Optimising sleep in adolescents: The challenges.

Background: Adolescence is a stage of significant transition as children develop into young adults. Optimal sleep is crucial during this period to ensure physical, emotional and mental wellbeing. However, it is well recognised that insufficient quality and quantity of sleep is common among adolescents worldwide.

An approach to common sleep presentations in infants and toddlers.

Background: Healthy sleep is vital for optimal child development, yet over 30% of Australian parents report having children with disrupted sleep affecting all family members. These sleep difficulties might co-exist with sleep breathing disorders, contributing to morbidity and reduced quality of life.

Objective: This article aims to provide general practitioners (GPs) with an evidence-based, biopsychosocial approach to managing common sleep problems in infants and preschool-aged children.

Reduced forced expiratory flow but not increased exhaled nitric oxide or airway responsiveness to methacholine characterises paediatric sickle cell airway disease.

Background: Asthma and airway hyper-responsiveness are reportedly more common in children with sickle cell disease (SCD).

Aim: To determine airway responsiveness, airway inflammation and clinical features of asthma in SCD.

Methods: A prospective, single-centre study of 50 SCD children without overt pulmonary vascular disease and 50 controls.

The impact of sickle cell disease on exercise capacity in children.

Background: Little is known about pulmonary vascular complications in children with sickle cell disease (SCD). We hypothesized that transfer factor (diffusing capacity of the lung for carbon monoxide [D(LCO)] ) may be used as a surrogate for the size of the pulmonary vascular bed and that pulmonary vascular abnormalities in children with SCD may limit exercise capacity.

Methods: Fifty stable patients with SCD aged 10 to 18 years and 50 healthy control subjects matched for race and age were recruited.

Paediatric sickle cell disease: pulmonary hypertension but normal vascular resistance.

Background: Adults with sickle cell disease (SCD) and pulmonary hypertension have high mortality but death in SCD children with pulmonary hypertension is rare. The authors hypothesised that pulmonary hypertension in SCD children may be secondary to anaemia-induced high cardiac output rather than pulmonary vascular disease.

Methods: Two independent, validated techniques were used to estimate pulmonary vascular resistance (PVR) in 50 SCD children and 50 matched controls.