Melbourne Childrens Sleep Unit

The MCSU is the only paediatric sleep research and clinical facility in Melbourne, Australia.  The Unit was established in 1978 and is located on level 5 of the Monash Medical Centre next to the Ritchie Centre for Baby Health Research.  The Unit provides a wide range of services of needs of both parents and doctors related to sleep and breathing in infants and children.

The Unit provides:

A clinical service involving clinical assessment and full polysomnography for the diagnosis of sleep disorders in children.

Research in sleep related areas with the emphasis on the role of arousal from sleep in relation to the Sudden Infant Death Syndrome (SIDS).  Research is also conducted  to examine respiritory cardiac and neurology physiology in infants and children.

A Home Monitoring Program for parents caring for an infant or child suffering from ongoing breathing problems or infants at risk of SIDS.

Educational programmes for undergraduate/postgraduate students, health professionals and parents.

THE CLINICAL SERVICE

Appoints may be made to see a Paediatric sleep physician by telephining 9594 2900.

Referrals to the Unit are received from general practitioners, ear, nose and throat specialists and paediatricians from across the State. Infants and children who have problems in either initiating or maintaining sleep are referred. The major medical problem seen is Obstructive Sleep Apnea Syndrome (OSAS), while others include central hypoventilation disorder, neuromuscular disorders, infants who have had an Apparent Life Threatening Events (ALTE), and nocturnal epilepsy. A major cause of sleep disorders in babies and children are behavioural problems and parasomnias. The Unit offers a full clinical assessment, counselling and behavioural programmes for these and other sleep related problems.

POLYSOMNOGRAPHY

Polysomnographic studies are performed overnight with two to three studies being performed each week. The paediatric age group studied are from infants to adolescents.
There is a 1:1 parent/staff ratio. The physiological variables which are routinely measured are EEG, EOG, EMG, nasal airflow, oral airflow, abdominal breathing effort, rib cage breathing effort, expired CO2, transcutaneous CO2, oxygen saturation (SpO2) and ECG.
Other variables such as tidal volume, CPAP, rectal temperature and oesophageal pH are added as required. All physiological recordings are recorded via a Grass 16 channel polygraph to a Compumedics computer S-series Sleep System. Version 5 and data is then stored on optical disk.

RESEARCH

Research studies currently being carried out are investigating various aspects of arousal from sleep. A failure to arouse from sleep following a prolonged breathing pause (apnoea) is a likely mechanism for Sudden Infant Death Syndrome (SIDS).

Our group has developed a unique stimulus which invariably produces cortical arousal in infants, but which is non-threatening and harmless. The use of this stimulus, a pulsatile jet of air applied to the nostrils, has allowed us to carry out longitudinal studies of arousability in normal full term infants over the past six years.

We have established that infants are more difficult to arouse from quiet sleep than from active sleep, and that the threshold at which they arouse in quiet sleep is highest at two to three months of age, a period which coincides with the peak incidence of SIDS.
Presently we are carrying out arousal studies in two groups of infants considered to be at increased risk for SIDS: preterm infants and infants who have previously suffered an Apparent Life Threatening Event (ALTE). Proposed studies for 1996 will investigate the relationships between maternal smoking, sleeping position and respiratory infection and arousal in both term and preterm infants.