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Management of Surgical Patients with SleepApnea: Guidelines Management of Surgical Patients with SleepApnea: Guidelines | CADTH.ca Find the information you need Management of Surgical Patients with SleepApnea: Guidelines Management of Surgical Patients with SleepApnea: Guidelines Last updated: July 29, 2019 Project Number: RB1369-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What are the evidence-based guidelines (...) for preoperative management of surgical patients with known or suspected sleepapnea? What are the evidence-based guidelines for post-operative monitoring and management of surgical patients with known or suspected sleepapnea? Key Message Two evidence-based guidelines were identified regarding preoperative management of surgical patients with known or suspected sleepapnea while no relevant guidelines were identified regarding post-operative management of surgical patients with suspected or known sleepapnea
Benzodiazepines for the Treatment of Adults with Mental Health Conditions or SleepDisorders Guidelines Benzodiazepines for the Treatment of Adults with Mental Health Conditions or SleepDisorders Guidelines | CADTH.ca Find the information you need Benzodiazepines for the Treatment of Adults with Mental Health Conditions or SleepDisorders Guidelines Benzodiazepines for the Treatment of Adults with Mental Health Conditions or SleepDisorders Guidelines Last updated: August 27, 2019 Project (...) Number: RB1375-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What are the evidence-based guidelines regarding the use of benzodiazepines and benzodiazepine-related drugs for the treatment of adults with mental health conditions or sleepdisorders? Key Message Nine evidence-based guidelines were identified regarding the use of benzodiazepines and benzodiazepine-related drugs for the treatment of adults with mental health conditions or sleep
The role of CPAP treatment in elderly patients with moderate obstructivesleepapnoea: a multicentre randomised controlled trial The efficacy of continuous positive airway pressure (CPAP) treatment in elderly patients with nonsevere obstructivesleepapnoea (OSA) is controversial. The objective of this study was to assess the effect of CPAP treatment in elderly patients with moderate OSA in terms of clinical, quality-of-life and neurocognitive measures.This was an open-label, randomised (...) , multicentre clinical trial in 145 elderly patients (≥70 years old) with confirmed moderate OSA (apnoea-hypopnoea index 15-29.9 events·h-1) randomised to receive CPAP (n=73) or no CPAP (n=72) for 3 months. The primary end-point was the Epworth Sleepiness Scale (ESS) score, and the secondary end-points included quality of life (Quebec Sleep Questionnaire (QSQ) domain scores), sleep-related symptoms, presence of anxiety/depression, office-based blood pressure measurements and some neurocognitive tests
as follows: ADVICE: following a full submission melatonin prolonged-release (Slenyto ® ) is not recommended for use within NHSScotland. Indication under review: Treatment of insomnia in children and adolescents aged 2 to 18 years with autism spectrum disorder and / or Smith-Magenis syndrome, where sleep hygiene measures have been insufficient. Melatonin prolonged-release (Slenyto ® ), compared with placebo, increased total sleep time and sleep onset latency in children aged 2 to 17.5 years with sleep (...) problems and autism spectrum disorder and / or Smith-Magenis syndrome who had an insufficient response to sleep hygiene measures. The submitting company’s justification of the treatment’s cost in relation to its health benefits was not sufficient and in addition the company did not present a sufficiently robust clinical and economic analysis to gain acceptance by SMC. Chairman Scottish Medicines Consortium www.scottishmedicines.org.uk 2 Indication Treatment of insomnia in children and adolescents aged
