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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
Efficacy of melatonin with behavioural sleep-wake scheduling for delayed sleep-wake phase disorder: A double-blind, randomised clinical trial Delayed Sleep-Wake Phase Disorder (DSWPD) is characterised by sleep initiation insomnia when attempting sleep at conventional times and difficulty waking at the required time for daytime commitments. Although there are published therapeutic guidelines for the administration of melatonin for DSWPD, to our knowledge, randomised controlled trials are lacking (...) . This trial tested the efficacy of 0.5 mg melatonin, combined with behavioural sleep-wake scheduling, for improving sleep initiation in clinically diagnosed DSWPD patients with a delayed endogenous melatonin rhythm relative to patient-desired (or -required) bedtime (DBT).This randomised, placebo-controlled, double-blind clinical trial was conducted in an Australian outpatient DSWPD population. Following 1-wk baseline, clinically diagnosed DSWPD patients with delayed melatonin rhythm relative to DBT
trial including baseline and post-treatment assessment and a 1-year post-treatment follow-up of the intervention group.Seven primary health care centers (Stockholm, Sweden).One hundred and sixty-five primary care patients who meet the criteria for insomniadisorder (mean age 54 years, SD 16). Most were women (73%).severe untreated illness, bipolar disorder, current stressful life event, night shift work, and untreated sleepdisorder other than insomnia.Data came from a randomized controlled trial (...) ), improved daytime symptomatology in primary care patients with insomnia.Fatigue (Fatigue Severity Scale [FSS]; main outcome), mood (General Health Questionnaire and Montgomery-Asberg Depression Rating Scale), health-related quality of life (Short-Form Health Survey), general daytime functioning, specific daytime symptoms (individual items from the Insomnia Severity Index and Uppsala Sleep Inventory), and dysfunctional beliefs (Dysfunctional Beliefs and Attitudes about Sleep).A randomized controlled
data from participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based study that enrolled 16,415 adults in 4 US communities. Sleep-disorderedbreathing was assessed using a home sleepapnea monitor for overnight recording and was defined using 3 thresholds of the apnea-hypopnea index (AHI; 3% desaturation): ≥5, ≥15, and ≥30. Albuminuria was defined as a urine albumin-to-creatinine ratio of ≥30 mg/g.There were 12,572 participants with complete data available (...) Sleep-DisorderedBreathing and Prevalent Albuminuria in Hispanics/Latinos Although sleep-disorderedbreathing has been found to be associated with higher urine albumin excretion, this association has not been evaluated in Hispanic/Latino populations, which experience a high burden of end-stage renal disease compared with non-Hispanics. We evaluated the association of sleep-disorderedbreathing with prevalent albuminuria among US Hispanics/Latinos.This was a cross-sectional study of baseline
Intermittent Hypoxia and Hypercapnia, a Hallmark of ObstructiveSleepApnea, Alters the Gut Microbiome and Metabolome Obstructivesleepapnea (OSA) is a common disorder characterized by episodic obstruction to breathing due to upper airway collapse during sleep. Because of the episodic airway obstruction, intermittently low O2 (hypoxia) and high CO2 (hypercapnia) ensue. OSA has been associated with adverse cardiovascular and metabolic outcomes, although data regarding potential causal pathways (...) are still evolving. As changes in inspired O2 and CO2 can affect the ecology of the gut microbiota and the microbiota has been shown to contribute to various cardiometabolic disorders, we hypothesized that OSA alters the gut ecosystem, which, in turn, exacerbates the downstream physiological consequences. Here, we model human OSA and its cardiovascular consequence using Ldlr-/- mice fed a high-fat diet and exposed to intermittent hypoxia and hypercapnia (IHH). The gut microbiome and metabolome were
Diagnostic accuracy of a two-stage model for detecting obstructivesleepapnoea in chronic tetraplegia Obstructivesleepapnoea (OSA) is highly prevalent in people with spinal cord injury (SCI). Polysomnography (PSG) is the gold-standard diagnostic test for OSA, however PSG is expensive and frequently inaccessible, especially in SCI. A two-stage model, incorporating a questionnaire followed by oximetry, has been found to accurately detect moderate to severe OSA (MS-OSA) in a non-disabled (...) thresholds for diagnosing MS-OSA. The accuracy of both models in diagnosing MS-OSA was prospectively evaluated in 100 participants with chronic tetraplegia across four international SCI units.Injury completeness, sleepiness, self-reported snoring and apnoeas were included in the modified questionnaire, which was highly predictive of MS-OSA (ROC area under the curve 0.87 (95% CI 0.79 to 0.95)). The 3% oxygen desaturation index was also highly predictive (0.93 (0.87-0.98)). The two-stage model
Cost-effectiveness of cognitiveâ€“behavioural therapy for sleepdisorder added to usual care in patients with schizophrenia: the BEST study Sleep problems are pervasive in people with schizophrenia, but there are no clinical guidelines for their treatment. The Better Sleep Trial (BEST) concluded that suitably adapted cognitive-behavioural therapy (CBT) is likely to be highly effective, although its cost-effectiveness is unknown.To assess the potential cost-effectiveness of CBT for sleep (...) needs, as well as very high rates of depression, suicidal ideation and poor physical health. The results of this study showed that treating pervasive sleep problems in this patient group with cognitive-behavioural therapy (CBT) is very likely to improve patient quality of life in the short term. Clinicians most commonly use hypnotic medication to treat sleepingdisorders. This study indicates that CBT may be an effective and cost-effective intervention in this patient group. This alternative would
