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Xomed Inc.) for obstructivesleepapnea . Lansdale: HAYES, Inc.. 2010 Authors' objectives Obstructivesleepapnea (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 disrupt normal sleep patterns, resulting in excessive daytime sleepiness and other symptoms of sleepdisordered breathing. The pauses (...) Pillar palatal implant system (Medtronic Xomed Inc.) for obstructivesleepapnea Pillar palatal implant system (Medtronic Xomed Inc.) for obstructivesleepapnea Pillar palatal implant system (Medtronic Xomed Inc.) for obstructivesleepapnea 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 Citation Pillar palatal implant system (Medtronic
to be given access to available CPAP machines in the home oxygen therapy program (POD). Upon concluding this analysis, AETMIS found that: Obstructivesleepapnea is a recognized disorder and a growing public health problem. This disorder has major impacts on patients’ health and quality of life. The public health and social service system offers no mechanism for the management of OSA patients. The purpose and current structure of the home oxygen therapy program (POD) do not respond to the needs of OSA (...) [Is there a place for home oxygen therapy in the management of obstructivesleepapnea?] Y a-t-il une place pour l'oxygenotherapie a domicile dans la prise en charge de l'apnee obstructive du sommeil? [Is there a place for home oxygen therapy in the management of obstructivesleepapnea?] Y a-t-il une place pour l'oxygenotherapie a domicile dans la prise en charge de l'apnee obstructive du sommeil? [Is there a place for home oxygen therapy in the management of obstructivesleepapnea?] Lobe C
Continuous positive airway pressure as treatment for systemic hypertension in people with obstructivesleepapnoea: randomised controlled trial. To assess the effect of continuous positive airway pressure (CPAP) on 24 hour ambulatory blood pressure monitoring values in a large number of patients with untreated systemic hypertension of new onset and obstructivesleep apnoea.Multicentre, double blind, randomised, placebo controlled trial.Eleven general hospitals in Spain between 2004 and 2007.340 (...) patients recently diagnosed as having systemic hypertension by a general practitioner (systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or both) and an apnoea-hypopnoea index per hour of sleep of >15 events/hour.Patients were assigned to CPAP (n=169) or sham CPAP (n=171) for three months. Main outcome measurements Net changes in the different 24 hour ambulatory blood pressure monitoring values from baseline to three months of optimal or sham CPAP.277 (81%) of the 340 patients
Surgical modifications of the upper airway for obstructivesleepapnea in adults: a systematic review and meta-analysis Surgical modifications of the upper airway for obstructivesleepapnea in adults: a systematic review and meta-analysis Surgical modifications of the upper airway for obstructivesleepapnea in adults: a systematic review and meta-analysis Caples SM, Rowley JA, Prinsell JR, Pallanch JF, Elamin MB, Katz SG, Harwick JD CRD summary The review concluded that substantial (...) and consistent reductions in the apnoea-hyponea index were observed following maxillomandibular advancement surgery; adverse events were reported uncommonly. Outcomes following pharyngeal surgery were less consistent; adverse events were reported more commonly. The review had some methodological problems and data limitations, so caution is warranted when interpreting the authors' conclusions. Authors' objectives To determine the outcomes for surgical modifications of the upper airway for obstructivesleep
Pre-operative screening and post-operative monitoring in adult patients with obstructivesleepapnea: clinical effectiveness and guidelines Pre-operative screening and post-operative monitoring in adult patients with obstructivesleepapnea: clinical effectiveness and guidelines Pre-operative screening and post-operative monitoring in adult patients with obstructivesleepapnea: clinical effectiveness and guidelines Canadian Agency for Drugs and Technologies in Health Record Status (...) This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Canadian Agency for Drugs and Technologies in Health. Pre-operative screening and post-operative monitoring in adult patients with obstructivesleepapnea: clinical effectiveness and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). 2010 Authors' conclusions PSG is the gold standard to evaluate
with primary insomnia. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Cognitive Therapys; Sleep Initiation and Maintenance Disorders; Treatment Outcome Language Published English Country of organisation Canada Province or state Ontario Address for correspondence Canadian Agency for Drugs and Technologies in Health, 865 Carling Avenue, Suite 600, K1S 5S8 Ottawa, Ontario Canada Email: email@example.com AccessionNumber 32011001178 Date abstract record published 28/09/2011 Health (...) been made for the HTA database. Citation Canadian Agency for Drugs and Technologies in Health. Cognitive behavioural therapy for insomnia in adults: a review of the clinical effectiveness. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). 2010 Authors' conclusions In the available literature, CBT seems to be effective in mediating the symptoms of primary insomnia as indicated by sleep outcome measures. The results demonstrate that CBT is as effective and in some studies even
Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructivesleepapnea: systematic review and meta-analysis Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructivesleepapnea: systematic review and meta-analysis Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructivesleepapnea: systematic review and meta-analysis Tregear S, Reston J, Schoelles K, Phillips (...) B CRD summary This review of observational studies concluded that continuous positive airway pressure reduced accident risk in drivers with obstructivesleepapnoea. Weaknesses in the evidence base suggest that the authors' conclusions should be interpreted with some caution. Authors' objectives To assess the impact of continuous positive airway pressure (CPAP) on risk of motor vehicle accidents in drivers with obstructivesleepapnoea. Searching PubMed, EMBASE, PsycINFO, CINAHL, TRIS
Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Effects of alcohol and sleep restriction on simulated driving performance in untreated patients with obstructivesleepapnea. Because of previous sleep disturbance and sleep hypoxia, patients with obstructivesleepapnea (OSA) might be more vulnerable to the effects of alcohol and sleep restriction than healthy persons.To compare the effects of sleep restriction and alcohol on driving simulator performance in patients with OSA and age-matched control participants.Driving simulator assessments (...) in 2 groups under 3 different conditions presented in random order.Adelaide Institute for Sleep Health, Sleep Laboratory, Adelaide, Australia.38 untreated patients with OSA and 20 control participants.Steering deviation, crashes, and braking reaction time.Unrestricted sleep, sleep restricted to a maximum of 4 hours, and ingestion of an amount of 40% vodka calculated to achieve a blood alcohol level of 0.05 g/dL.Patients with OSA demonstrated increased steering deviation compared with control
A randomized study on the effect of weight loss on obstructivesleepapnea among obese patients with type 2 diabetes: the Sleep AHEAD study The belief that weight loss improves obstructivesleepapnea (OSA) has limited empirical support. The purpose of this 4-center study was to assess the effects of weight loss on OSA over a 1-year period.The study included 264 participants with type 2 diabetes and a mean (SD) age of 61.2 (6.5) years, weight of 102.4 (18.3) kg, body mass index (BMI (...) ) (calculated as weight in kilograms divided by height in meters squared) of 36.7 (5.7), and an apnea-hypopnea index (AHI) of 23.2 (16.5) events per hour. The participants were randomly assigned to either a behavioral weight loss program developed specifically for obese patients with type 2 diabetes (intensive lifestyle intervention [ILI]) or 3 group sessions related to effective diabetes management (diabetes support and education [DSE]).The ILI participants lost more weight at 1 year than did DSE
How Should You Approach a Geriatric Insomniac? How Should You Approach a Geriatric Insomniac? – Clinical Correlations Search How Should You Approach a Geriatric Insomniac? September 2, 2009 6 min read Gilda Boroumand, MS4 Faculty Peer Reviewed Chronic insomnia, defined as difficulty with the initiation, maintenance, duration, and quality of sleep for at least one month, is a common complaint with significant impact on an individual’s daytime functioning and quality of life. It is particularly (...) . National Institutes of Health State of the Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults. Sleep. 2005;28:1049-1057 3. Bloom HG, Ahmed I, Alessi CA, et al. Evidence-based recommendations for the assessment and management of sleepdisorders in older persons. J Am Geriatr Soc. 2009;57:761-789. 4. Morin CM, Koetter U, Bastien C, Ware JC, Wooten V. Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial
Update on the state of the science: sleep-wake disturbances in adult patients with cancer To update the state of the science on sleep-wake disturbances in adult patients with cancer, focusing on insomnia in the areas of prevalence, mechanisms and models, measurement, interventions, and implications for practice, health policy, education, and research.Published articles, books, book chapters, MEDLINE, CINAHL, and PsycINFO computerized databases.Since the 2004 conference on Sleep-Wake (...) Disturbances in People With Cancer and Their Caregivers, an increased focus has existed on the prevalence and distress experienced by patients with cancer with sleep-wake disturbances, particularly insomnia. Evidence suggests that altered physiology directly related to the cancer process may play a prominent role in disrupting sleep, circadian rhythms, and hypothalamic-pituitary-adrenal axis-regulated processes. Reliable and valid objective and subjective measurements for screening and assessing sleep-wake
restructuring, and relapse prevention.The Insomnia Severity Index and daily sleep diary data were used to determine changes in insomnia severity and the main sleep variables, including wake after sleep onset and sleep efficiency.Intention-to-treat analyses showed that scores on the Insomnia Severity Index significantly improved from 15.73 (95% confidence interval [CI], 14.07 to 17.39) to 6.59 (95% CI, 4.73 to 8.45) for the Internet group but did not change for the control group (16.27 [95% CI, 14.61 (...) to 17.94] to 15.50 [95% CI, 13.64 to 17.36]) (F(1,42) = 29.64; P < .001). The Internet group maintained their gains at the 6-month follow-up. Internet participants also achieved significant decreases in wake after sleep onset (55% [95% CI, 34% to 76%]) and increases in sleep efficiency (16% [95% CI, 9% to 22%]) compared with the nonsignificant control group changes of wake after sleep onset (8% [95% CI, -17% to 33%) and sleep efficiency (3%; 95% CI, -4% to 9%).Participants who received the Internet
