache spontaneously resolved over the next months.
Familial history was negative for sleep, respiratory, neurological and other relevant medical disorders.
Clinical and neurological examination was normal. Length was on the 25th percentile and weight on the 50th percentile. His body mass index was 16.5 kg·m−2.
A single-night, full polysomnography was performed to rule out residual obstructive sleep apnea syndrome after adenotonsillectomy (fig. 1).
Question 1: Which respiratory abnormality does figure 1 show?
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a) Obstructive apnoea
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b) Central apnoea
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c) Periodic breathing
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d) Normal breathing
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e) Flow limitation
Answer 1:
The tracing shows the presence …