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. Marcus CL, Brooks LJ, Draper KA, et al.; American Academy of Pediatrics. Diagnosis and Management of Childhood ObstructiveSleepApneaSyndrome. Pediatrics. 2012;130(3):576-584. 9. Roland PS, Rosenfeld RM, Brooks LJ, et al; American Academy of Otolaryngology—Head and Neck Surgery Foundation. Clinical practice guideline: polysomnography for sleep-disorderedbreathing prior to tonsillectomy in children. Otolaryngol Head Neck Surg. 2011 Jul;145(1 Suppl):S1-15. Other Literature 1. Berry RB, Hill G (...) and/or cognitive impairment are not suitable candidates for home sleep studies. Patients with sleepdisorders other than OSA are not suitable candidates for home sleep testing. Regardless of the site of testing, sleep studies objectively measure the degree of respiratory disturbance during sleep. Episodes of apnea (cessation of breathing lasting at least 10 seconds and hypopnea (reduction, but not a cessation of air exchange, with an associated fall in oxygen saturation [at least 3% to 4%] or arousal
Combined electroacupuncture and auricular acupuncture for primary insomnia: a randomised controlled trial of dose-response effect. 30674705 2019 01 24 1024-2708 25 Suppl 2 2019 Feb Hong Kong medical journal = Xianggang yi xue za zhi Hong Kong Med J Combined electroacupuncture and auricular acupuncture for primary insomnia: a randomised controlled trial of dose-response effect. 28-33 Chung K F KF Department of Psychiatry, The University of Hong Kong. Yeung W F WF School of Chinese Medicine
randomized to the HT002 (n = 20) or waitlist (n = 20) groups. The HT002 group consumed HT002 twice daily for 4 weeks. Outcomes were assessed using the Insomnia Severity Scale (ISI), Pittsburgh Sleep Quality Index (PSQI), and 12-item Short Form Health Survey (SF-12) at baseline and after 4 and 8 weeks.The ISI score differences from baseline at weeks 4 and 8 were significantly greater in the HT002 than that in the waitlist group (week 4: -4.0 ± 0.8 vs. -0.4 ± 0.8, p < 0.05; week 8: -4.8 ± 0.7 vs. -0.9 (...) Effect of Traditional East Asian Medicinal herbal tea (HT002) on insomnia: a randomized controlled pilot study. Complementary and alternative medicine treatment for insomnia has been sought due to the possible adverse effects of conventional pharmacotherapies. We performed a preliminary evaluation of the feasibility of using, and of the effect of a herbal tea (HT002), based on Traditional East Asian Medicine, in mild-to-moderate insomnia.Patients (n = 40) with mild-to-moderate insomnia were
Positive airway pressure for sleep-disorderedbreathing in acute quadriplegia: a randomised controlled trial Highly prevalent and severe sleep-disorderedbreathing caused by acute cervical spinal cord injury (quadriplegia) is associated with neurocognitive dysfunction and sleepiness and is likely to impair rehabilitation.To determine whether 3 months of autotitrating CPAP would improve neurocognitive function, sleepiness, quality of life, anxiety and depression more than usual care in acute (...) of CPAP during a 3-day run-in and were randomised. 149 participants (134 men, age 46±34 years, 81±57 days postinjury) completed the trial. CPAP use averaged 2.9±2.3 hours per night with 21% fully 'adherent' (at least 4 hours use on 5 days per week). Intention-to-treat analyses revealed no significant differences between groups in the Paced Auditory Serial Addition Task (mean improvement of 2.28, 95% CI -7.09 to 11.6; p=0.63). Controlling for premorbid intelligence, age and obstructivesleepapnoea
performance and safety implications [ ], and associated risks of tolerance and dependence [ ]. Considering sleep clinic advice or referral The recommendation to consider specialist advice or referral to a sleep clinic is extrapolated from the AASM publication, as shift workers with excessive sleepiness may have another co-morbid primary sleepdisorder, such as obstructivesleepapnoeasyndrome, causing sleep disturbance. Sleep studies may be helpful to assess the person and provide appropriate specialist (...) a person who does shift work has difficulty adjusting to different sleep/wake schedules and experiences sleep disturbance before or after the shift, and/or excessive sleepiness and fatigue during shifts. There may be associated insomnia in addition [ ; ; ]. Shift work describes work time arrangements outside of conventional daytime hours, which includes fixed early morning, evening, and night work, and rotating shift work (alternating day, evening, and night shift) [ ; ; ]. Jet lag disorder (JLD
Long-term efficacy of an education programme in improving adherence with continuous positive airway pressure treatment for obstructivesleepapnoea. 29938667 2018 12 11 2018 12 11 1024-2708 23 Suppl 2 3 2017 06 Hong Kong medical journal = Xianggang yi xue za zhi Hong Kong Med J Long-term efficacy of an education programme in improving adherence with continuous positive airway pressure treatment for obstructivesleepapnoea. 24-27 Lai A A Department of Medicine, Queen Mary Hospital (...) of Life SleepApnea, Obstructive therapy 2018 6 26 6 0 2018 6 26 6 0 2018 12 12 6 0 ppublish 29938667
Continuous positive airway pressure effect on visual acuity in patients with type 2 diabetes and obstructivesleepapnoea: a multicentre randomised controlled trial We sought to establish whether continuous positive airway pressure (CPAP) for obstructivesleepapnoea (OSA) in people with type 2 diabetes and diabetic macular oedema (DMO) improved visual acuity.We randomly assigned 131 eligible patients aged 30-85 years from 23 UK centres with significant DMO causing visual impairment (LogMAR
Does Armodafinil Improve Driving Task Performance and Weight Loss in SleepApnea? A Randomized Trial Patients with obstructivesleepapnea (OSA) unable to tolerate standard treatments have few alternatives. They may benefit from weight loss, but the major symptom of daytime performance impairment may remain during weight loss programs.We hypothesized that wakefulness-promoter armodafinil would improve driving task performance over placebo in patients undergoing weight loss.This was a placebo (...) -controlled, double-blind, randomized trial of armodafinil versus placebo daily for 6 months in patients who were also randomized to one of two diets for 6 months with follow-up at 1 year in overweight, adult, patients with OSA who had rejected standard treatment and suffered daytime sleepiness.Primary outcome was change in steering deviation in the final 30 minutes of a 90-minute afternoon driving task (AusED) at 6 months. Secondary outcomes were Epworth Sleepiness Scale, Functional Outcomes of Sleep
Improved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial Acute myeloid leukemia (AML) in elderly patients has a poor prognosis. In an attempt to improve outcome for these patients, the prospective open-label phase III LAM-SA 2007 (Adding Lomustine to Chemotherapy in Older Patients With Acute Myelogenous Leukemia (AML), and Allogeneic Transplantation for Patients From 60 to 65 Years
Elevated obstructivesleepapnoea risk score is associated with poor healing of diabetic foot ulcers: a prospective cohort study To assess the prevalence of risk factors for obstructivesleepapnoea in people with diabetic foot ulcers and to determine whether this risk predicts diabetic foot ulcer healing.We studied 94 consecutive people (69% men) with diabetic foot ulcers (Type 2 diabetes, n=66, Type 1 diabetes, n=28) attending a university hospital foot unit. All participants were screened (...) for obstructivesleepapnoea using the STOP-BANG questionnaire, with a score ≥4 identifying high risk of obstructivesleepapnoea. The primary outcome was poor diabetic foot ulcer healing, defined as diabetic foot ulcer recurrence (diabetic foot ulcers which healed and re-ulcerated in same anatomical position) and/or diabetic foot ulcer persistence (no evidence of healing on clinical examination). All participants were evaluated at 12 months.Of the 94 participants, 60 (64%) had a STOP-BANG score ≥4. Over 12
