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Anatomic measures of upper airway structures in obstructivesleepapnea Determine if anatomic dimensions of airway structures are associated with airway obstruction in obstructivesleepapnea (OSA) patients.Twenty-eight subjects with (n = 14) and without (n = 14) OSA as determined by clinical symptoms and sleep studies; volunteer sample. Skeletal and soft tissue dimensions were measured from radiocephalometry and magnetic resonance imaging. The soft palate thickness, mandibular plane-hyoid (MP
Hyoid myotomy and suspension without simultaneous palate or tongue base surgeryÂ for obstructivesleepapnea Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructivesleepapnea (OSA).Patients with OSA treated with HMS were identified using CPT code (21685) at an academic and private sleep surgery clinic. Those who underwent concurrent palatal or tongue base sleep surgery were excluded. Outcomes included simultaneous (...) procedures, apnea-hypopnea index (AHI), lowest oxyhemoglobin saturation (LSAT), and Epworth Sleepiness Scale (ESS).Nineteen patients with OSA underwent HMS without palatal or tongue base sleep surgery. The average age at surgery was (55.3 ± 13.5) years with a majority of patients being male (71%). Concurrent procedures included the following: torus mandibularis excision (n = 1), endoscopic sinus surgery (n = 4), septoplasty (n = 10), inferior turbinate reduction (n = 12), and nasal valve repair (n = 2
Publication trends in obstructivesleepapnea: Evidence of need for more evidence Published research in obstructivesleepapnea (OSA) appears limited despite OSA being a highly prevalent adult and pediatric disease leading to many adverse outcomes if left untreated. We aimed to quantify the deficit in OSA scientific literature in order to provide a novel way of identifying gaps in knowledge and a need for further research inquiry.This was a Bibliometric analysis study. Using Ovid Medline
Impact of Mandibular Advancement Therapy on Endothelial Function in Severe ObstructiveSleepApnea Endothelial dysfunction, a major predictor of late cardiovascular events, is linked to the severity of obstructivesleepapnea (OSA).To determine whether treatment with mandibular advancement device, the main alternative to continuous positive airway pressure, improves endothelial function in patients with severe OSA.In this trial, we randomized patients with severe OSA and no overt cardiovascular (...) disease to receive 2 months of treatment with either effective mandibular advancement device or a sham device. The primary outcome, change in reactive hyperemia index, a validated measurement of endothelial function, was assessed on an intention-to-treat basis. An embedded microsensor objectively measured treatment compliance.A total of 150 patients (86% males; mean [SD] age, 54  yr; median [interquartile range] apnea-hypopnea index, 41 [35-53]; mean [SD] Epworth sleepiness scale, 9.3 [4.2]) were
Tonsillectomy for obstructivesleep-disorderedbreathing or recurrent throat infection in children Tonsillectomy for obstructivesleep-disorderedbreathing or recurrent throat infection in children Tonsillectomy for obstructivesleep-disorderedbreathing or recurrent throat infection in children Francis DO, Chinnadurai S, Sathe NA, Morad A, Jordan AK, Krishnaswami S, Fonnesbeck C, McPheeters ML Record Status This is a bibliographic record of a published health technology assessment (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation Francis DO, Chinnadurai S, Sathe NA, Morad A, Jordan AK, Krishnaswami S, Fonnesbeck C, McPheeters ML. Tonsillectomy for obstructivesleep-disorderedbreathing or recurrent throat infection in children. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 183. 2017 Authors' objectives To systematically review evidence addressing tonsillectomy in children with obstructive
