Obstructive sleep apnea (OSA)

Insomnia in adults

Oral appliances in the treatment of sleep disordered breathing

Central sleep apnea

Unresponsive wakefulness syndrome

of deployment of CBT-I to provide effective first-line treatment of insomnia into general medical and healthcare practice. Similar studies should be conducted to replicate and extend this finding and explore its likely generalisability beyond the older veteran population. Such research should explore which patients with insomnia respond best to non-clinical sleep coaches and which might require referral to practitioners with greater clinical expertise. Context Insomnia is the most common sleep disorder (...) is effective, safe and highly deployable Michael V Vitiello Statistics from Altmetric.com Commentary on: Alessi C , Martin JL , Fiorentino L , et al . Cognitive behavioral therapy for insomnia in older veterans using nonclinician sleep coaches: randomized controlled trial . Implications for practice and research The ability of non-clinician sleep coaches to deliver efficacious cognitive–behavioural therapy for insomnia (CBT-I) was demonstrated, suggesting such coaches can increase the rate and range

Cognitive behavioural therapy for chronic insomnia RACGP - Handbook of Non-Drug Interventions (HANDI) Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship

alcohol consumption or pain). In patients reporting excessive daytime sleepiness, consider obstructive sleep apnoea. Do not use sleep restriction strategies with patients who have bipolar disorder as this can precipitate manic episodes. Sleep restriction may be contraindicated in people with unstable or untreated medical or psychiatric conditions, seizure disorders or excessive daytime sleepiness, or those who already demonstrate sleep restriction (<6 hours in bed). Advise those who drive vehicles (...) waking behaviours, the physiological systems that regulate sleep (homeostatic and circadian drives) can be modified. Indication Chronic primary insomnia in adults Primary insomnia is defined as repeated difficulty with sleep initiation, duration, consolidation or quality despite adequate time and opportunity for sleep, lasting for at least a month. Precautions Ensure the diagnosis is most likely to be primary insomnia (there are no other conditions or causes such as anxiety, depression, excessive

for single agents. Finally, there was insufficient evidence found to determine the balance of benefits versus harms. BACKGROUND Insomnia disorder is defined in the International Classification of Sleep Disorders, Third Edition as a complaint of trouble initiating or maintaining sleep which is associated with daytime consequences and is not attributable to environmental circumstances or inadequate opportunity to sleep. The disorder is identified as chronic when it has persisted for at least three months (...) for treatment of chronic insomnia in the adult populations regardless of comorbidities. In summary, the analysis indicates moderate and significant improvement in major sleep parameters with both BZDs and BzRAs in both objective (PSG) and subjective (sleep diary) assessments, with the exception of PSG results for wake after sleep onset (WASO) and TST, which yielded results just below the range of significance. Far fewer studies were available for antidepressants. These showed significant reduction in sleep

Mayo Clinic, Rochester, MN; 7 American Academy of Sleep Medicine, Darien, IL ABSTRACT Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review (...) -determined obstructive respiratory disturbance index (RDI) ≥ 5 events/h associated with the typical symptoms of OSA (e.g., unrefreshing sleep, daytime sleepiness, fatigue or insomnia, awakening with a gasping or choking sensation, loud snoring, or witnessed apneas), or an obstructive RDI ≥ 15 events/h (even in the absence of symptoms). In addition to apneas and hypopneas that are included in the AHI, the RDI includes respiratory effort-related arousals (RERAs). The scoring of respiratory events

a general introduc- tion to circadian biology, addresses “exogenous” circadian rhythm sleep disorders, including shift work disorder (SWD) and jet lag disorder (JLD). The second review paper addresses the “endogenous” circadian rhythm sleep disorders, including advanced sleep phase disorder (ASPD), de- layed sleep phase disorder (DSPD), irregular sleep-wake rhythm (ISWR), and the non–24-hour sleep-wake syndrome (nonentrained type) or free- running disorder (FRD). These practice parameters were developed (...) for sleep related complaints. For example, shift workers with hypersomnia may have both suspected obstructive sleep apnea and clinical characteristics consistent with shift work dis- order. In this event, PSG is indicated to evaluate and establish appropriate therapy for OSA. 3.2 Recommendations for Evaluation and Treatments of Circadian Rhythm Sleep Disorders 3.2.1 Shift Work Disorder Shift work refers to non-standard work schedules, including permanent or intermittent night work, early morning work