Therapeutic Approaches of ObstructiveSleepApnea in China 29607299 2019 01 28 2450-131X 6 1 2018 Mar Journal of translational internal medicine J Transl Int Med Therapeutic Approaches of ObstructiveSleepApnea in China. 16-20 10.2478/jtim-2018-0004 Li Wen-Yang WY Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China. Wang Wei W Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China. eng Journal Article 2018 (...) 23589584 J Clin Sleep Med. 2015 Jul 15;11(7):773-827 26094920 SleepBreath. 2015 Mar;19(1):281-9 24859614 Eur Respir J. 2011 May;37(5):1000-28 21406515 J Appl Physiol (1985). 2017 Jul 1;123(1):116-125 28408696 Int J Oral Maxillofac Surg. 2015 Feb;44(2):189-94 25305697 Laryngoscope. 2008 May;118(5):902-8 18300704 Respir Care. 2013 May;58(5):810-5 23051618 Ann Intern Med. 2013 Oct 1;159(7):471-83 24061345 BMJ. 2006 Feb 4;332(7536):266-70 16377643 SleepBreath. 2013 May;17(2):705-12 22821223 Thorax. 2010
Ventilatory support or respiratory muscle training as adjuncts to exercise in obese CPAP-treated patients with obstructivesleepapnoea: a randomised controlled trial Obstructivesleepapnoea (OSA) and obesity are interdependent chronic diseases sharing reduced exercise tolerance and high cardiovascular risk.A 3-month intervention with innovative training modalities would further improve functional capacity and cardiovascular health than usual cycle exercise training in already continuous (...) positive airway pressure (CPAP)-treated obese patients with OSA.Fifty three patients (35sleep quality were evaluated.All training modalities increased 6 min walking
The REM Sleep Behavior Disorder Screening Questionnaire is not Valid in De Novo Parkinson's Disease Rapid eye movement (REM) sleep behavior disorder (RBD) is one of the most specific prodromal indicators for Parkinson's disease (PD).To test the validity of the RBD-Screening Questionnaire (RBDSQ) in assessing RBD in early PD.The RBDSQ was completed before video-supported polysomnography (vPSG) by 134 de novo PD patients, 109 matched controls without neurological disorder (CTR) and 30 subjects
Simulation of the upper airways in patients with obstructivesleepapnea and nasal obstruction: A novel finite element method To evaluate the biomechanical properties of the soft palate and velopharynx in patients with obstructivesleepapnea (OSA) and nasal obstruction.Prospective experimental study.Two finite element (FE) models of the soft palate were created in six patients undergoing nasal surgery, one homogeneous model based on CT images, and one layered model based on soft tissue (...) . The obstruction occurs mainly at the level of the lateral attachments to the pharyngeal wall, and the width of the soft palate is an indicator of the degree of critical closing pressure. A less negative closing pressure corresponds to small total transverse strain. The effect of nasal surgery on OSA is most likely not explained by change in soft palate biomechanics.NA.
Effect of ObstructiveSleepApnea Treatment on Renal Function in Patients with Cardiovascular Disease Obstructivesleepapnea (OSA) is associated with impaired renal function, but uncertainty exists over whether OSA treatment can influence renal outcomes.To determine the effects of continuous positive airway pressure (CPAP) on renal function in subjects with coexisting OSA and cardiovascular disease.This was a substudy of the international SAVE (SleepApnea Cardiovascular Endpoints) trial
Interventions for InsomniaDisorder Interventions for InsomniaDisorder | CADTH.ca Find the information you need Interventions for InsomniaDisorder Interventions for InsomniaDisorder Last updated: December 10, 2018 Project Number: HT0003-OP0527 Product Line: Result type: Report Insomnia 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 up frequently (...) , experience early awakening, have a limited amount of sleep, or have a poor quality of sleep. Insomnia may be acute, meaning it generally starts suddenly and lasts for less than three months, or it may be chronic, meaning it lasts for a longer duration. Insomnia may affect a person’s ability to work or study, and can negatively affect their relationships with others. People with insomnia may experience a reduced quality of life because of the consequences of poor sleep. Approaches to treating insomnia
Impact of Dexmedetomidine on Intraoperative Wake-Up Tests in Patients Undergoing Spinal Surgery. To evaluate the impact of dexmedetomidine (DEX) on intraoperative wake-up tests.American Society of Anesthesiologists category I or II patients were divided into two groups: a propofol-remifentanil group (group R, n = 20) and a DEX-propofol-remifentanil group (group D, n = 20).The patients in group D received DEX, whereas the patients in group R received the same volume of saline. The other (...) anesthetic methods and drugs (propofol and remifentanil) were the same in both groups. During the wake-up test, patients were repeatedly asked to move their fingers.All the wake-up tests were successfully performed. There was no significant difference in the mean wake-up time between the two groups. Eighteen patients exhibited better wake-up quality in group D as did eight patients in group R. The patients in group D had a significantly better overall wake-up quality than those in group R (P <.05).DEX