filtration rate <60 ml/min/1.73m2 or urine albumin-to-creatinine ratio ≥30 mg/g. Sleep duration, sleep symptoms (difficulty falling asleep, difficulty staying asleep, daytime sleepiness and non-restorative sleep), and sleepdisorders (restless legs syndrome and sleepapnea) were self-reported. Vital status was determined using NHANES mortality linkage through December 2011.Mean age was 61 years, 58% were women, and 75% non-Hispanic white. During 4.4 years of median follow-up, we observed 234 deaths (...) Association of Sleep Duration, Symptoms, and Disorders With Mortality in Adults With Chronic Kidney Disease In general populations, short and long sleep duration, poor sleep quality and sleepdisorders have been associated with increased risk of death. We evaluated these associations in individuals with chronic kidney disease (CKD).Prospective cohort study of 1,452 National Health and Nutrition Examination Survey (NHANES) 2005-2008 participants with CKD. CKD was defined by estimated glomerular
) for 12-week treatment. Upon completion of treatment, snoring, mouth breathing, and sleep discomfort were re-measured. Before treatment, all children had snoring most times or always. Posttreatment, 80% of children treated with Montelukast only snored sometimes or never. Sleep discomfort and mouth breathing studies showed statistically significant improvement (P #2) Venekamp/2016 Three studies on children with obstructivesleepdisorders Meta-Analysis Key results The authors examined three different (...) Adenotonsillectomy Remains the Treatment of Choice for Children with ObstructiveSleepApnea but Multiple Non-surgical Options Exist for Select Cases UTCAT3217, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Adenotonsillectomy Remains the Treatment of Choice for Children with ObstructiveSleepApnea but Multiple Non-surgical Options Exist for Select Cases Clinical Question Are nonsurgical treatments
Insomnia and somnolence in idiopathic RBD: a prospective cohort study Although some sleepdisorders are markers of prodromal Parkinson's disease and dementia with Lewy bodies, it is unclear whether insomnia and somnolence can predict disease. We assessed a large cohort of patients with idiopathic rapid eye movement sleep behavior disorder and age/sex matched controls, comparing the Epworth sleepiness scale, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, and polysomnographic (...) remaining disease-free (6.7+/-4.4 vs. 7.1+/-4.7, p = 0.70). Pittsburgh Index scores were higher in patients than controls (7.2+/-3.8 vs. 4.9+/-3.4, p = 0.004), mainly driven by the sleep disturbance/medication components (reflecting rapid eye movement sleep behavior disorder symptoms/treatment). Baseline Pittsburgh scores did not predict conversion to neurodegeneration, although sleep duration increased over time in those converting to neurodegenerative disease (+0.88+/-1.32 h, p = 0.014). Insomnia
Appropriate Use of Interventions for Adults With InsomniaDisorder Interventions for InsomniaDisorder | CADTH.ca Find the information you need Interventions for InsomniaDisorder Interventions for InsomniaDisorder Published on: 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
[Tasimelteon (non-24-hour sleep-wakedisorder in totally blind adults) - assessment according to õ 35a (para. 1, sentence 10) Social Code Book V] Tasimelteon (Non-24 bei völlig blinden erwachsenen): bewertung gemäß § 35a abs. 1 satz 10 SGB V; dossierbewertung; auftrag G16-08 [Tasimelteon (non-24-hour sleep-wakedisorder in totally blind adults) - assessment according to § 35a (para. 1, sentence 10) Social Code Book V] Tasimelteon (Non-24 bei völlig blinden erwachsenen): bewertung gemäß § 35a (...) abs. 1 satz 10 SGB V; dossierbewertung; auftrag G16-08 [Tasimelteon (non-24-hour sleep-wakedisorder in totally blind adults) - assessment according to § 35a (para. 1, sentence 10) Social Code Book V] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) 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 Institut für Qualität
Ultrasonographic Detection of Airway Obstruction in a Model of ObstructiveSleepApnea Purpose Obstructivesleepapnea (OSA) is a common clinical disorder characterized by repetitive airway obstruction during sleep. The gold standard for diagnosis of OSA, polysomnogram (PSG), cannot anatomically localize obstruction. Precise identification of obstruction has potential to improve outcomes following surgery. Current diagnostic modalities that provide this information require anesthesia, involve (...) ionizing radiation or disrupt sleep. To mitigate these problems, we conceived that ultrasound (US) technology may be adapted (i) to detect, quantify and localize airway obstruction and (ii) for translational application to home-based testing for OSA. Materials and Methods Segmental airway collapse was induced in 4 fresh cadavers by application of negative pressure. Following visualization of airway obstruction, a rotary US probe was used to acquire transcervical images of the airway before and after
