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REM Sleep Behavior Disorder

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241. Excessive daytime sleepiness in Chinese patients with sporadic amyotrophic lateral sclerosis and its association with cognitive and behavioural impairments. (Abstract)

with ALS compared with 121 age-matched and sex-matched healthy subjects. EDS was diagnosed using the Epworth Sleepiness Scale (ESS). Other characteristics of patients with ALS including sleep quality, REM sleep behaviour disorder (RBD), restless legs syndrome (RLS), cognition, behaviour, depression and anxiety were also evaluated.EDS was significantly more frequent in patients with ALS than in controls (26.4% vs 8.3%; p<0.05). Patients with ALS with EDS scored lower scores on the revised ALS Functional (...) with ALS, and these patients might have more serious physical, cognitive and frontal behaviour impairment. Patients with ALS might improve quality of life from the timely recognition and optimised management of EDS symptoms. Our results further suggest that ALS is a heterogeneous disease that might exhibit abnormal sleep-wake patterns.© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.

2018 Neurosurgery and Psychiatry

242. Lariglutide injection for obesity: sleep apnea study (Saxenda)

per hour) ? Proportion of supine sleep ? Period limb movement with arousal index (visit 2 only) ? Central apnea percentage (visit 2 only) ? Time in bed ? Heart rate The following patient-reported outcomes (PRO) pertinent to OSA were measured: ? daytime sleepiness (Epworth Sleepiness Scale), ? health-related quality of life (Short Form 36 [SF-36] Health Survey) ? the impact of daytime sleepiness on multiple everyday activities (Functional Outcomes of Sleep Questionnaire [FOSQ]) The primary endpoint (...) ), ? Health-related quality of life (Short Form 36 [SF-36] Health Survey) ? The impact of daytime sleepiness on multiple everyday activities (Functional Outcomes of Sleep Questionnaire [FOSQ]) The primary endpoint was change from baseline AHI at week 32. Reviewer comment: DNP notes that OSA severity can be classified by AHI but the correlation between any specific improvement in AHI and clinically relevant benefit is poorly established. Reference ID: 3645293Clinical Review Golden, J. NDA 206321 Saxenda

2014 FDA - Drug Approval Package

243. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015

. Untreated OSA is associated with multiple adverse health outcomes including systemic hypertension, coronary artery disease, stroke, atrial fibrillation, increased motor vehicle accidents, congestive heart failure, daytime sleepiness, decreased quality of life, and increased mortality. Snoring is also a significant social problem and contributes to decreased quality of life for bed partners through disrupted sleep. Snoring itself may have a negative health impact, such as increased risk (...) for cardiovascular disease. In recent years, oral appliances (OAs) have become an increasingly common treatment modality for OSA and snoring. Although positive airway pressure (PAP) remains the most common and most efficacious treatment for sleep disordered breathing, OAs offer effective therapy for many patients with OSA. These devices offer advantages over PAP in that they do not require a source of electricity and are less cumbersome, especially with travel. Oral appliances are well tolerated in most patients

2015 American Academy of Sleep Medicine

244. Canadian guideline for Parkinson disease

suffering from an REM-sleep associated behavioural disorder). Several drug challenges or diagnostic tests have been proposed to aid in the diagnosis of Parkinson disease or in the differentiation between Parkinson disease and other parkinsonian syndromes. If an individual has Parkinson disease then he or she should respond to dopamine replacement therapy (e.g., levodopa-carbidopa 600 mg/d) and therefore, if they do have a clear response, this can be used to help reinforce that an accurate diagnosis has (...) sleep behaviour disorder can pre-date the diagnosis of Parkinson disease. PALLIATIVE CARE n The palliative care needs of people with Parkinson disease should be considered throughout all phases of the disease. n If the patient asks, the option of medical assistance in dying should be discussed. TREATMENT n Levodopa is the most eective medication and may be used early. n A regular exercise regimen begun early has proven benet. n Patients with possible diagnosis of Parkinson disease may benet from

