Administration 14 GERD: gastroesophageal reflux disease 15 OSA: obstructive sleep apnea 16 OTC: over the counter 17 RMD: raw mean difference 18 SE: sleep efficiency 19 SOL: sleep onset latency 20 STS: Sound-to-Sleep 21 TST: time to sleep 22 WASO: wake after sleep onset 23 12 1 2 13 ABSTRACT 1 Objective: To review pharmacologic and nonpharmacologic strategies for treating sleep 2 disturbances in children and adolescents with autistic spectrum disorder (ASD) and to develop 3 recommendations for addressing (...) Weighted blankets 22 23 A 2-week crossover trial in children (5–16 years old) with ASD was Class II for actigraphy 1 outcomes (74% of randomized participants included in analysis) and Class III for sleep diary 2 outcomes. 36 Children had a =5-month history of sleep complaints in the absence of obstructive 3 sleep apnea (OSA), night terrors, or other sleep disorders (n=54–67, depending on arm). Sleep 4 onset latency was no shorter during weeks weighted blankets were used than during weeks 5 regular

Lemborexant (Dayvigo) - insomnia Drug Approval Package: DAYVIGO DAYVIGO " /> U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: DAYVIGO Company: Eisai Inc. Application Number: 212028 Approval Date: 12/20/2019 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date created

Staff and associate specialist (SAS) grade handbook www.anaesthetists.org The SAS Handbook 4th edition | 20202 Association of Anaesthetists | The SAS Handbook 2020 Back to contents This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivs 4.0 International License CC BY-NC-ND Every effort was made to ensure that the information in this book was accurate at the time of going to press, but articles (particularly those to do with the organisation of training) have (...) a tendency to go out of date, so you are advised to check with the appropriate organisation for the most up-to-date information. This has been designed as an interactive document and accessible links are highlighted in blue. Weblinks were correct as of October 2019. Foreword I am very pleased to introduce the 4th edition of the Association of Anaesthetists SAS Handbook. I hope it will continue to be an invaluable resource for our SAS members, but also other members, clinical directors and managers

Associations Between Sleep Quality, Sleep Architecture and Sleep Disordered Breathing and Memory After Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea in the Apnea Positive Pressure Long-term Efficacy Study (APPLES). The role of sleep architecture in consolidation of memory has not been extensively investigated. In this study, the association of continuous positive airway pressure (CPAP) and sleep architecture and quality, and sleep disordered breathing on changes (...) as well as in relationship to changes in sleep architecture, sleep quality and sleep disordered breathing (SDB).Sleep architecture, sleep quality and SDB improved in the CPAP group at 6 months; performance on the Buschke and DSST improved equally in both CPAP and Sham CPAP groups. There also were no significant correlations between changes in the amount or percentage of sleep stages between baseline and the 6 months, and corresponding changes in either the Buschke or the DSST. However, when stratified

? Carolin Weigel Keywords: melatonin, sleep initiation and maintenance disorders, autism spectrum disorder, Smith-Magenis syndrome, child, adolescent, benefit assessment Extract of dossier assessment A19-04 Version 1.0 Melatonin (Insomnia in children and adolescents with ASD and/or SMS) 11 April 2019 Institute for Quality and Efficiency in Health Care (IQWiG) - iii - Table of contents Page List of tables iv List of abbreviations v 2 Benefit assessment 1 2.1 Executive summary of the benefit assessment 1 (...) ”). The dossier was sent to IQWiG on 11 January 2019. Research question The aim of this report was to assess the added benefit of melatonin in comparison with best supportive care (BSC) as appropriate comparator therapy (ACT) for the treatment of insomnia in children and adolescents aged 2 to 18 years with autism spectrum disorder and/or Smith- Magenis syndrome, when sleep hygiene measures were insufficient. This resulted in 1 research question for the present assessment, for which the G-BA specified the ACT

patients with obstructive sleep apnea (OSA) and a transverse maxillary deficiency, is miniscrew-assisted rapid palatal expansion (MARPE) an effective treatment option compared to surgically assisted rapid palatal expansion (SARPE)? Clinical Bottom Line For adult patients with obstructive sleep apnea and a transverse maxillary deficiency and who are seeking a non-surgical treatment option, miniscrew-assisted rapid palatal expansion may be an effective treatment modality to improve breathing. However (...) Miniscrew-Assisted Rapid Palatal Expansion May Be an Effective Treatment Modality for Adult Patients with Obstructive Sleep Apnea and a Transverse Maxillary Deficiency UTCAT3413, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Miniscrew-Assisted Rapid Palatal Expansion May Be an Effective Treatment Modality for Adult Patients with Obstructive Sleep Apnea and a Transverse Maxillary Deficiency Clinical Question In adult

