Latest & greatest articles for insomnia

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401. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy Full Text available with Trip Pro

Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy Dexmedetomidine, a specific α(2) agonist, has an analgesic-sparing effect and reduces emergence agitation. We compared an intraoperative dexmedetomidine infusion with bolus fentanyl to reduce perioperative opioid use and decrease emergence agitation in children with obstructive sleep apnea syndrome undergoing adenotonsillectomy (...) (T&A).One hundred twenty-two patients with obstructive sleep apnea syndrome undergoing T&A, ages 2 to 10 years, completed this prospective, randomized, U.S. Food and Drug Administration-approved study. After mask induction with sevoflurane, group D received IV dexmedetomidine 2 μg · kg(-1) over 10 minutes, followed by 0.7 μg · kg(-1) · h(-1), and group F received IV fentanyl bolus 1 μg · kg(-1). Anesthesia was maintained with sevoflurane, oxygen, and nitrous oxide. Fentanyl 0.5 to 1 μg · kg(-1

2010 EvidenceUpdates Controlled trial quality: uncertain

402. Comparison of continuous positive airway pressure and valsartan in hypertensive patients with sleep apnea (Abstract)

Comparison of continuous positive airway pressure and valsartan in hypertensive patients with sleep apnea Randomized controlled trials (RCTs) have shown that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) reduces blood pressure (BP). CPAP treatment has never been compared with antihypertensive medications in an RCT.To assess the respective efficacy of CPAP and valsartan in reducing BP in hypertensive patients with OSA never treated for either condition.In (...) this 8-week randomized controlled crossover trial, 23 hypertensive patients (office systolic BP/diastolic BP: 155 ± 14/102 ± 11 mm Hg) with OSA (age, 57 ± 8 yr; body mass index, 28 ± 5 kg/m(2); apnea-hypopnea index, 29 ± 18/h) were randomized first to either CPAP or valsartan (160 mg). The second 8-week period consisted of the alternative treatment (crossover) after a 4-week washout period.Office BP and 24-hour BP were measured before and at the end of the two active treatment periods. Twenty-four

2010 EvidenceUpdates Controlled trial quality: uncertain

403. Inconclusive evidence on the efficacy of different interventions for obstructive sleep apnea in children

that is defined as a “disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction that disrupts normal ventilation during sleep and normal sleep patterns”. OSA can affect children of all ages, although preschool-aged children are the most affected. If left untreated, children are at risk of neurocognitive deficits and can result in serious morbidity. Nocturnal polysomnography (sleep study) is the standard for diagnosis to quantitate (...) ventilatory and sleep abnormalities. Currently, adenotonsillectomy is the first line of treatment for most children.1 1 American Academy of Pediatrics, Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics. 2002; 109(4):704-712. Strengths and Weaknesses of the Systematic Review: The review used accepted methods to identify and select RCT studies. There were

2010 ADA Center for Evidence-Based Dentistry

404. Inconclusive evidence on the efficacy of different interventions for obstructive sleep apnea in children

that is defined as a “disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction that disrupts normal ventilation during sleep and normal sleep patterns”. OSA can affect children of all ages, although preschool-aged children are the most affected. If left untreated, children are at risk of neurocognitive deficits and can result in serious morbidity. Nocturnal polysomnography (sleep study) is the standard for diagnosis to quantitate (...) ventilatory and sleep abnormalities. Currently, adenotonsillectomy is the first line of treatment for most children.1 1 American Academy of Pediatrics, Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics. 2002; 109(4):704-712. Strengths and Weaknesses of the Systematic Review: The review used accepted methods to identify and select RCT studies. There were

2010 ADA Center for Evidence-Based Dentistry

405. Inconclusive evidence on the efficacy of different interventions for obstructive sleep apnea in children

that is defined as a “disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction that disrupts normal ventilation during sleep and normal sleep patterns”. OSA can affect children of all ages, although preschool-aged children are the most affected. If left untreated, children are at risk of neurocognitive deficits and can result in serious morbidity. Nocturnal polysomnography (sleep study) is the standard for diagnosis to quantitate (...) ventilatory and sleep abnormalities. Currently, adenotonsillectomy is the first line of treatment for most children.1 1 American Academy of Pediatrics, Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics. 2002; 109(4):704-712. Strengths and Weaknesses of the Systematic Review: The review used accepted methods to identify and select RCT studies. There were