2019 CPG Infobase

245. Canadian guidelines on benzodiazepine receptor agonist use disorder among older adults

(el-Guebaly et al ., 2010) . Efforts to reduce physiological dependency would include minimizing dosages, prescribing only for short periods of time, and/or only using intermittently (Ibid) . It should be noted that there are a few conditions, such as REM sleep disorder, for which longer-term use of a BZRA might be appropriate (Aurora et al ., 2010) .10 Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults RECOMMENDATION #2: Appropriate first-line non (...) : an indicator for inappropriately treated geriatric depression? Int J Geriatr Psychiatry, 24(6), 563-569. doi:10.1002/gps.2155 Aurora, R. N., et al. (2010). Best practice guide for the treatment of REM sleep behavior disorder (RBD). Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 6(1), 85-95. Belanger, L., et al. (2005). Self-efficacy and compliance with benzodiazepine taper in older adults with chronic insomnia. Health Psychol, 24(3), 281-287. doi

2019 CPG Infobase

246. Exogenous melatonin for sleep disorders in neurodegenerative diseases: a meta-analysis of randomized clinical trials. (Abstract)

: 4.20, 95 % CI: 0.92-7.48; P = 0.01), and by changes in PSQI component 4 in AD patients (MD: 0.67, 95 % CI: 0.04-1.30; P = 0.04), but not on objective sleep outcomes in both AD and PD patients. Treatment with melatonin effectively improved the clinical and neurophysiological aspects of rapid eye movement (REM) sleep behavior disorder (RBD), especially elderly individuals with underlying neurodegenerative disorders. This meta-analysis provided some evidence that melatonin improves sleep quality (...) Exogenous melatonin for sleep disorders in neurodegenerative diseases: a meta-analysis of randomized clinical trials. The purpose of this work is to investigate the efficacy of exogenous melatonin in the treatment of sleep disorders in patients with neurodegenerative disease. We searched Pubmed, the Cochrane Library, and ClinicalTrials.gov, from inception to July 2015. We included randomized clinical trials (RCTs) that compared melatonin with placebo and that had the primary aim of improving

2015 Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

247. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis. Full Text available with Trip Pro

-4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0-1.6% for narcolepsy, 14.4-57.5% for restless legs syndrome, 2.22-3.2% for REM behavior disorder, and 7.14-58.1% for obstructive sleep apnea.This review suggests that seizure disorders and sleep disorders are common in MS, but highlights gaps in the epidemiological knowledge of these conditions in MS worldwide. Other than central-western Europe and North America, most regions (...) A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis. Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS).To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies included.The PUBMED, EMBASE, Web of Knowledge, and SCOPUS databases, conference proceedings, and reference

2015 Multiple sclerosis (Houndmills, Basingstoke, England)

248. Arousal and sleep circuits. (Abstract)

Arousal and sleep circuits. The principal neurons of the arousal and sleep circuits are comprised by glutamate and GABA neurons, which are distributed within the reticular core of the brain and, through local and distant projections and interactions, regulate cortical activity and behavior across wake-sleep states. These are in turn modulated by the neuromodulatory systems that are comprised by acetylcholine, noradrenaline, dopamine, serotonin, histamine, orexin (hypocretin), and melanin (...) -concentrating hormone (MCH) neurons. Glutamate and GABA neurons are heterogeneous in their profiles of discharge, forming distinct functional cell types by selective or maximal discharge during (1) waking and paradoxical (REM) sleep, (2) during slow wave sleep, (3) during waking, or (4) during paradoxical (REM) sleep. The neuromodulatory systems are each homogeneous in their profile of discharge, the majority discharging maximally during waking and paradoxical sleep or during waking. Only MCH neurons

