J Korean Med Sci.  2013 May;28(5):792-794. 10.3346/jkms.2013.28.5.792.

Narcolepsy with Obstructive Sleep Apnea in a 4-Year-Old Korean Girl: A Case Report

• Kwon S
• Jang K
• Hwang S
• Cho M
• Seo H

• KMID: 1777572
• DOI: http://doi.org/10.3346/jkms.2013.28.5.792

Abstract

A 4-yr-old girl has exhibited severe snoring, restless sleep and increasing daytime sleepiness over the last 3 months. The physical examination showed that she was not obese but had kissing tonsils. Polysomnography demonstrated increased apnea-hypopnea index (AHI) of 5.2, and multiple sleep latency tests (MSLT) showed shortened mean sleep latency and one sleep-onset REM period (SOREMP). She was diagnosed with obstructive sleep apnea (OSA) and underwent tonsillectomy and adenoidectomy. After the surgery, her sleep became much calmer, but she was still sleepy. Another sleep test showed normal AHI of 0.2, the mean sleep latency of 8 min, and two SOREMPs. Diagnosis of OSA to be effectively treated by surgery and narcolepsy without cataplexy was confirmed. Since young children exhibiting both OSA and narcolepsy can fail to be diagnosed with the latter, it's desirable to conduct MSLT when they have severe daytime sleepiness or fail to get better even with good treatment.

Keyword

Narcolepsy Without Cataplexy; Obstructive Sleep Apnea; Children

MeSH Terms

Adenoidectomy
Asian Continental Ancestry Group
Child, Preschool
Disorders of Excessive Somnolence/diagnosis
Female
Humans
Methylphenidate/therapeutic use
Narcolepsy/complications/*diagnosis/surgery
Polysomnography
Republic of Korea
Sleep Apnea, Obstructive/*diagnosis/drug therapy/surgery
Tonsillectomy
Methylphenidate

Figure

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  Fig. 1 The first and follow up MSLT of the subject. (A) The first MSLT showed a mean sleep latency of 3.5 min and one sleep-onset REM period. (B) Follow up MSLT showed the mean sleep latency of 8 min and two sleep-onset REM periods.

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