2010 ADA Center for Evidence-Based Dentistry

406. Effectiveness of acupressure for residents of long-term care facilities with insomnia: a randomized controlled trial (Abstract)

Effectiveness of acupressure for residents of long-term care facilities with insomnia: a randomized controlled trial Acupressure on the Shenmen point (indexed as HT7) can improve insomnia, but there has been no longitudinal study to evaluate its efficacy for residents of long-term care facilities. No evidence from the existing literature indicates how long its efficacy can be maintained after stopping acupressure.The aim of this study was to evaluate the effectiveness of acupressure (...) on the Shenmen point for residents of long-term care facilities with insomnia.Fifty residents with insomnia in long-term care facilities were enrolled in a randomized controlled trial, with 25 participants allocated to the experimental group and 25 participants to the control group. For a 5-week period, the experimental group received standard acupressure on the HT7 points of both wrists, whereas the control group received only light touch on the same places. Insomnia was measured with the Athens Insomnia

2010 EvidenceUpdates Controlled trial quality: uncertain

407. Continuous positive airway pressure titration for obstructive sleep apnoea: automatic versus manual titration Full Text available with Trip Pro

Continuous positive airway pressure titration for obstructive sleep apnoea: automatic versus manual titration Manual laboratory continuous positive airway pressure (CPAP) titration for obstructive sleep apnoea (OSA) is costly, time intensive and delays access to treatment. Automatic positive airway pressure (APAP) titration has the potential to reduce cost and improve access to treatment. The aim of this study was to assess the clinical efficacy and costs of APAP titration compared with manual (...) titration in moderate-severe OSA.Patients with moderate-severe OSA (apnoea/hypopnoea index >15 and Epworth Sleepiness Score > or = 8) who were free of co-morbidities that could impair APAP titration were eligible. 249 participants were randomised to manual titration, home APAP or laboratory APAP titration to determine a fixed pressure for CPAP. Clinical and direct cost outcomes were assessed after 4 weeks of treatment.Average nightly CPAP use, subjective sleepiness, SF36 quality of life, Trails A and B

2010 EvidenceUpdates Controlled trial quality: uncertain

408. Noninvasive ventilation immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery Full Text available with Trip Pro

Noninvasive ventilation immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery Noninvasive positive pressure ventilation (NIPPV) may improve postoperative lung function and reduce postoperative complications in patients undergoing abdominal surgery. The purpose of our study was to determine whether the timing of postoperative NIPPV affects lung function 1 day postoperatively.Forty morbidly obese (...) patients with known obstructive sleep apnea undergoing laparoscopic bariatric surgery with standardized anesthesia care were randomly assigned to receive NIPPV immediately after tracheal extubation (immediate group) or supplemental oxygen (standard group). All patients had continuous positive airway pressure initiated 30 minutes after extubation in the postanesthesia care unit (PACU) via identical noninvasive ventilators. Spirometry was performed by a blinded observer in the perioperative holding area

2010 EvidenceUpdates Controlled trial quality: uncertain

409. Derivation and validation of a simple perioperative sleep apnea prediction score (Abstract)

Derivation and validation of a simple perioperative sleep apnea prediction score Obstructive sleep apnea (OSA) is a largely underdiagnosed, common condition, which is important to diagnose preoperatively because it has implications for perioperative management. Our purpose in this study was to identify independent clinical predictors of a diagnosis of OSA in a general surgical population, develop a perioperative sleep apnea prediction (P-SAP) score based on these variables, and validate the P

2010 EvidenceUpdates

410. Report of an EFNS task force on management of sleep disorders in neurologic disease (degenerative neurologic disorders and stroke).

Report of an EFNS task force on management of sleep disorders in neurologic disease (degenerative neurologic disorders and stroke). Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You

2010 European Federation of Neurological Societies

411. Severity of REM atonia loss in idiopathic REM sleep behavior disorder predicts Parkinson disease Full Text available with Trip Pro

Severity of REM atonia loss in idiopathic REM sleep behavior disorder predicts Parkinson disease Over 50% of persons with idiopathic REM sleep behavior disorder (RBD) will develop Parkinson disease (PD) or dementia. At present, there is no way to predict who will develop disease. Since polysomnography is performed in all patients with idiopathic RBD at diagnosis, there is an opportunity to analyze if baseline sleep variables predict eventual neurodegenerative disease.In a longitudinally studied (...) 41.0 +/- 6.0%, p = 0.002), and not in those who developed dementia (54.3 +/- 10.3, p = 0.28). There was no difference in phasic submental REM EMG activity between groups.In patients with REM sleep behavior disorder initially free of neurodegenerative disease, the severity of REM atonia loss on baseline polysomnogram predicts the development of Parkinson disease.

