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Yogic Pranayama and PAP Therapy: Is There a Connection?
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Recurrent Hypersomnia and Autonomic Dysregulation in Posttraumatic Stress Disorder
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

PAP and Cardiovascular Events in Adults With Sleep Apnea: Is PAP Useful?
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Confusing Signals During a Positive Airway Pressure Titration
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Disordered Consciousness or Disordered Wakefulness? The Importance of Prolonged Polysomnography for the Diagnosis, Drug Therapy, and Rehabilitation of an Unresponsive Patient With Brain Injury
We present a pediatric case of insufficient wakefulness in a patient with severe disability following a pilocytic astrocytoma. Polysomnography was crucial for diagnosis, as it detected a well-structured pattern with daytime sleep initiations in the REM sleep phase. Treatment with modafinil was successful, as confirmed by polysomnography, leading to partial recovery of the patient's consciousness and communication ability. We suggest that polysomnography is a useful diagnostic tool to direct the pharmacotherapy and rehabilitation of states of reduced consciousness.Citation:Formica F, Pozzi M, Avantaggiato P, Molteni E, Arri...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Efficacy of the Addition of a Cervical Collar in the Treatment of Persistent Obstructive Apneas Despite Continuous Positive Airway Pressure
We report a small group of patients in whom addition of a cervical collar to a face mask allowed correction of obstructive events.Citation:Prigent A, Grassion L, Guesdon S, Gonzalez-Bermejo J. Efficacy of the addition of a cervical collar in the treatment of persistent obstructive apneas despite continuous positive airway pressure.J Clin Sleep Med. 2017;13(12):1473–1476. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Admission Criteria for Children With Obstructive Sleep Apnea After Adenotonsillectomy: Considerations for Cost
Study Objectives:Postoperative respiratory complications (PRCs) are common among children with obstructive sleep apnea (OSA) after adenotonsillectomy. We analyzed postoperative admission guidelines to determine which optimally balanced patient safety and cost.Methods:Retrospective study of children aged 12 years or younger undergoing adenotonsillectomy for OSA after polysomnography at a tertiary academic care center over 2 years. Demographics, medical history, and hospital course were collected. Advanced Excel modeling was used to assess the number of children with PRCs identified with guideline admission criteria and to v...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Functional Evaluation of Small Fiber Pathways in Primary Restless Legs Syndrome: A δ Pathway Study
Study Objectives:The aim of this study was to provide a neurophysiological evaluation of the function of large and small fibers, particularly the peripheral part of the thermonociceptive Aδ pathway in patients with primary restless legs syndrome (RLS).Methods:The main evaluation was based on an analysis of the parameters of laser-evoked potentials (LEPs), N2 and P2 components, and an assessment of thermonociceptive thresholds (pain thresholds; PThs). Routine nerve conduction studies (NCS) were also performed.Results:No essential or important differences of clinical significance were observed in the parameters of larg...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Improving Sleep for Hospitalized Antepartum Patients: A Non-Randomized Controlled Pilot Study
Conclusions:This pilot study provides evidence of the feasibility and preliminary efficacy of the SIP-AP intervention for reducing symptoms and improving sleep of antepartum patients during hospitalization. Further detailed evaluation of specific components of this protocol is warranted, and other types of hospitalized patients may benefit from unit-based modifications to this SIP-AP protocol.Citation:Lee KA, Gay CL. Improving sleep for hospitalized antepartum patients: a non-randomized controlled pilot study.J Clin Sleep Med. 2017;13(12):1445–1453. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

A Longitudinal Follow-Up Study on Multiple Sleep Latency Test and Body Mass Index of Patients With Narcolepsy Type 1 in Korea
Conclusions:MSLT has good test-retest validity in patients with narcolepsy type 1. Close surveillance for the detection and management of obesity is warranted in clinical settings.Citation:Um YH, Kim TW, Jeong JH, Seo HJ, Han JH, Kim SM, Song JH, Hong SC. A longitudinal follow-up study on Multiple Sleep Latency Test and body mass index of patients with narcolepsy type 1 in Korea.J Clin Sleep Med. 2017;13(12):1441–1444. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Correlates to Problem Behaviors in Pediatric Narcolepsy: A Pilot Study
The objective of this study was to examine neurobehavioral problems in children with narcolepsy and to define associations with these problem behaviors.Methods:A cross-sectional study was performed where the Child Behavior Checklist (CBCL) was completed by guardians of children (age 18 years or younger) in whom narcolepsy with or without cataplexy was diagnosed (based on the International Classification of Sleep Disorders, Second Edition) between July 2008 and October 2014. Spearman correlations (continuous variables) and Wilcoxon rank-sum tests (categorical variables) were performed for the CBCL findings and narcolepsy fa...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