2019 Neuropsychopharmacology

249. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness Full Text available with Trip Pro

and/or display intentional communication) or minus (e.g. if they only show voluntary signs of consciousness such as localization to pain or visual pursuit but no behaviors suggestive of language processing) . Patients who recover functional communication or functional object use are considered as ‘emerged from MCS’ . Disorders of consciousness must be differentiated from conditions mimicking unresponsiveness but in which consciousness is intact. As stated earlier, in the locked‐in syndrome a patient is fully (...) -text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Shareable Link Use the link below to share a full-text version of this article with your friends and colleagues. Copy URL Share a link Share on - . Further complicating matters, the origin of many clinical signs and behaviors in patients with disorders of consciousness (DoC) is not entirely clear and their significance as to whether the patient is conscious is even less certain , , . Moreover

2020 European Academy of Neurology

250. Istradefylline (Nourianz) - Parkinson's disease

Insomnia, sleep disturbance, abnormal dreams = 65 3.9 3.3 Nausea, vomiting = 65 4.1 3.7 Abdominal pain, distension, bloating, spasm, IBS = 65 6.2 6 Reviewer created table from the ISS ADAE dataset with ANL01FL=Y, studyID=6002-US-005, 6002-0608, 6002-009, 6002-US-013. Grouped by USUBJID, AEDECOD, and TRPO1A. *Denominator: All IST = 75 8.6 7.3 Fall, dizziness, balance disorder = 75 12.9 12.7 Dyspepsia, N, V, indigestion, epigastric pain, = 75 6.5 14.5 Insomnia, sleep disturbance, abnormal dreams = 75 4.3 (...) for Pools 1 and 2 and did not find any TEAEs of withdrawal syndrome. The sponsor concluded that a low likelihood for developing withdrawal symptoms exists given the relatively long elimination half-life of istradefylline (82.7 to 148.3 hours). With regards to rebound symptoms, the sponsor searched Pool 1 for adverse events with rebound potential occurring within 40 days of discontinuation with istradefylline. AEs of rebound potential included AEs related to constipation, nausea, falls, fractures

2019 FDA - Drug Approval Package

251. Periodic limb movement disorder

in terms of sleep disturbance and excessive daytime sleepiness is controversial. May be either primary (idiopathic) or secondary. Secondary periodic limb movement disorder (PLMD) may occur in restless legs syndrome, obstructive sleep apnoea syndrome, REM sleep behaviour disorder (RBD), narcolepsy, congestive heart failure, essential hypertension, end-stage renal disease, spinal cord injury, syringomyelia, alcohol dependence, Parkinson's disease, and Tourette's syndrome. May be related to intake (...) of medications including lithium, tricyclic antidepressants, and selective serotonin-reuptake inhibitors. There is no evidence for treatment of primary PLMD. Treatment is traditionally with dopamine agonists, benzodiazepines, and opiates. Definition Periodic limb movements of sleep (PLMS) are characterised as repetitive limb movements (mostly of the legs) arising mainly during non-rapid eye movement (non-REM) sleep. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed

2018 BMJ Best Practice

252. Polysomnography for Sleep-Disordered Breathing Prior to Tonsillectomy in Children

the need for tonsillectomy, the clinician should refer children with sleep-disordered breathing for poly- somnography if they exhibit certain complex medical conditions such as obesity, Down syndrome, craniofacial abnormalities, neu- romuscular disorders, sickle cell disease, or mucopolysacchari- doses. (2) The clinician should advocate for polysomnography prior to tonsillectomy for sleep-disordered breathing in children without any of the comorbidities listed in statement 1 for whom the need (...) : peter.roland@utsouthwestern.eduRoland et al S3 Background and Significance SDB represents a spectrum of sleep disorders ranging in severity from snoring to OSA. In children, the estimated prevalence for habitual snoring is 10% to 12%, whereas the estimated preva- lence of OSA is only 1% to 3 %. 3,9,10 In addition to nighttime symptoms, SDB also affects daytime behavior, including school performance, neurocognitive function, and quality of life. 11-13 Upper airway obstruction caused by the tonsils, adenoid

2011 American Academy of Otolaryngology - Head and Neck Surgery

253. CPG on sleep disorders in childhood and adolescence in primary care

disorders (neurological, pain, gastroesophageal re? ux, ear infection, blindness or others), self-stimulating behaviours, convulsions and other parasomnias and movement disorders (bruxism, sleep spasms, tics, spasmus nutans, REM sleep behaviour disorder or restless legs syndrome with periodic limb movement disorder or RLS-PLMD). It has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. 24 CLINICAL PRACTICE GUIDELINES IN THE SNS Treatment D As the ? rst (...) Project. This is the context within which this CPG on Sleep Disorders in Childhood and Adolescence in Primary Care Health Centers is framed. Sleep plays a fundamental role in many spheres of child development, such as behaviour, academic performance and growth. Sleep alterations in childhood are frequent, and unlike what generally happens in adulthood, they also and intensely affect the quality of life of a child’s family environment, not just the child’s own development. Sleep alterations

2011 GuiaSalud

254. Brain perfusion anomalies in rapid eye movement sleep behavior disorder with mild cognitive impairment. (Abstract)

Brain perfusion anomalies in rapid eye movement sleep behavior disorder with mild cognitive impairment. Rapid eye movement (REM) sleep behavior disorder is an important risk factor for Parkinson's disease and dementia with Lewy bodies. Approximately 50% of patients with REM sleep behavior disorder have mild cognitive impairment. Our objective was to investigate brain perfusion changes associated with mild cognitive impairment in REM sleep behavior disorder. Twenty patients with REM sleep (...) specific patterns of posterior cortical hypoperfusion and hyperperfusion in some brain areas in patients with REM sleep behavior disorder and mild cognitive impairment, similar to those found in Parkinson's disease dementia and dementia with Lewy bodies. This suggests the presence of an identifiable neuroimaging marker of synucleinopathy in REM sleep behavior disorder with mild cognitive impairment. © 2012 Movement Disorder Society.Copyright © 2012 Movement Disorder Society.

2012 Movement Disorders

255. A single-question screen for rapid eye movement sleep behavior disorder: A multicenter validation study. Full Text available with Trip Pro

A single-question screen for rapid eye movement sleep behavior disorder: A multicenter validation study. Idiopathic rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia that is an important risk factor for Parkinson's disease (PD) and Lewy body dementia. Its prevalence is unknown. One barrier to determining prevalence is that current screening tools are too long for large-scale epidemiologic surveys. Therefore, we designed the REM Sleep Behavior Disorder Single-Question Screen (...) or patients with other sleep diagnoses.A single-question screen for RBD may reliably detect disease, with psychometric properties favorably comparable to those reported for longer questionnaires.Copyright © 2012 Movement Disorder Society.

2012 Movement Disorders

256. Sleep Disorders (PDQ®): Patient Version

nervousness, , and a change in the phase of sleep that increases dreaming, including nightmares. This change in REM sleep may be dangerous for patients with or heart conditions. Sleep Disorders in Special Cases Key Points for This Section Patients Who Have Pain In patients with pain that disturbs their sleep, treatment to relieve the pain will be used before sleep are used. Pain , other drugs being taken, and any other health may affect which sleeping medicines are . Older Patients It's normal for older (...) followed by a REM phase. Each cycle lasts about 90 minutes and is repeated 4 to 6 times during 7 to 8 hours of sleep. Sleep disorders affect normal sleep patterns. Normal sleep patterns differ from person to person. The amount of sleep you need to feel rested may be less or more than others need. If sleep is interrupted or does not last long enough, the phases of sleep are not completed and the brain cannot finish all the tasks that help restore the body and mind. There are five major types