Ambulatory Sleep Study for diagnosing obstructive sleep apnoea '); } else { document.write(' '); } ACE | Ambulatory Sleep Study for diagnosing obstructive sleep apnoea Search > > Ambulatory Sleep Study for diagnosing obstructive sleep apnoea - Ambulatory Sleep Study for diagnosing obstructive sleep apnoea Published on 2 May 2019 Guidance Recommendation The Ministry of Health's MTAC has recommended: Ambulatory sleep study or home sleep test (HST) with a type 2 or type 3 device for diagnosing (...) obstructive sleep apnoea (OSA) in adults aged ≥18 years who fulfil both (A) and (B) . High pre-test probability for moderate-severe OSA, where signs and symptoms indicating a high pre-test probability for moderate-severe OSA include: Excessive daytime sleepiness; and At least two of the following three criteria: (i) habitual loud snoring; (ii) witnessed apnoea, gasping, or choking; and (iii) diagnosed hypertension No complicated conditions that include: Awake hypoventilation or high risk of sleep-related

effects of melatonin on global sleep outcomes, specific sleep outcomes, and outcomes related to functioning and mood, as well as unclear effects on quality of life for adults with primary and comorbid insomnia. Evidence from one systematic review showed no statistical difference between melatonin and placebo for safety outcomes. No evidence-based guidelines or evidence regarding the cost-effectiveness of melatonin for the treatment of insomnia were identified. Files Rapid Response Summary (...) Melatonin for Insomnia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Melatonin for Insomnia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Melatonin for Insomnia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Melatonin for Insomnia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Last updated: February 22, 2019 Project Number: RC1073-000 Product Line: Research

Management of Surgical Patients with Sleep Apnea: Guidelines Management of Surgical Patients with Sleep Apnea: Guidelines | CADTH.ca Find the information you need Management of Surgical Patients with Sleep Apnea: Guidelines Management of Surgical Patients with Sleep Apnea: 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 sleep apnea? What are the evidence-based guidelines for post-operative monitoring and management of surgical patients with known or suspected sleep apnea? Key Message Two evidence-based guidelines were identified regarding preoperative management of surgical patients with known or suspected sleep apnea while no relevant guidelines were identified regarding post-operative management of surgical patients with suspected or known sleep apnea

Benzodiazepines for the Treatment of Adults with Mental Health Conditions or Sleep Disorders Guidelines Benzodiazepines for the Treatment of Adults with Mental Health Conditions or Sleep Disorders Guidelines | CADTH.ca Find the information you need Benzodiazepines for the Treatment of Adults with Mental Health Conditions or Sleep Disorders Guidelines Benzodiazepines for the Treatment of Adults with Mental Health Conditions or Sleep Disorders 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 sleep disorders? 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 obstructive sleep apnoea: a multicentre randomised controlled trial The efficacy of continuous positive airway pressure (CPAP) treatment in elderly patients with nonsevere obstructive sleep apnoea (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 obstructive sleep apnoea. 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 obstructive sleep apnoea 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 obstructive sleep e sleep apnoea apnoea 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 sleep disorders as primary diagnosis are summarized below. Eliminating other sleep disorder 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? (obstructive sleep apnoea syndrome (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 sleep disorders 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 wakefulness syndrome or a prolonged minimally conscious state Early Intensive Neurorehabilitation of adults with unresponsive wakefulness syndrome or a prolonged minimally conscious state | Report | National Health Care Institute You are here: Early Intensive Neurorehabilitation of adults with unresponsive wakefulness syndrome or a prolonged minimally conscious state Search within English part of National Health Care Institute (...) Search Early Intensive Neurorehabilitation of adults with unresponsive wakefulness syndrome or a prolonged minimally conscious state Share this page Service About this site

of Nursing, The University of Toronto, Toronto, Ontario, Canada. eng Journal Article Comment 2019 05 30 England Evid Based Nurs 9815947 1367-6539 IM N Int J Nurs Stud. 2018 Sep;85:126-135 29886347 Cognition Cognitive Behavioral Therapy Humans Primary Health Care Sleep Initiation and Maintenance Disorders nursing primary care Competing interests: None declared. 2019 01 29 2019 5 31 6 0 2019 6 27 6 0 2019 6 1 6 0 ppublish 31147344 ebnurs-2018-102975 10.1136/ebnurs-2018-102975 (...) Nurse-led cognitive behavioural group treatment intervention for insomnia successfully reduces daytime symptomatology. 31147344 2019 06 26 2019 06 26 1468-9618 22 3 2019 07 Evidence-based nursing Evid Based Nurs Nurse-led cognitive behavioural group treatment intervention for insomnia successfully reduces daytime symptomatology. 79 10.1136/ebnurs-2018-102975 Scott Lauren L 0000-0001-9526-2385 Faculty of Nursing, The University of Toronto, Toronto, Ontario, Canada. Bawden Jessica J Faculty

The Combination of Atomoxetine and Oxybutynin Greatly Reduces Obstructive Sleep Apnea Severity. A Randomized, Placebo-controlled, Double-Blind Crossover Trial Rationale: There is currently no effective pharmacological treatment for obstructive sleep apnea (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 obstructive sleep apnea with current or prior sleep apnea 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 obstructive sleep apnea 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 sleep disorders (e.g., obstructive sleep apnea (...) , restless legs syndrome, circadian rhythm sleep-wake disorders) 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