2010 EvidenceUpdates

412. Best Practice Guide for the Treatment of REM Sleep Behavior Disorder (RBD)

Best Practice Guide for the Treatment of REM Sleep Behavior Disorder (RBD) R. Nisha Aurora" /> JCSM - Best Practice Guide for the Treatment of REM Sleep Behavior Disorder (RBD) Search article archive here ADVERTISEMENT Current Issue: Volume: 15 Number: 03 Issue Navigator Volume 06 No. 01 .9-10 Charles F. Reynolds III, M.D. 1 ; Susan Redline, M.D. 2 ; for the DSM-V Sleep-Wake Disorders Workgroup and Advisors* .11-17 Nathaniel F. Watson, M.D., M.S. 1 ; Dedra Buchwald, M.D. 2 ; Michael V. Vitiello (...) , of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website. E-mail Share Slides Please login to download PDF Subscribers can download and print full articles from current and past issues of the JCSM Not a subscriber? and receive a subscription to JCSM with your membership Special Articles Best Practice Guide for the Treatment of REM Sleep Behavior Disorder (RBD) Standards of Practice Committee: R. Nisha Aurora, M.D. 1

2010 American Academy of Sleep Medicine

413. Practice Parameters for the Surgical Modifications of the Upper Airway for Obstructive Sleep Apnea in Adults

. A review of neuroimaging in obstructive sleep apnea. J Clin Sleep Med 2006;2:461-71. 16. Shahar E, Whitney C, Redline S, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 2001;163:19-25. 17. Marin JM, Carrizo SJ, Vicente E, et al. Long-term cardiovascular out- comes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet (...) , MI; 7 Penn State University Hershey Medical Center, Hershey, P A and University of Louisville School of Medicine, Louisville, KY; 8 Children’ s Hospital of NY – Presbyterian, Columbia University Medical Center, New York, NY; 9 Mayo Clinic, Rochester, MN; 10 Sleep Disorders Center, University of California, San Francisco, San Francisco, CA Background: Practice parameters for the treatment of obstructive sleep apnea syndrome (OSAS) in adults by surgical modification of the upper airway were first

2010 American Academy of Sleep Medicine

414. Unattended Sleep Studies in the Diagnosis of Obstructive Sleep Apnoea

number of studies, MSAC found Level 2, 3 and 4 unattended sleep settings to be as safe as the currently funded Level 1 studies (which have trained staff in attendance) for obstructive sleep apnoea (OSA), except in the case of young children or patients with cognitive disorders. MSAC concluded that the more physiological parameters that are measured, the more accurate the diagnostic performance of the service, with performance decreasing from Level 1 (thirteen parameters) to Level 4 (one to two (...) Unattended Sleep Studies in the Diagnosis of Obstructive Sleep Apnoea Medical Services Advisory Committee Public Summary Document Application No. 1130 – Unattended Sleep Studies in the Diagnosis and Reassessment of Obstructive Sleep Apnoea Applicants: Australasian Sleep Association / Thoracic Society of Australia and New Zealand Healthy Workplace Solutions Pty Ltd, trading as Healthy Sleep Solutions Date of MSAC consideration: 48th MSAC meeting, 29-30 March 2010 1. Purpose of Application In May

2010 Medical Services Advisory Committee

415. An assessment of sleep disordered breathing diagnosis using Level I versus Level III sleep studies

An assessment of sleep disordered breathing diagnosis using Level I versus Level III sleep studies An assessment of sleep disordered breathing diagnosis using Level I versus Level III sleep studies An assessment of sleep disordered breathing diagnosis using Level I versus Level III sleep studies Health Technology & Policy Unit Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA (...) database. Citation Health Technology & Policy Unit. An assessment of sleep disordered breathing diagnosis using Level I versus Level III sleep studies. Edmonton: Health Technology & Policy Unit (HTPU). 2010 Authors' conclusions Based upon limited published economic evidence (1 study) for the diagnosis of uncomplicated OSA, level III tests are almost as effective as, and are less expensive than level I tests. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Respiratory

