AASM BOARD REVIEW - PEDIATRIC SLEEP MEDICINE
REVIEW 2026
What is less likely a correct response in pedi questions? - Answers -less likely
pharmacotherapy
*** What should you be thinking about if given a wake/sleep schedule in the stem? -
Answers -calculate the hours of sleep and see if it's age appropriate
If sufficient --> hypersomnia
If insufficient --> extend and/or regularize
Correct response if child has suspected SDB? - Answers -PSG
If child has tonsils and SDB, what's the right treatment? What is the wrong answer -
Answers -Could be adenotonsillectomy
However if symptoms and PSG findinsg are very mild ---> watchful waiting, supportive
care is a viable option as well
CPAP wrong answer
If a child has sleep behavior problems - Answers -behavioral change is correct
If a child has RLS symptoms --> what thoughts ought to be considered? - Answers -
check ferritin and start with iron
If patient has simple parasomnia symptoms, next step? - Answers -education and
safety
If daytime napping despite sufficient sleep is occurring, next step? - Answers -MSLT
If a shifted schedule has occurred, what steps are reasonable? - Answers -usually
correct responses:
Anchor wake time
Avoid late day naps
Nix late night electronics
Morning light
What to consider if head banging and otherwise normal development? - Answers -
education and safety are correct
What to consider if enuresis occurs? - Answers -OSA
, What is the timeline for pediatric sleep problems to occur according to age? - Answers -
additional notes: adenoids and tonsils usually grow at this pint
What's the usual # of awakenings for normal children? - Answers -4-6 times a night,
briefly
Review the timeline on a PSG where sleep problems occur in children
- settling problems
- bedtime resistance
- restless leg syndrome
- rhythmic movements
- confusional arousals
- sleep terrors
- sleep walking
- parasomnias
- prolonged night wakings
- SDB
- nightmares - Answers -
What are the major differences between children and adults in terms of OSA
characteristics? - Answers -- prevalence is equal among genders for children
- children usually sleep through the night (less arousals)
- obese child has more characteristics akin to adults in terms of gender prevalence,
arousals
Difference in terms of treatment for obese pts and nl children? - Answers -higher
chance of residual OSA after adenotonsillectomy in obese children
Why don't kids normally present with EDS as manifestation of OSA? - Answers -Kids
typically sleep through the night and preserve sleep archiecture
What's the positive predictive value of the exam and role of exam in diagnosis of OSA in
children? - Answers -45% positive predictive value of physical exam
Tonsil size and mallampati limited utility
Alternative treatment for mild / residual OSA aside from watchful waiting, surgery,
CPAP? - Answers -antiinflammatories
What are the outcomes from the RCT early AT vs watchful waiting trial for OSA? -
Answers -no significant differences in terms of executive functioning
However:
- improvements in behavioral measures after AT including attention, QOL, OSA
symptoms, snoring and sleepiness
REVIEW 2026
What is less likely a correct response in pedi questions? - Answers -less likely
pharmacotherapy
*** What should you be thinking about if given a wake/sleep schedule in the stem? -
Answers -calculate the hours of sleep and see if it's age appropriate
If sufficient --> hypersomnia
If insufficient --> extend and/or regularize
Correct response if child has suspected SDB? - Answers -PSG
If child has tonsils and SDB, what's the right treatment? What is the wrong answer -
Answers -Could be adenotonsillectomy
However if symptoms and PSG findinsg are very mild ---> watchful waiting, supportive
care is a viable option as well
CPAP wrong answer
If a child has sleep behavior problems - Answers -behavioral change is correct
If a child has RLS symptoms --> what thoughts ought to be considered? - Answers -
check ferritin and start with iron
If patient has simple parasomnia symptoms, next step? - Answers -education and
safety
If daytime napping despite sufficient sleep is occurring, next step? - Answers -MSLT
If a shifted schedule has occurred, what steps are reasonable? - Answers -usually
correct responses:
Anchor wake time
Avoid late day naps
Nix late night electronics
Morning light
What to consider if head banging and otherwise normal development? - Answers -
education and safety are correct
What to consider if enuresis occurs? - Answers -OSA
, What is the timeline for pediatric sleep problems to occur according to age? - Answers -
additional notes: adenoids and tonsils usually grow at this pint
What's the usual # of awakenings for normal children? - Answers -4-6 times a night,
briefly
Review the timeline on a PSG where sleep problems occur in children
- settling problems
- bedtime resistance
- restless leg syndrome
- rhythmic movements
- confusional arousals
- sleep terrors
- sleep walking
- parasomnias
- prolonged night wakings
- SDB
- nightmares - Answers -
What are the major differences between children and adults in terms of OSA
characteristics? - Answers -- prevalence is equal among genders for children
- children usually sleep through the night (less arousals)
- obese child has more characteristics akin to adults in terms of gender prevalence,
arousals
Difference in terms of treatment for obese pts and nl children? - Answers -higher
chance of residual OSA after adenotonsillectomy in obese children
Why don't kids normally present with EDS as manifestation of OSA? - Answers -Kids
typically sleep through the night and preserve sleep archiecture
What's the positive predictive value of the exam and role of exam in diagnosis of OSA in
children? - Answers -45% positive predictive value of physical exam
Tonsil size and mallampati limited utility
Alternative treatment for mild / residual OSA aside from watchful waiting, surgery,
CPAP? - Answers -antiinflammatories
What are the outcomes from the RCT early AT vs watchful waiting trial for OSA? -
Answers -no significant differences in terms of executive functioning
However:
- improvements in behavioral measures after AT including attention, QOL, OSA
symptoms, snoring and sleepiness
