AASM Board - Pediatric Sleep Medicine questions and
answers with solutions 2025
What is less likely a correct response in pedi questions? - ANSWER less likely pharmacotherapy
*** What should you be thinking about if given a wake/sleep schedule in the stem? - ANSWER
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? - ANSWER PSG
if child has tonsils and SDB, what's the right treatment? what is the wrong answer - ANSWER
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 - ANSWER behavioral change is correct
If a child has RLS symptoms --> what thoughts ought to be considered? - ANSWER check ferritin
and start with iron
,If patient has simple parasomnia symptoms, next step? - ANSWER education and safety
If daytime napping despite sufficient sleep is occurring, next step? - ANSWER MSLT
If a shifted schedule has occurred, what steps are reasonable? - ANSWER 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? - ANSWER education
and safety are correct
What to consider if enuresis occurs? - ANSWER OSA
What is the timeline for pediatric sleep problems to occur according to age? - ANSWER
additional notes: adenoids and tonsils usually grow at this pint
What's the usual # of awakenings for normal children? - ANSWER 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 - ANSWER
What are the major differences between children and adults in terms of OSA characteristics? -
ANSWER - 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? - ANSWER higher chance of
residual OSA after adenotonsillectomy in obese children
Why don't kids normally present with EDS as manifestation of OSA? - ANSWER 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? - ANSWER 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? -
ANSWER antiinflammatories
What are the outcomes from the RCT early AT vs watchful waiting trial for OSA? - ANSWER no
significant differences in terms of executive functioning
answers with solutions 2025
What is less likely a correct response in pedi questions? - ANSWER less likely pharmacotherapy
*** What should you be thinking about if given a wake/sleep schedule in the stem? - ANSWER
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? - ANSWER PSG
if child has tonsils and SDB, what's the right treatment? what is the wrong answer - ANSWER
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 - ANSWER behavioral change is correct
If a child has RLS symptoms --> what thoughts ought to be considered? - ANSWER check ferritin
and start with iron
,If patient has simple parasomnia symptoms, next step? - ANSWER education and safety
If daytime napping despite sufficient sleep is occurring, next step? - ANSWER MSLT
If a shifted schedule has occurred, what steps are reasonable? - ANSWER 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? - ANSWER education
and safety are correct
What to consider if enuresis occurs? - ANSWER OSA
What is the timeline for pediatric sleep problems to occur according to age? - ANSWER
additional notes: adenoids and tonsils usually grow at this pint
What's the usual # of awakenings for normal children? - ANSWER 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 - ANSWER
What are the major differences between children and adults in terms of OSA characteristics? -
ANSWER - 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? - ANSWER higher chance of
residual OSA after adenotonsillectomy in obese children
Why don't kids normally present with EDS as manifestation of OSA? - ANSWER 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? - ANSWER 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? -
ANSWER antiinflammatories
What are the outcomes from the RCT early AT vs watchful waiting trial for OSA? - ANSWER no
significant differences in terms of executive functioning