syndrome or Treacher-Collins syndrome, and patients with Down's syndrome are more likely to have obstructivesleepapnoea. There are certain genetic disorders that predispose to obesity, for example Prader-Willi syndrome. Patients with certain congenital conditions may be considered to have a disability. Clinical and technical e Clinical and technical evidence vidence A literature search was carried out for this briefing in accordance with the interim process and methods statement. This briefing (...) SuperNO2VA for the relief of upper airway obstruction in people with obstructivesleepapnoea SuperNO2V SuperNO2VA for the relief of upper airwa A for the relief of upper airway y obstruction in people with obstructiv obstruction in people with obstructivesleep e sleepapnoeaapnoea Medtech innovation briefing Published: 9 September 2019 www.nice.org.uk/guidance/mib190 pathways Summary Summary The technology technology described in this briefing is SuperNO2VA. It is used for preventing
to daytime impairment. Preliminary questions for eliminating other sleepdisorders as primary diagnosis are summarized below. Eliminating other sleepdisorder as primary: preliminary questions – see Appendix for more detailed follow-up questions. ? Are you a very heavy snorer? Does your partner say that you sometimes stop breathing at night? (obstructivesleepapnoeasyndrome (OSAS)) ? Do your legs often twitch and can’t keep still in bed? Do you wake from sleep with jerky leg movements? (restless legs (...) of epidemiological evidence suggests that insomnia typically predates other psy- chiatric symptoms and may represent an independent risk factor for the development of depression in particular (see below). Circadian rhythm disorder Circadian rhythm disorders are sleepdisorders where there is a mismatch between circadian rhythms and required sleep– wake cycle. Thus there can be sleeplessness when trying to sleep at a time not signalled by the internal clock, and exces- sive sleepiness when needing to be awake
Early Intensive Neurorehabilitation of adults with unresponsive wakefulnesssyndrome or a prolonged minimally conscious state Early Intensive Neurorehabilitation of adults with unresponsive wakefulnesssyndrome or a prolonged minimally conscious state | Report | National Health Care Institute You are here: Early Intensive Neurorehabilitation of adults with unresponsive wakefulnesssyndrome or a prolonged minimally conscious state Search within English part of National Health Care Institute (...) Search Early Intensive Neurorehabilitation of adults with unresponsive wakefulnesssyndrome or a prolonged minimally conscious state Share this page Service About this site
The Combination of Atomoxetine and Oxybutynin Greatly Reduces ObstructiveSleepApnea Severity. A Randomized, Placebo-controlled, Double-Blind Crossover Trial Rationale: There is currently no effective pharmacological treatment for obstructivesleepapnea (OSA). Recent investigations indicate that drugs with noradrenergic and antimuscarinic effects improve genioglossus muscle activity and upper airway patency during sleep. Objectives: We aimed to determine the effects of the combination (...) of a norepinephrine reuptake inhibitor (atomoxetine) and an antimuscarinic (oxybutynin) on OSA severity (apnea-hypopnea index [AHI]; primary outcome) and genioglossus responsiveness (secondary outcome) in people with OSA. Methods: A total of 20 people completed a randomized, placebo-controlled, double-blind, crossover trial comparing 1 night of 80 mg atomoxetine plus 5 mg oxybutynin (ato-oxy) to placebo administered before sleep. The AHI and genioglossus muscle responsiveness to negative esophageal pressure
-110), a selective dopamine and norepinephrine reuptake inhibitor with robust wake-promoting effects, for the treatment of excessive sleepiness in participants with obstructivesleepapnea with current or prior sleepapnea treatment. Methods: This was a double-blind, randomized, placebo-controlled, parallel-group, 12-week trial comparing solriamfetol, 37.5, 75, 150, and 300 mg, with placebo. Measurements and Main Results: Of 476 randomized participants, 459 were included in the prespecified (...) participants; five participants experienced serious adverse events (two [1.7%] placebo, three [0.8%] solriamfetol); none were deemed related to study drug. The most common adverse events with solriamfetol were headache (10.1%), nausea (7.9%), decreased appetite (7.6%), anxiety (7.0%), and nasopharyngitis (5.1%). Conclusions: Solriamfetol significantly increased wakefulness and reduced sleepiness in participants with obstructivesleepapnea and excessive sleepiness; most adverse events were mild or moderate