2010 Health Technology Assessment (HTA) Database.

416. Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial. Full Text available with Trip Pro

Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial. Expanded access to combination antiretroviral therapy (ART) in resource-poor settings is dependent on task shifting from doctors to other health-care providers. We compared outcomes of nurse versus doctor management of ART care for HIV-infected patients.This randomised non-inferiority trial was undertaken at two South African primary-care clinics. HIV-positive

2010 Lancet Controlled trial quality: predicted high

417. Adding zolpidem to CBT produces limited benefits in persistent insomnia

of zolpidem to cognitive behavioural therapy (CBT) improve persistent insomnia compared with CBT alone? Patients: 160 adults (97 female; >30 years old) with chronic insomnia (DSM-IV and International Classification of Sleep Disorders). Setting: University Hospital Sleep Centre, Quebec, Canada; January 2002-April 2005. Intervention: Acute phase (6 weeks’ duration) : CBT versus CBT plus zolpidem (10 mg/night). CBT involved one 90 min group session per week. Extended phase (6 months’ duration) : The CBT (...) sleep evaluations (polysomnography); response (defined as change from baseline >7 in the patient reported Insomnia Severity Index (ISI) total score) and remission (ISI score <8). Patient follow-up: 93.1% completed the acute phase, 88.1% completed the extended phase and 79.4% completed the … Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price

2010 Evidence-Based Mental Health

418. Oral Appliances are Effective for the Treatment of Obstructive Sleep Apnea

Oral Appliances are Effective for the Treatment of Obstructive Sleep Apnea UTCAT295, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Oral Appliances are Effective for the Treatment of Obstructive Sleep Apnea Clinical Question Do oral appliances provide effective prevention of OSA in middle-age men when compared to CPAP? Clinical Bottom Line Oral appliances for the management of OSA provide significant reduction (...) Systematic Review with Meta-Analysis Key results CPAP reduces OSA to a significantly greater extent than an oral appliance. Evidence Search National Library of Medicine (PubMed) was searched using the following search terms: Sleep Apnea, Obstructive/therapy(MeSH); Continuous Positive Airway Pressure (MeSH); oral appliance Comments on The Evidence The conclusions of these papers should be strongly considered due to the high level of evidence. The reviews relied on well controlled studies and provided

2010 UTHSCSA Dental School CAT Library

419. Occlusal Splints Are A Suitable Treatment Option For Patients With A Mild Form Of Sleep Apnea

into “severe,” “moderate,” and “mild.” Systematic Review Key results CPAP significantly reduced subjective sleepiness, and objective sleepiness (for one out of two objectives scales used), especially for patients whose apnea was most severe at baseline. CPAP did not differ from dental splints in reducing sleepiness for patients with moderate, but not severe, apnea. #2) Hoekema/2008 667 patients of at least 21 years of age, with obstructive sleep apnea syndrome Individual randomized controlled trial Key (...) the use of a continuous positive airway pressure device? Clinical Bottom Line Mandibular advancement splints may provide comparable relief to continuous positive airway pressure in relieving mild to moderate obstructive sleep apnea. (See Comments on the CAT below) Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) McDaid/2009 Unstated number of patients with varying degrees of sleep apnea, divided

2010 UTHSCSA Dental School CAT Library

420. Repose Tongue and Hyoid Suspension (THS) system (Medtronic Xomed Inc.) for obstructive sleep apnea

Citation Repose Tongue and Hyoid Suspension (THS) system (Medtronic Xomed Inc.) for obstructive sleep apnea . Lansdale: HAYES, Inc.. 2010 Authors' objectives Obstructive sleep apnea (OSA) is a disorder in which breathing stops for periods of at least 10 seconds during sleep. Partial or complete collapse of airway at the back of the throat decreases oxygen uptake and carbon dioxide release. Several apneic episodes during a night’s sleep can disrupt normal sleep patterns, resulting in excessive daytime (...) Repose Tongue and Hyoid Suspension (THS) system (Medtronic Xomed Inc.) for obstructive sleep apnea Repose Tongue and Hyoid Suspension (THS) system (Medtronic Xomed Inc.) for obstructive sleep apnea Repose Tongue and Hyoid Suspension (THS) system (Medtronic Xomed Inc.) for obstructive sleep apnea Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Report may be purchased from

2010 Health Technology Assessment (HTA) Database.