Cross-sectional study of brucellosis and Q fever in Thailand among livestock in two districts at the Thai-Cambodian border, Sa Kaeo province Brucellosis and Q fever impart high morbidity in humans and economic losses among livestock worldwide. However their prevalence is still not fully known in Thailand. We conducted a sero-survey of brucellosis and Q fever in beef, dairy cattle, goat, and sheep herds from Thai communities at the border with Cambodia, a cross-border trading center. Serum
with neurological conditions, such as autism spectrum disorder (ASD) and Smith-Magenis syndrome, who also have insomnia is high and not many treatments are available. Slenyto has been shown to improve sleeping times in these patients, with patients taking Slenyto sleeping for an extra 51 minutes a night compared with an extra 19 minutes with placebo. The side effects seen with the medicine over 2 years appear mild or moderate but more data are needed on longer term safety. The European Medicines Agency decided (...) Melatonin (Slenyto) - insomnia (difficulty sleeping) in children and adolescents (2 to 18 years old) Slenyto | European Medicines Agency Search Search Menu Slenyto melatonin Table of contents Authorised This medicine is authorised for use in the European Union. Overview Slenyto is a medicine for treating insomnia (difficulty sleeping) in children and adolescents (2 to 18 years old) who have: autism spectrum disorder (ASD), a range of conditions that affects the patient’s social interactions
=apnea–hypopnea index; C=control; CI=con?dence interval; CPAP=continuous positive airway pressure; D=drug; ER=extended release; IWQoL-Lite= Impact of Weight on Quality of Life–Lite instrument; OSA=obstructivesleepapnea; QOL=quality of life; SF-36=36-item Short Form Health Survey. AMERICAN THORACIC SOCIETY DOCUMENTS e78 American Journal of Respiratory and Critical Care Medicine Volume 198 Number 6 | September 15 2018 noted among those taking liraglutide. Changes in daytime somnolence did not differ (...) The Role of Weight Management in the Treatment of Adult ObstructiveSleepApnea Guideline AMERICANTHORACICSOCIETY DOCUMENTS TheRoleofWeightManagementintheTreatmentofAdultObstructive SleepApnea An Of?cial American Thoracic Society Clinical Practice Guideline David W. Hudgel, Sanjay R. Patel, Amy M. Ahasic, Susan J. Bartlett, Daniel H. Bessesen, Melisa A. Coaker, P. Michelle Fiander, Ronald R. Grunstein, Indira Gurubhagavatula, Vishesh K. Kapur, Christopher J. Lettieri, Matthew T. Naughton
Management of obstructivesleepapnoea in a primary care vs sleep unit setting: a randomised controlled trial To assess the effectiveness and cost-effectiveness of primary care (PC) and sleep unit (SU) models for the management of subjects with suspected obstructivesleepapnoea (OSA).Multicentre, open-label, two-arm, parallel-group, non-inferiority randomised controlled trial. A total of 302 subjects with suspected OSA and/or resistant hypertension were consecutively enrolled, 149 were treated (...) at 11 PC units and 153 patients at a SU. The primary outcomes were a 6-month change in the Epworth Sleepiness Scale (ESS) score and Health Utilities Index (HUI). The non-inferiority margin for the ESS score was -2.0.A total of 80.2% and 70.6% of the PC and SU patients were diagnosed with OSA, respectively, and 59.3% and 60.4% of those were treated with CPAP in PC and SU units, respectively. The Apnoea-Hypopnoea Index was similar between the groups (PC vs SU (median (IQR); 23.1 (26.8) events/h vs
Effect of 1 month of zopiclone on obstructivesleepapnoea severity and symptoms: a randomised controlled trial Hypnotic use in obstructivesleepapnoea (OSA) is contraindicated due to safety concerns. Recent studies indicate that single-night hypnotic use worsens hypoxaemia in some and reduces OSA severity in others depending on differences in pathophysiology. However, longer clinical trial data are lacking. This study aimed to determine the effects of 1 month of zopiclone on OSA severity (...) , sleepiness and alertness in patients with low-moderate respiratory arousal thresholds without major overnight hypoxaemia.69 participants completed a physiology screening night with an epiglottic catheter to quantify arousal threshold. 30 eligible patients (apnoea-hypopnoea index (AHI) 22±11 events·h-1) then completed standard in-laboratory polysomnography (baseline) and returned for two additional overnight sleep studies (nights 1 and 30) after receiving either nightly zopiclone (7.5 mg) or placebo
