Approximately two thirds of infants with Noonan syndrome also have heart (cardiac) abnormalities at birth (congenital heart defects). In about half of such cases, affected infants have obstruction of the normal flow of blood from the lower right chamber (ventricle) of the heart to the lungs (pulmonary stenosis). In those with pulmonary stenosis, the heart must work harder to send blood to the lungs for oxygenation. The symptoms resulting from pulmonary stenosis will vary, depending on the severity of the stenosis and any other associated findings. In some severe cases, an affected infant’s heart may begin to enlarge immediately after birth (., upon initiation of breathing in the newborn). In such cases, the heart may be unable to pump blood effectively (heart failure) to the lungs and throughout the body. Associated symptoms and findings may include bluish discoloration of the skin and mucous membranes (cyanosis) due to abnormally low levels of circulating oxygen (hypoxia), breathlessness, swelling of the abdomen, feeding difficulties, and/or other abnormalities. Potentially life-threatening complications may result without appropriate treatment. In less severe cases of pulmonary stenosis, symptoms may not become apparent until later childhood. Such symptoms may include breathlessness, easy fatigability, and/or other abnormalities. In other cases, pulmonary stenosis may be mild and symptoms may not occur (asymptomatic).
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include: