surgically implanted an upper-airway stimulation device in patients with obstructive sleep apnea who had difficulty either accepting or adhering to CPAP therapy. The primary outcome measures were the apnea-hypopnea index (AHI; the number of apnea or hypopnea events per hour, with a score of ≥15 indicating moderate-to-severe apnea) and the oxygen desaturation index (ODI; the number of times per hour of sleep that the blood oxygen level drops by ≥4 percentage points from baseline). Secondary outcome (...) Upper-airway stimulation for obstructive sleep apnea. Obstructive sleep apnea is associated with considerable health risks. Although continuous positive airway pressure (CPAP) can mitigate these risks, effectiveness can be reduced by inadequate adherence to treatment. We evaluated the clinical safety and effectiveness of upper-airway stimulation at 12 months for the treatment of moderate-to-severe obstructive sleep apnea.Using a multicenter, prospective, single-group, cohort design, we

Review: recommendations for the assessment and management of sleep disorders in ADHD Review: recommendations for the assessment and management of sleep disorders in ADHD | Evidence-Based Mental Health We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers (...) of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: recommendations for the assessment and management of sleep disorders in ADHD Article Text Outcomes Review: recommendations for the assessment and management of sleep disorders in ADHD Statistics from

, expert and practitioner opinion, open-forum commentary, and clinical feasibility data. This document updates the “Practice Guidelines for the Perioperative Management of Obstructive Sleep Apnea: a Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Obstructive Sleep Apnea,” adopted by the ASA in 2005 and published in 2006. Methodology A. Definition of Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a syndrome characterized by periodic, partial (...) Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea:An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea | Anesthesiology | ASA Publications 1102063482 ASA Publications Log in to access full content You must be logged in to access this feature. ASA members enjoy

). Nonpharmacologic treatment of chronic insomnia: An American Academy of Sleep Medicine review. Sleep , 22, 1134-1156. Riedel B., Lichstein, K.L., Peterson, B.A., Means, M.K., Epperson, M.T., & Aguillarel, R.N. (1998). A comparison of the efficacy of stimulus control for medicated and nonmedicated insomniacs. Behavior Modification , 22, 3-28 Morin, C.M., & Azrin, N.H. Behavioral and cognitive treatments of geriatric insomnia (1988). Journal of Consulting and Clinical Psychology , 56, 748-753. Morin, C.M (...) Stimulus Control Therapy for Insomnia Stimulus Control Therapy for Insomnia – Society of Clinical Psychology Description The main goal in stimulus control therapy is to reduce the anxiety or conditioned arousal individuals may feel when attempting to go to bed. Specifically, a set of instructions designed to reassociate the bed/bedroom with sleep and to re-establish a consistent sleep schedule are implimented. These include: 1) Going to bed only when sleepy; 2) Getting out of bed when unable

Sleep Restriction Therapy for Insomnia Sleep Restriction Therapy for Insomnia – Society of Clinical Psychology Description Sleep restriction therapy utilizes a form of systematic sleep deprivation in which a sleep window is established and maintained to allow the body to (re)learn proper sleeping dynamics and increase sleep efficiency. For example, if a patient reports spending about 8 hours per night in bed, but only sleeps 6 of those hours, the amount of time in bed would be reduced (...) to closely match the amount of time the patient typically sleeps in bed (in this case, 6 hours). Periodic adjustments to this sleep window are made contingent upon sleep efficiency, until an optimal sleep duration is reached. Key References (in reverse chronological order) Morin, C., Bootzin, R., Buysse, D., Edinger, J., Espie, C., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep , 29, 1398-1414. Lichstein, K.L., Riedel, B.W

., & Morin, C.M. (Eds.), Treatment of late-life insomnia (pp. 185-206). London: Sage Publications. Hauri, P., & Linde, S. (1996). Bedtime relaxation techniques. In Hauri, P., & Linde, S. (1996). No More Sleepless Nights (pp. 91-105). New York Press: John Wiley & Sons, Inc. Bernstein, D. A., & Borkovec, T. D. (1973). Progressive relaxation training . Champaign, IL: Research Press. Training Opportunities The Sleep Research Society Trainee Manual provides a variety of resources on training opportunities (...) gain mastery of the relaxation techniques. Although relaxation therapy is demonstrably effective, there is little evidence suggesting differential effectiveness across the range of relaxation modalities. Key References (in reverse chronological order) Morin, C., Bootzin, R., Buysse, D., Edinger, J., Espie, C., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep , 29, 1398-1414. Edinger, J.D., Wohlgemuth, W.K., Radtke, R.A

Paradoxical Intention for Insomnia Paradoxical Intention for Insomnia – Society of Clinical Psychology Description Paradoxical intention is a cognitive technique that consists of persuading a patient to engage in his or her most feared behavior. In the context of insomnia, this type of therapy is premised on the idea that performance anxiety inhibits sleep onset. Paradoxically, if a patient stops trying to fall asleep and instead stays awake for as long as possible, the performance anxiety (...) is expected to diminish; thus, sleep may occur more easily. In clinical practice, some patients are fairly reluctant to use this procedure, and compliance is often problematic. Sleep restriction therapy, a similar technique with a different rationale, may be more readily accepted by patients. Key References (in reverse chronological order) Morin, C., Bootzin, R., Buysse, D., Edinger, J., Espie, C., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence

Summary Basic premise: The interaction between cognitive and behavioral factors is the key mechanism involved in the perpetuation of insomnia. Essence of therapy: Cognitive-behavioral therapy for insomnia focuses on teaching techniques to modify sleep disruptive behaviors and cognitions that interfere with normal sleep and contribute to insomnia. Length : approx. 6 sessions Treatment Resources Editors: John Otis, PhD Note: The resources provided below are intended to supplement not replace (...) foundational training in mental health treatment and evidence-based practice Treatment Manuals / Outlines Treatment Manuals Books Available for Purchase Through External Sites (Perlis, Aloia, & Kuhn) (Treatments That Work; Edinger & Carney) (Manber & Carney) Training Materials and Workshops Principles and Practice of Sleep Medicine (Kryger, Roth, & Dement; in press) (Morin & Espie) Etiology of Insomnia (Perlis et al.; in press) (Perlis et al.) (Szuba, Kloss, & Dinges) Measures, Handouts and Worksheets

., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep , 29, 1398-1414. Barrowsky, E.I., Moskowitz, J., & Zweig, J.B. (1990). Biofeedback for disorders of initiating and maintaining sleep. Annals of the New York Academy of Sciences, 602 , 97-103. Sanavio, E., Vidotto, G., Bettinardi, O., Roletto, T., & Zorzi, M. (1990). Behavior therapy for DIMS: Comparison of three treatment procedures with follow-up. Behavioural Psychotherapy, 18 (...) , 151-167. VanderPlate, C., & Eno, E.N. (1983). Electromyograph biofeedback and sleep onset insomnia: Comparison of treatment and placebo. Behavioral Engineering, 8, 146-153 Nicassio, P.M., Boylan, M.B., & McCabe, T.G. (1982). Progressive relaxation, EMG biofeedback and biofeedback placebo in the treatment of sleep-onset insomnia. British Journal of Medical Psychology, 55,159-166. Freedman, R., & Papsdorf, J.D. (1976). Biofeedback and progressive relaxation treatment of sleep-onset insomnia

Continuous positive airway pressure compared with oral devices or lifestyle changes for the treatment of obstructive sleep apnea: a review of the clinical and cost-effectiveness Continuous positive airway pressure compared with oral devices or lifestyle changes for the treatment of obstructive sleep apnea: a review of the clinical and cost-effectiveness Continuous positive airway pressure compared with oral devices or lifestyle changes for the treatment of obstructive sleep apnea: a review (...) of the clinical and cost-effectiveness CADTH 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 CADTH. Continuous positive airway pressure compared with oral devices or lifestyle changes for the treatment of obstructive sleep apnea: a review of the clinical and cost-effectiveness. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid

patients were randomized (76.6%). Trial 3970 This was a 32-week trial designed to explore the effect of liraglutide on endpoints related to obstructive sleep apnea (OSA). Reviewer comment: During the ongoing NDA review, DMEP consulted the expertise of the Division of Neurology Products (DNP) for input regarding the sponsor’s study design and choice of endpoints. Key Inclusion Criteria ? BMI = 30 kg/m 2 ? Diagnosis of moderate or severe OSA (apnea-hypopnea index, AHI = 15) ? Unwilling or unable to use (...) obstructive sleep apnea (OSA). The sponsor proposes the following text for the INDICATIONS AND USAGE section of labeling: Saxenda is indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of ? 30 kg/m2 or greater (obese) (1) or Reference ID: 3645660Ronald Farkas, M.D., Ph.D., HFD-120 Medical Review Page 2 of 7 ? 27 kg/m2 or greater (overweight) in the presence of at least one weight related

Hetlioz (tasimelteon) - To treat non-24- hour sleep-wake disorder (?non-24?) in totally blind individuals. Non-24 is a chronic circadian rhythm (body clock) disorder in the blind that causes problems with the timing of sleep Drug Approval Package: Brand Name (Generic Name) NDA # Drug Approval Package U.S. Food & Drug Administration Search FDA Drug Approval Package - HETLIOZ (tasimelteon) 20 mg oral Capsules Company: Vanda Pharmaceuticals, Inc. Application No.: 205677 Approval Date: 1/31/2014

Belsomra (suvorexant) - To treat difficulty in falling and staying asleep (insomnia) Drug Approval Package: Brand Name (Generic Name) NDA # Drug Approval Package U.S. Food & Drug Administration Search FDA Drug Approval Package - Belsomra (suvorexant, MK-4305) Oral Tablets Company: Merck & Co., Inc. Application No.: 204569 Approval Date: 8/13/2014 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF) (PDF) (PDF

Systematic review: Individual clinical symptoms have limited utility in the diagnosis of obstructive sleep apnoea Individual clinical symptoms have limited utility in the diagnosis of obstructive sleep apnoea | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password (...) For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Individual clinical symptoms have limited utility in the diagnosis of obstructive sleep apnoea Article Text Diagnosis Systematic review Individual clinical symptoms have limited

Stiripentol (Diacomit ? Biocodex SA) indication: severe myoclonic epilepsy in infancy (Dravet syndrome) Stiripentol (Diacomit — Biocodex SA) indication: severe myoclonic epilepsy in infancy (Dravet syndrome) Stiripentol (Diacomit — Biocodex SA) indication: severe myoclonic epilepsy in infancy (Dravet syndrome) CADTH 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 CADTH. Stiripentol (Diacomit — Biocodex SA) indication: severe myoclonic epilepsy in infancy (Dravet syndrome) Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). CDEC Final Recommendation; SR0360. 2014 Authors' conclusions The Canadian Drug Expert Committee (CDEC) recommends that stiripentol be listed for use in combination with clobazam and valproate as adjunctive therapy of refractory generalized tonic-clonic seizures in patients with severe myoclonic

Text Therapeutics Randomised controlled trial Symptoms of obstructive sleep apnoea are treated by adenotonsillectomy, but without change in neurocognitive outcome James D Ramsden Statistics from Altmetric.com Commentary on: Marcus CL , Moore RH , Rosen CL , et al . A randomised trial of adenotonsillectomy for childhood sleep apnea . Context Adenotonsillectomy (T&A) in children is a very common surgical intervention for sleep disordered breathing and obstructive sleep apnoea (OSA). OSA in children (...) Randomised controlled trial: Symptoms of obstructive sleep apnoea are treated by adenotonsillectomy, but without change in neurocognitive outcome Symptoms of obstructive sleep apnoea are treated by adenotonsillectomy, but without change in neurocognitive outcome | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see

hypoxemia, recurrent arousals from sleep, daytime sleepiness, apnea (cessation of breathing), hypopnea (shallow breathing), hypoxia (low blood oxygen concentration), hypercapnia (high blood carbon dioxide level), and loud snoring. Untreated OSA is more common in the aged and in obese and overweight patients and is associated with daytime sleepiness, fatigue, insomnia, decreased quality of life, and increased healthcare utilization. The apnea hypopnea index (AHI), which expresses the number of apnea (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation Hypoglossal nerve stimulation (Inspire Upper Airway Stimulation; Inspire Medical Systems Inc.) for treatment of obstructive sleep apnea. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2014 Authors' conclusions Obstructive sleep apnea (OSA) is a chronic disorder affecting 2% to 4% of adults. It is characterized by repetitive collapse of the oropharyngeal airway during sleep, with resultant nocturnal

of cardiovascular risk.We conducted a randomized, controlled trial in which patients with cardiovascular disease or multiple cardiovascular risk factors were recruited from cardiology practices. Patients were screened for obstructive sleep apnea with the use of the Berlin questionnaire, and home sleep testing was used to establish the diagnosis. Participants with an apnea-hypopnea index of 15 to 50 events per hour were randomly assigned to receive education on sleep hygiene and healthy lifestyle alone (...) CPAP versus oxygen in obstructive sleep apnea. Obstructive sleep apnea is associated with hypertension, inflammation, and increased cardiovascular risk. Continuous positive airway pressure (CPAP) reduces blood pressure, but adherence is often suboptimal, and the benefit beyond management of conventional risk factors is uncertain. Since intermittent hypoxemia may underlie cardiovascular sequelae of sleep apnea, we evaluated the effects of nocturnal supplemental oxygen and CPAP on markers

Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: the HIPARCO randomized clinical trial. More than 70% of patients with resistant hypertension have obstructive sleep apnea (OSA). However, there is little evidence about the effect of continuous positive airway pressure (CPAP) treatment on blood pressure in patients with resistant hypertension.To assess the effect of CPAP treatment on blood pressure values and nocturnal blood pressure patterns (...) in patients with resistant hypertension and OSA.Open-label, randomized, multicenter clinical trial of parallel groups with blinded end point design conducted in 24 teaching hospitals in Spain involving 194 patients with resistant hypertension and an apnea-hypopnea index (AHI) of 15 or higher. Data were collected from June 2009 to October 2011.CPAP or no therapy while maintaining usual blood pressure control medication.The primary end point was the change in 24-hour mean blood pressure after 12 weeks

. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication. 2013 Authors' conclusions Obstructive sleep apnea (OSA) is a breathing disorder that is defined by either a decrease or complete cessation of airflow during sleep. Airflow obstruction arises when the muscles in the back of the throat fail to keep the airway open. OSA is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation (...) . These pauses in breathing, called apneas, typically last 20 to 40 seconds. Hypopnea involves episodes of overly shallow breathing or an abnormally low respiratory rate. Hypopnea differs from apnea in that there remains some flow of air. Untreated OSA is associated with symptoms of sleep deprivation and excessive sleepiness, cognitive dysfunction, diminished quality of life and productivity, sexual dysfunction, mood changes, increased accident risk, and cardiovascular disease and stroke. OSA has