2014 PDQ - NCI's Comprehensive Cancer Database

257. Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease Full Text available with Trip Pro

adolescents is ≈10% (8.7% for MDD, 2.6% for BD). By comparison, the prevalence of the 4 existing Expert Panel tier II moderate-risk conditions ranges from ≈0.5% (chronic inflammatory disease) to <0.05% (HIV, Kawasaki disease, nephrotic syndrome). In other words, MDD and BD together are at least 10 times more prevalent than the 4 previously identified moderate-risk conditions combined. Because mood disorders are highly prevalent among adolescents and are generally amenable to treatment, there could (...) Medications and Cardiovascular Risk Factors in Youth.” Behavioral and Environmental Factors Contributing to CVD Risk A number of behavioral and psychosocial characteristics that are disproportionately prevalent among adolescents and young adults with mood disorders are associated with increased CVD risk. Such characteristics include early maltreatment, sleep disturbance, sedentary lifestyle, suboptimal nutrition, and tobacco smoking and substance abuse. Early Maltreatment This section focuses

2015 American Heart Association

258. Guidance on the clinical management of anxiety disorders, specifically focusing on diagnosis and treatment strategies

, professional bodies, and specialist groups with interest and expertise in anxiety disorders. Results: The guidelines recommend a pragmatic approach beginning with psychoeducation and advice on lifestyle fac- tors, followed by initial treatment selected in collaboration with the patient from evidence-based options, taking into account symptom severity, patient preference, accessibility and cost. Recommended initial treatment options for all three anxiety disorders are cognitive–behavioural therapy (face (...) . Overview of the management of anxiety disorders. CBT: cognitive–behavioural therapy. CBT can be delivered face-to-face by an experienced clinician or as guided digital CBT. dCBT: guided digital CBT (CBT accessed by computer, tablet or smartphone application). §Watchful waiting includes monitoring response to psychoeducation and lifestyle measures. *For the purpose of initial treatment choice, mild, moderate and severe are defined pragmatically, according to effect on function, as inability to perform

2018 Royal Australian and New Zealand College of Psychiatrists

259. Sleep and neuropsychological performance in HIV+ subjects on efavirenz-based therapy and response to switch in therapy. Full Text available with Trip Pro

Sleep and neuropsychological performance in HIV+ subjects on efavirenz-based therapy and response to switch in therapy. The antiretroviral drug efavirenz (EFV) has been linked to disordered sleep and cognitive abnormalities. We examined sleep and cognitive function and subsequent changes following switch to an alternative integrase inhibitor-based regimen. Thirty-two HIV-infected individuals on EFV, emtricitabine, and tenofovir (EFV/FTC/TDF) without traditional risk factors for obstructive (...) sleep apnea (OSA) were randomized 2:1 to switch to elvitegravir/cobicistat/emtricitabine/tenofovir (EVG/COBI/FTC/TDF) or to continue EFV/FTC/TDF therapy for 12 weeks. Overnight polysomnography and standardized sleep and neuropsychological assessments were performed at baseline and at 12 weeks. No significant differences in change over 12 weeks were noted between the two arms in any sleep or neuropsychological test parameter. At entry, however, the rate of sleep disordered breathing (SDB

2018 HIV clinical trials

260. Accuracy and Efficacy of Trazodone (Desyrel) on Sleep Quality and Pain Management of TMD Patient

starting the study. Use of any psychotropic medication or drug known to influence sleep or pain such as amphetamines, benzodiazepines, anticonvulsants, neuroleptics, or antidepressants. Alcohol or substance abuse. Presence of major neurological or psychiatric disorders, such as epilepsy, schizophrenia or major depression; other sleep disorders such as narcolepsy, sleep apnea syndrome (SAS) or REM sleep behavior disorder. Presence of cardiovascular or bleeding disorders. History of tachycardia (...) being the baseline. Half of the patient will receive trazodone on their 2nd PSG and placebo on their 3rd PSG, and the other half will receive placebo bedofe their 2nd PSG and trazodone for the 3rd PSG. Pain quality and sleep quality will be assessed before and after PSG. polysomnograms from baseline, placebo night and trazodone night will also be compared. Condition or disease Intervention/treatment Phase TMD Sleep Bruxism TMJ Pain Chronic Pain Sleep Disorder Diagnostic Test: polysomnography Drug

2018 Clinical Trials

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