Belsomra (Suvorexant) - for the treatment of insomnia Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product. The for is located below. Recent Activity for SBDs written for approved after September 1
process. 3 Insomnia Assessment and Diagnosis Insomnia is a diagnosis of exclusion. Patients who report difficulty initiating sleep, difficulty maintaining sleep, waking too early, or experiencing non-restorative sleep should be assessed to evaluate for: • Comorbid medical conditions (e.g., pulmonary disease, heart failure, chronic pain) • Comorbid psychiatric disorders (e.g., depression, anxiety, post-traumatic stress disorder, substance abuse) • Other sleepdisorders (e.g., obstructivesleepapnea (...) , restless legs syndrome, circadian rhythm sleep-wakedisorders) It is important to screen the patient for depression, substance use, and alcohol use, as about 1 in 3 patients reporting insomnia have co-occurring psychiatric illness (typically depression or anxiety) and 1 in 6 have alcohol- or drug-induced sleep problems. It is also important to review the patient’s current medications. Table 1 lists medications that may interfere with sleep. • Medication effects on sleep are complex. Medications can
Association of Unrecognized ObstructiveSleepApnea With Postoperative Cardiovascular Events in Patients Undergoing Major Noncardiac Surgery. Unrecognized obstructivesleepapnea increases cardiovascular risks in the general population, but whether obstructivesleepapnea poses a similar risk in the perioperative period remains uncertain.To determine the association between obstructivesleepapnea and 30-day risk of cardiovascular complications after major noncardiac surgery.Prospective cohort (...) sleep monitoring.The primary outcome was a composite of myocardial injury, cardiac death, heart failure, thromboembolism, atrial fibrillation, and stroke within 30 days of surgery. Proportional-hazards analysis was used to determine the association between obstructivesleepapnea and postoperative cardiovascular complications.Among a total of 1364 patients recruited for the study, 1218 patients (mean age, 67 [SD, 9] years; 40.2% women) were included in the analyses. At 30 days after surgery, rates
Solriamfetol (Sunosi) - To treat excessive sleepiness in adult patients with narcolepsy or obstructivesleepapnea Drug Approval Package: Sunosi U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Sunosi Company: Jazz Pharmaceuticals Ireland Limited Application Number: 211230 Approval Date: 03/20/2019 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF
Indigenous Food Safety and Security: Community Adaptations in the Wake of Climate Pressures INDIGENOUS FOOD SAFETY AND SECURITY: COMMUNITY ADAPTATIONS IN THE WAKE OF CLIMATE PRESSURES FEBRUARY 2019 Prepared by: Leela Steiner, National Collaborating Centre for Environmental Health Casey Neathway, First Nations Health AuthorityNational Collaborating Centre for Environmental Health 1 INTRODUCTION Indigenous people have long relied on traditional foods, as they are nutritionally, culturally (...) public health risks while at the same time supporting community efforts to improve food safety in the wake of their adaptation efforts to address climatic pressures. This review presents evidence on six unique food safety issues, based on adaptation measures taken or planned to be taken to help ensure food security: 1) smokehouse construction considerations; 2) gardening and the use of tires as planters; 3) greywater use in crop irrigation; 4) traditional preservation techniques (specifically sun