Disorders in Older Men Study underwent unattended polysomnography. Nocturnal AF and CVE were ascertained by electrocardiogram-specific analysis of the polysomnographic data. Exposures were (1) SDB defined by respiratory disturbance index (RDI) quartile (a major index including all apneas and hypopneas), and ancillary definitions incorporating (2) obstructive events, obstructivesleepapnea (OSA; ObstructiveApneaHypopnea Index quartile), or (3) central events, central sleepapnea (CSA; Central Apnea (...) Nocturnal Arrhythmias across a spectrum of obstructive and central sleep-disorderedbreathing in older men: outcomes of sleepdisorders in older men (MrOS sleep) study Rates of cardiac arrhythmias increase with age and may be associated with clinically significant morbidity. We studied the association between sleep-disorderedbreathing (SDB) with nocturnal atrial fibrillation or flutter (AF) and complex ventricular ectopy (CVE) in older men.A total of 2911 participants in the Outcomes of Sleep
in children with persistent insomnia after simple conservative sleep hygiene measures have been tried. The limited research evidence currently available has not investigated potential long-term effects of melatonin administration and further high quality data from systematic studies are needed. Clinical Bottom Line Melatonin administration can be used to advance sleep onset to normal values in children with attention deficit hyperactivity disorder (ADHD) who are not on stimulant medication. (Grade (...) , Starreveld JS, et al. Melatonin for treatment of sleepingdisorders in children with attention deficit/hyperactivity disorder: a preliminary open label study. Eur J Pediatr 2003;162:554–5. Van der Heijden KB, Smits MG, Van Someren EJ, et al. Effect of melatonin on sleep, behavior, and cognition in ADHD and chronic sleep-onset insomnia. J Am Acad Child Adolesc Psychiatry 2007;46:233–41. Betancourt-Fursow de Jimenez YM, Jimenez-Leon JC, Jimenez-Betancourt CS. Attention deficit hyperactivity disorder
to persistent sleep on polysomnographic recordings after 4 weeks of treatment in children and adolescents 6 through 17 years of age who had attention-deficit/hyperactivity disorder-associated insomnia. (...) Controlled clinical trial of zolpidem for the treatment of insomnia associated with attention-deficit/ hyperactivity disorder in children 6 to 17 years of age The goal was to evaluate the hypnotic efficacy of zolpidem at 0.25 mg/kg per day (maximum of 10 mg/day), compared with placebo, in children 6 through 17 years of age who were experiencing insomnia associated with attention-deficit/hyperactivity disorder.An 8-week, North American, multicenter, double-blind, placebo-controlled, parallel
Adenotonsillectomy for obstructivesleepapnoea in children. Current treatment of sleepapnoea in children consists of largely surgical based treatments. Adenotonsillectomy is the most commonly used intervention to treat sleepapnoea in children.To determine the efficacy of adenotonsillectomy in the treatment of obstructivesleepapnoea in children.The Cochrane Airways Group Specialised Register was searched with pre-specified terms. Searches were current as of August 2008.Randomised trials (...) as to the criteria required to diagnose significant obstructivesleepapnoea in children. Also the natural history of the condition has not been fully delineated. There is an absence of randomised controlled trials investigating the efficacy of treatment of confirmed obstructivesleepapnoea with adenotonsillectomy in children. Research is required before recommendations for the treatment of obstructivesleepapnoea in children can be formulated. The quality of research in this area could be improved
Scheduled Bright Light for Treatment of Insomnia in Older Adults To determine whether bright light can improve sleep in older individuals with insomnia.Single-blind, placebo-controlled, 12-week, parallel-group randomized design comparing four treatment groups representing a factorial combination of two lighting conditions and two times of light administration.At-home light treatment; eight office therapy sessions.Thirty-six women and fifteen men (aged 63.6+/-7.1) meeting primary insomnia (...) (melatonin midpoint) and sleep (darkness) predicted the magnitude of phase delays, but not phase advances, engendered by bright light.Except for one subjective measure, scheduled morning or evening bright light effects were not different from those of scheduled dim light. Thus, support was not found for bright light treatment of older individuals with primary insomnia.
63 obese men (body mass index 30-40, age 30-65 years) with moderate to severe obstructivesleepapnoea (apnoea-hypopnoea index (AHI) >or=15), treated with continuous positive airway pressure.The intervention group received a liquid very low energy diet (2.3 MJ/day) for seven weeks to promote weight loss, followed by two weeks of gradual introduction of normal food, reaching 6.3 MJ/day at week 9. The control group adhered to their usual diet during the nine weeks of follow-up.AHI, the major (...) Effect of a very low energy diet on moderate and severe obstructivesleepapnoea in obese men: a randomised controlled trial. To assess the effect of weight loss induced by a very low energy diet on moderate and severe obstructivesleepapnoea in obese men. Design Single centre, two arm, parallel, randomised, controlled, open label trial. Blocked randomisation procedure used for treatment allocation. Setting Outpatient obesity clinic in a university hospital in Stockholm, Sweden. Participants