Recanalisation therapies for wake-up stroke. About one in five strokes occur during sleep (wake-up stroke). People with wake-up strokes have traditionally been considered ineligible for thrombolytic treatment because the time of stroke onset is unknown. However, some studies suggest that these people may benefit from recanalisation therapies.To assess the effects of intravenous thrombolysis and other recanalisation therapies versus control in people with acute ischaemic stroke presenting (...) and unpublished data.We included one pilot trial with nine participants. The trial was a feasibility trial that included participants with an unknown onset of stroke and signs on perfusion computed tomography of ischaemic tissue at risk of infarction, who were randomised to alteplase (0.9 mg/kg) or placebo. One trial was prematurely terminated due to signs of efficacy of the intervention arm; we did not include this trial because we were not able to obtain data for the portion of the participants with wake-up
is a sleepdisorder affecting approximately 13% of the Canadian population. People with insomnia often have difficulty falling asleep or difficulty remaining asleep. They may also wake 2017 11. Treatments for Insomnia : A Review of Patient and Experiences and Perspectives Treatments for Insomnia : A Review of Patient and Experiences and Perspectives | CADTH.ca Find the information you need Treatments for Insomnia : A Review of Patient and Experiences and Perspectives Treatments for Insomnia : A Review (...) of what constitutes normal sleep. It usually takes less than 30 minutes for a person to fall asleep. Average (...) total nocturnal sleep time decreases with age from about 8 hours at 15 years of age to less than 6 hours at 80 years of age. Insomnia can be categorized according to duration or likely duration: Short-term insomnia lasts less than 4 weeks. Long-term (or persistent) insomnia lasts for 4 weeks or longer. Sleepdisorders that need to be excluded when making a diagnosis of insomnia are: Sleep
American Thoracic Society Documents 289 Overview The overlap syndrome (OVS) is the co-occurrence of chronic obstructive pulmonarydisease (COPD)and obstructivesleepapnea (OSA). This statement summarizestheexistingliterature,identi?es knowledge gaps, and provides guidance regarding future priorities in research for sleep-disorderedbreathing (SDB) in patientswithCOPDandotherlungdiseases. Key Conclusions d OVS is common because COPD and OSA are common. There is no de?nitive evidence that patients (...) without comorbid insomnia. Although the detection of apnea is reasonably straightforward, hypopneas, as de?ned by Decreased I/E Airflow ?PaO2 ?PaCO2 Chemoreceptor Stimulation Arousal Expiratory UA Narrowing Diaphragm Dysfunction Dynamic Hyperinflation Alveolar Hypoventilation Inspiratory UA Narrowing Ventilatory Overshoot Increased work of Breathing Decreased Ventilatory Motor Output Worsening Airflow Obstruction Upper Airway Muscle Activity ? Caudal Traction Sleep + Circadian Factors + Supine
syndrome? Introduction Methods Committee Composition Workshop Structure and Literature Review Document Development Perioperative Outcomes of Patients with Sleep- disorderedBreathing Screening for ObstructiveSleepApnea in Surgical Patients ObstructiveSleepApnea Endotypes and Potential Relevance in the Perioperative Period Role of Algorithms in the Perioperative Management of ObstructiveSleepApnea and Obesity Hypoventilation Syndrome Perioperative Use of Positive Airway Pressure Obesity (...) Hypoventilation Syndrome in the Perioperative Period OpioidsandtheSurgicalPatient with ObstructiveSleepApnea The Use of Administrative Databases and Patient Registries Patient Safety and Healthcare Management Considerations Conclusions American Thoracic Society Documents 117 Overview Perioperative management of sleep- disorderedbreathing, such as obstructivesleepapnea (OSA) and obesity hypoventilationsyndrome(OHS),isanarea of patient care that requires improvement due to the risk of morbidity