Positional therapy for obstructivesleepapnoea. The modalities of therapy for obstructivesleepapnoea (OSA) include behavioural and lifestyle modifications, positional therapy, oral appliances, surgery and continuous positive airway pressure therapy (CPAP). Though CPAP has proven efficacy in treating OSA, adherence with CPAP therapy is suboptimal. Positional therapy (to keep people sleeping on their side) is less invasive and therefore expected to have better adherence. This review considered (...) therapy. Two studies showed that CPAP produced a greater reduction in Apnoea-Hypopnoea Index (AHI) with a mean difference (MD) of 6.4 events per hour (95% CI 3.00 to 9.79; low-certainty evidence) compared to positional therapy. Subjective adherence, evaluated in one study, was found to be significantly greater with positional therapy (MD 2.5 hours per night, 95% CI 1.41 to 3.59; moderate-certainty evidence).In terms of secondary outcomes, one study each reported quality-of-life indices and quality
to treat adult patients with sleep-related breathingdisorders. Sleep . 2006;29(3):375–380. [ ] 2 Kushida CA, Chediak A, Berry RB, et al. Clinical guidelines for the manual titration of positive airway pressure in patients with obstructivesleepapnea. J Clin Sleep (...) , Minnesota; 4 McGill University Health Centre, Montreal, Quebec, Canada; 5 University of Pittsburgh, Pittsburgh, Pennsylvania; 6 American Academy of Sleep Medicine, Darien, Illinois ABSTRACT Introduction: This guideline establishes clinical practice recommendations for positive airway pressure (PAP) treatment of obstructivesleepapnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines in the evaluation and treatment of sleep-disordered
Proof of Concept for an Adaptive Treatment Strategy to Prevent Failures in Internet-Delivered CBT: A Single-Blind Randomized Clinical Trial With Insomnia Patients This study aimed to demonstrate proof of concept for an adaptive treatment strategy in Internet-delivered cognitive-behavioral therapy (ICBT), where risk of treatment failure is assessed early in treatment and treatment for at-risk patients is adapted to prevent treatment failure.A semiautomated algorithm assessed risk of treatment (...) failure early in treatment in 251 patients undergoing ICBT for insomnia with therapist guidance. At-risk patients were randomly assigned to continue standard ICBT or to receive adapted ICBT. The primary outcome was self-rated insomnia symptoms using the Insomnia Severity Index in a linear mixed-effects model. The main secondary outcome was treatment failure (having neither responded nor remitted at the posttreatment assessment).A total of 102 patients were classified as at risk and randomly assigned
(CPAP) withdrawal on CVR.41 OSA patients (88% male, mean age 57±10 years) were randomised to either subtherapeutic or continuation of therapeutic CPAP. At baseline and after 2 weeks, patients underwent a sleep study and magnetic resonance imaging (MRI). CVR was estimated by quantifying the blood oxygen level-dependent (BOLD) MRI response to breathing stimuli.OSA did recur in the subtherapeutic CPAP group (mean treatment effect apnoea-hypopnoea index +38.0 events·h-1, 95% CI 24.2-52.0; p<0.001 (...) Effects of short-term continuous positive airway pressure withdrawal on cerebral vascular reactivity measured by blood oxygen level-dependent magnetic resonance imaging in obstructivesleepapnoea: a randomised controlled trial Impaired cerebral vascular reactivity (CVR) increases long-term stroke risk. Obstructivesleepapnoea (OSA) is associated with peripheral vascular dysfunction and vascular events. The aim of this trial was to evaluate the effect of continuous positive airway pressure
with sleep-disorderedbreathing: The Sleep Heart Health Study. Am J Respir Crit Care Med 2006; 173:910. Gottlieb DJ, Yenokyan G, Newman AB, et al. Prospective study of obstructivesleepapnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation 2010; 122:352. Yumino D, Tsurumi Y, Takagi A, et al. Impact of obstructivesleepapnea on clinical and angiographic outcomes following percutaneous coronary intervention in patients with acute coronary syndrome. Am J (...) , Vgontzas AN, Lin HM, et al. Prevalence of sleep-disorderedbreathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608-613. Basner RC. Continuous positive airway pressure for obstructivesleepapnea. N Engl J Med . 2007;356:1751–8. doi: 10.1056/NEJMct066953. White DP. Pathogenesis of obstructive and central sleepapnea. Am J Respir Crit Care Med 2005;172:1363-1370. Loube DI, Gay PC, Strohl KP, Pack AI, White DP, Collop NA. Indications for positive airway pressure treatment of adult