The PAP-NAP one decade later: patient risk factors, indications, and clinically relevant emotional and motivational influences on PAP use

AbstractStudy objectivesPositive airway pressure (PAP) noncompliance remains a major barrier in obstructive sleep apnea (OSA) treatment. The PAP-NAP, a daytime PAP “test-drive,” has been associated with increased PAP use, but risk factors and indications for the procedure remain unspecified.MethodsA retrospective chart review was conducted on 139 patients who (1) were diagnosed with OSA (n = 116) or upper airway resistance syndrome (UARS) (n = 23); (2) adamantly refused to proceed with either a full-night attended titration or in-home trial of PAP; and (3) elected to proceed with a PAP-NAP instead. Risk factors for PAP rejection (identified on intake) and indications for the PAP-NAP (identified post-diagnostic polysomnography) were confirmed through multiple encounters with sleep center personnel. All patients completed the PAP-NAP, which utilizes an elaborate desensitization program to provide a less challenging introduction and facilitate a gentler adaptation to pressurized air as well as to test advanced PAP modes when subjective or objective expiratory pressure intolerance emerges. Both emotional aversion toward and lack of motivation for PAP therapy were assessed pre- and post-PAP-NAP. PAP use was determined several months post-procedure.ResultsAt intake, most common risk factors for PAP rejection were depression, insomnia, and claustrophobia; most common indications for PAP-NAP were general reluctance, anxiety, and claustrophobia. Procedure averaged 3+ hours...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research

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Abstract Clinical factors associated with daytime sleepiness and insomnia in persons with epilepsy (PWE) were examined in this cross-sectional study of 126 participants (men, 50.8%). Excessive daytime sleepiness (EDS; score of ≥11 on the Epworth Sleepiness Scale (ESS)) was noted in 17.5% of participants (mean score, 6.1 ± 4.2), and moderate-to-severe insomnia (Insomnia Severity Index (ISI) scores of ≥15) was noted in 20.6% (mean score, 7.8 ± 6.4). Linear regression analyses revealed that ESS scores were independently associated with obstructive sleep apnea (OSA; snoring, tiredness, obse...
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
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Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
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Source: Current Dermatology Reports - Category: Dermatology Source Type: research
Abstract STUDY OBJECTIVES: Positive airway pressure (PAP) noncompliance remains a major barrier in obstructive sleep apnea (OSA) treatment. The PAP-NAP, a daytime PAP "test-drive," has been associated with increased PAP use, but risk factors and indications for the procedure remain unspecified. METHODS: A retrospective chart review was conducted on 139 patients who (1) were diagnosed with OSA (n = 116) or upper airway resistance syndrome (UARS) (n = 23); (2) adamantly refused to proceed with either a full-night attended titration or in-home trial of PAP; and (3) elected to proceed with a PAP-NAP ins...
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
Conclusions: Our data are in accordance with previous findings outlining that N + insomniacs have higher PSQI scores than N-. Our results do not confirm the suggested association between napping and depressive or obsessive-compulsive symptoms. Conversely, we found a statistically significant difference (p = 0.0014) in EAT scores in N + and N-. Hyperarousal and REM sleep instability in insomniac patients may create an unbalance of the neuroendocrine hypothalamic regulation leading to an appetite alteration. PMID: 31790624 [PubMed - as supplied by publisher]
Source: Nordic Journal of Psychiatry - Category: Psychiatry Tags: Nord J Psychiatry Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
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Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Agitation Anger Memory and Perception Psychology Research Sleep Anger Management Circadian Rhythm Immune Function Insomnia nemuri nightmare disorder Nightmares Sleep Apnea Sleep Disorder sleep quality Source Type: blogs
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Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Tags: J Sleep Res Source Type: research
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Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Review excessive daytime sleep fatigue head injury modafinil stroke TBI traumatic brain injury Source Type: research
This article reviews this relationship and provides recommendations for management. Keywords: Insomnia, sleep disorder, psychiatric disorder, depression, psychosis, schizophrenia, anxiety disorder Insomnia affects 25 million people in the United States annually and leads to an estimated $100 billion health care burden. Insomnia has also been shown to be a causal factor in other medical and psychiatric disorders, cognitive impairments, accidents, absenteeism, and reduced quality of life.1 The cost of not treating insomnia is more than the cost of treating insomnia.2 Insomnia as a symptom is seen in up to one third of the Un...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Review anxiety disorder depression insomnia psychiatric disorder psychosis schizophrenia sleep disorder Source Type: research
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