Screening for ObstructiveSleepApnea in Adults: US Preventive Services Task Force Recommendation Statement. Based on data from the 1990s, estimated prevalence of obstructivesleepapnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment
Physician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for ObstructiveSleepApnea: A Randomized Trial. The clinical utility of limited-channel sleep studies (which are increasingly conducted at home) versus laboratory polysomnography (PSG) for diagnosing obstructivesleepapnea (OSA) is unclear.To compare patient outcomes after PSG versus limited-channel studies.Multicenter, randomized, noninferiority study. (Australian New Zealand (...) Questionnaire (FOSQ) score at 4 months. Secondary outcomes included the Epworth Sleepiness Scale (ESS), the SleepApnea Symptoms Questionnaire (SASQ), continuous positive airway pressure (CPAP) compliance, and physician decision making.Change in FOSQ score was not inferior for L3 (mean difference [MD], 0.01 [95% CI, -0.47 to 0.49; P = 0.96]) or L4 (MD, -0.46 [CI, -0.94 to 0.02; P = 0.058]) versus L1 (noninferiority margin [NIM], -1.0). Compared with L1, change in ESS score was not inferior for L3 (MD, 0.08
HL NHLBI NIH HHS United States T32 HL007287 HL NHLBI NIH HHS United States Journal Article Comment 2017 01 10 United States Ann Intern Med 0372351 0003-4819 AIM IM Ann Intern Med. 2017 Mar 7;166(5):332-340 28114683 Decision Making Humans Medicine Polysomnography SleepApneaSyndromesSleepApnea, Obstructive 2017 1 24 6 0 2019 3 13 6 0 2017 1 24 6 0 ppublish 28114686 2599137 10.7326/M16-2902 PMC5459380 NIHMS860395 J Clin Sleep Med. 2007 Dec 15;3(7):737-47 18198809 Chest. 2010 Aug;138(2):257-63 (...) Making the Most of Simplified SleepApnea Testing 28114686 2019 03 12 2019 03 12 1539-3704 166 5 2017 03 07 Annals of internal medicine Ann. Intern. Med. Making the Most of Simplified SleepApnea Testing. 366-367 10.7326/M16-2902 Donovan Lucas M LM From University of Washington, Seattle, Washington, and University of Pittsburgh, Pittsburgh, Pennsylvania. Patel Sanjay R SR From University of Washington, Seattle, Washington, and University of Pittsburgh, Pittsburgh, Pennsylvania. eng K24 HL127307
. ( Strong ) Recommendation 3 : The TF recommends that if a single home sleepapnea test is negative, inconclusive or technically inadequate, polysomnography be performed for the diagnosis of OSA. ( Strong ) Remarks : The following remarks are based on specifications used by studies that support these recommendation statements: An uncomplicated patient is defined by the absence of: Conditions that place the patient at increased risk of non-obstructivesleep-disorderedbreathing (e.g., central sleepapnea (...) or suspicion of sleep-related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. ( Strong ) Diagnosis of ObstructiveSleepApnea in Adults Using a Split-Night versus a Full-Night Polysomnography Protocol Recommendation 5 : The TF suggests that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protocol for polysomnography be used in the diagnosis of OSA. ( Weak ) Remarks : Clinically appropriate is defined as the absence
of the following three criteria: habitual loud snoring, witnessed apnea or gasping or choking, or diagnosed hypertension. The developer defines an uncomplicated patient as the absence of the following: conditions that place the patient at increased risk of non-obstructivesleep-disorderedbreathing; concern for significant non-respiratory sleepdisorder(s) that require evaluation; and environmental or personal factors that preclude the adequate acquisition and interpretation of data from HSAT. Diagnostic (...) apnea test is negative, inconclusive or technically inadequate, polysomnography be performed for the diagnosis of OSA. ( Strong ) Remarks : The following remarks are based on specifications used by studies that support these recommendation statements: An uncomplicated patient is defined by the absence of: Conditions that place the patient at increased risk of non-obstructivesleep-disorderedbreathing (e.g., central sleepapnea, hypoventilation and sleep related hypoxemia). Examples