or cerebrovascular disease and moderate to severe obstructive sleep apnoea Article Text Therapeutics/Prevention Randomised controlled trial CPAP did not reduce cardiovascular events in patients with coronary or cerebrovascular disease and moderate to severe obstructive sleep apnoea Yüksel Peker 1 , 2 , Patrick J Strollo Jr 3 , 4 Statistics from Altmetric.com Commentary on : McEvoy RD , Antic NA , Heeley E , et al . CPAP for prevention of cardiovascular events in obstructive sleep apnea . Context Cardiovascular (...) Randomised controlled trial: CPAP did not reduce cardiovascular events in patients with coronary or cerebrovascular disease and moderate to severe obstructive sleep apnoea CPAP did not reduce cardiovascular events in patients with coronary or cerebrovascular disease and moderate to severe 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

Otolaryngol Head Neck Surg . 2015;141(11):990–996. [ ] 25 Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med . 2013;368(25):2366–2376. [ ][ ] 26 Kasapkara CS, Tumer L, Aslan AT, et al. Home sleep study characteristics in patients with mucopolysaccharidosis. Sleep Breath . 2014;18(1):143–149. [ ] 27 Jheeta S, McGowan M, Hadjikoumi I. Is oximetry an effective screening tool for obstructive sleep apnoea in children with Down syndrome? Arch (...) , Rosen C, Larkin E, Tishler P, Aylor J, Redline S. Predictors of sleep-disordered breathing in children with a history of tonsillectomy and/or adenoidectomy. Sleep . 2001;24(7):823–829. [ ] 8 Gozal D, Capdevila OS, Kheirandish-Gozal L. Metabolic alterations and systemic inflammation in obstructive sleep apnea among nonobese and obese prepubertal children. Am J Respir Crit Care Med . 2008;177(10):1142–1149. [ ][ ] 9 Gozal D, Kheirandish-Gozal L. Cardiovascular morbidity in obstructive sleep apnea

. Marcus CL, Brooks LJ, Draper KA, et al.; American Academy of Pediatrics. Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics. 2012;130(3):576-584. 9. Roland PS, Rosenfeld RM, Brooks LJ, et al; American Academy of Otolaryngology—Head and Neck Surgery Foundation. Clinical practice guideline: polysomnography for sleep-disordered breathing prior to tonsillectomy in children. Otolaryngol Head Neck Surg. 2011 Jul;145(1 Suppl):S1-15. Other Literature 1. Berry RB, Hill G (...) and/or cognitive impairment are not suitable candidates for home sleep studies. Patients with sleep disorders other than OSA are not suitable candidates for home sleep testing. Regardless of the site of testing, sleep studies objectively measure the degree of respiratory disturbance during sleep. Episodes of apnea (cessation of breathing lasting at least 10 seconds and hypopnea (reduction, but not a cessation of air exchange, with an associated fall in oxygen saturation [at least 3% to 4%] or arousal

. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA . 2000;284(23):3015-21. Jonas DE, Amick HR, Feltner C, et al. Primary care screening for and treatment of obstructive sleep apnea in adults: evidence report and systematic review for the US Preventive Services Task Force. JAMA . 2017;317(4):415-33. Mold JW, Quattlebaum C, Schinnere E, Boeckman L, Orr W, Hollabaugh K. Identification by primary care clinicians of patients with obstructive sleep apnea: a Practice-Based Research (...) Network (PBRN) study. J Am Board Fam Med . 2011;24(2):138-45. Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Ann Intern Med. 2005;142(3):187-97. Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea? The Rational Clinical Examination systematic review. JAMA . 2013;310(7):731-41. Young T, Shahar E, Nieto FJ, et al; Sleep Heart Health Study Research Group. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern

Hypoglossal nerve stimulation for obstructive sleep apnea: A review of the literature To review the indications and clinical evidence supporting hypoglossal nerve stimulation (HNS) therapy for the treatment of moderate-to-severe obstructive sleep apnea (OSA).Peer reviewed literature on hypoglossal nerve stimulation therapy for obstructive sleep apnea from 2001 to 2016.The only currently FDA-approved HNS device for the treatment of moderate-to-severe OSA is produced by Inspire Medical Systems (...) , which recently published its 36-month outcomes data from its Stimulation Therapy for Apnea Reduction (STAR) trial. HNS therapy is currently indicated for moderate-to-severe OSA patients who are CPAP-intolerant, have a body mass index <32, apnea-hypopnea index <50, and without a concentric pattern of upper airway collapse on sleep endoscopy.Data from the STAR trial suggests that a subset of OSA patients can achieve a significant therapeutic response from hypoglossal nerve stimulation. However

Sleep apnoea and stroke Sleep disorders have been known to physicians for a long time. In his famous aphorisms, Hippocrates said "Sleep or watchfulness exceeding that which is customary, augurs unfavorably". Modern medicine has been able to disentangle some of the phenomena that disturb sleep. Among the most notable offenders is sleep apnoea that has gained prominence in the past few decades. It is being proposed as one of the potentially modifiable risk factors for vascular diseases including (...) stroke. The pathological mechanisms linking sleep apnoea to vascular risk factors include hypoxia, cardiac arrhythmias, dysautonomia, impaired glucose tolerance, hypertension, dyslipidaemia and inflammation. In this article, we review literature linking sleep apnoea and stroke, including sleep apnoea as a risk factor for primary prevention with the potential to improve outcome after acute stroke and as a secondary risk factor, amenable to modification and hence vascular risk reduction.

Acupuncture for persistent insomnia associated with major depressive disorder: a randomised controlled trial. 26908336 2016 12 13 2016 12 30 1024-2708 22 Suppl 2 2016 Feb Hong Kong medical journal = Xianggang yi xue za zhi Hong Kong Med J Acupuncture for persistent insomnia associated with major depressive disorder: a randomised controlled trial. S9-14 Chung K F KF Department of Psychiatry, University of Hong Kong. Yeung W F WF School of Chinese Medicine, University of Hong Kong. Zhang S P SP (...) Female Hong Kong Humans Male Middle Aged Psychiatric Status Rating Scales Sleep Initiation and Maintenance Disorders therapy Treatment Outcome 2016 2 25 6 0 2016 2 26 6 0 2016 12 15 6 0 ppublish 26908336

Humidified Continuous Positive Airway Pressure Devices for Adults with Obstructive Sleep Apnea: Clinical Effectiveness and Cost-Effectiveness Humidified Continuous Positive Airway Pressure Devices for Adults with Obstructive Sleep Apnea: Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Humidified Continuous Positive Airway Pressure Devices for Adults with Obstructive Sleep Apnea: Clinical Effectiveness and Cost-Effectiveness Humidified Continuous Positive (...) Airway Pressure Devices for Adults with Obstructive Sleep Apnea: Clinical Effectiveness and Cost-Effectiveness Published on: December 12, 2016 Project Number: RB1044-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of humidified continuous positive airway pressure (CPAP) versus non-humidified CPAP for adult patients with obstructive sleep apnea? What is the cost-effectiveness

Sleep disordered breathing and autonomic function in overweight and obese children and adolescents Obstructive sleep apnoea (OSA), common in children with obesity, is associated with cardiovascular morbidity. Autonomic dysfunction has been suggested to be a key player in the development of these complications. We investigated the relationship between obesity, OSA and sympathetic activity in children. 191 children with obesity were included and distributed into two groups: 131 controls and 60