The REM Sleep Behavior Disorder Screening Questionnaire: Validation Study of the Korean Version (RBDQ-KR)
Study Objectives:REM sleep behavior disorder (RBD) is a parasomnia that is commonly associated with neurodegenerative disorders. We aimed to validate the Hong Kong version of the self-reported RBD questionnaire (RBDQ-HK) with the Korean version (RBDQ-KR) and to investigate its clinical usefulness.Methods:One-hundred five patients with RBD and 105 age- and sex-matched controls were enrolled. Thirty were randomly selected for a retest with the questionnaire after 2 to 4 weeks without any treatment. Receiver operating characteristic curve and exploratory factor analysis were used to evaluate the scale, which had a score rangi...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

CPAP Adherence is Associated With Attentional Improvements in a Group of Primarily Male Patients With Moderate to Severe OSA
Conclusions:The results of this study showed that higher levels of CPAP adherence were associated with significant improvements in vigilance. Because the PVT is a performance-based measure that is not influenced by prior learning and is not subjective, it may be an important supplement to patient self-reported assessments.Clinical Trial Registration:Name: Effect of Self-Management on Improving Sleep Apnea Outcomes, URL:https://clinicaltrials.gov/ct2/show/NCT00310310, Identifier: NCT00310310Citation:Deering S, Liu L, Zamora T, Hamilton J, Stepnowsky C. CPAP adherence is associated with attentional improvements in a group of...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Dissociation of Objective and Subjective Daytime Sleepiness and Biomarkers of Systemic Inflammation in Sleep-Disordered Breathing and Systolic Heart Failure
Conclusions:In systolic HF, although overall objective sleepiness was observed, this was not associated with subjective sleepiness (ie, a discordance was identified). Differential upregulation of systemic inflammation in objective sleepiness was observed, findings not observed with subjective sleepiness. These findings suggest that underlying mechanistic pathways of inflammation may provide the explanation for dissonance of objective and subjective sleepiness symptoms in HF, thus potentially informing targeted diagnostic and therapeutic approaches.Commentary:A commentary on this article appears in this issue on page 1369.C...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Changes in Caregiving Status and Intensity and Sleep Characteristics Among High and Low Stressed Older Women
Conclusions:Overall, sleep characteristics did not differ among noncaregivers, ceased caregivers, or those with high-/low-intensity caregiving among older women. However, subgroups of caregivers may be vulnerable to developing sleep problems, particularly those with high stress levels.Citation:Song Y, Harrison SL, Martin JL, Alessi CA, Ancoli-Israel S, Stone KL, Fredman L. Changes in caregiving status and intensity and sleep characteristics among high and low stressed older women.J Clin Sleep Med. 2017;13(12):1403–1410. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Nocturnal Hypoxemia is Associated With Low Testosterone Levels in Overweight Males and Older Men With Normal Weight
This study evaluated the association between the total testosterone (TT) level and OSA in patients who are not obese.Methods:A retrospective review of 523 records of patients in whom OSA was diagnosed from 2013–2016 was performed. The study included men with a BMI
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Barriers to CPAP Use in India: An Exploratory Study
Conclusions:The main cause of nonuse of CPAP in India is the inability to buy a CPAP device. In patients who are able to buy a CPAP device, adherence was significantly higher (82.7%) compared to adherence in the study's overall population (30.3%). Furthermore, patients with more severe OSA were more likely to buy a device and adhere to CPAP. Patients' behaviors and attitudes are also important barriers in using CPAP. There needs to be increased awareness of the benefits of CPAP therapy among patients.Citation:Goyal A, Agarwal N, Pakhare A. Barriers to CPAP use in India: an exploratory study.J Clin Sleep Med. 2017;13(12):13...
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Ambivalent Adherence and Nonadherence to Continuous Positive Airway Pressure Devices: A Qualitative Study
Conclusions:Both adherence and nonadherence to CPAP are dynamic processes that are characterized by patients' ambivalence and contingent upon diverse factors. These findings have practical implications as they suggest that all patients, regardless of their initial adherence status, would benefit from a close follow-up.Citation:Zarhin D, Oksenberg A. Ambivalent adherence and nonadherence to continuous positive airway pressure devices: a qualitative study.J Clin Sleep Med. 2017;13(12):1375–1384. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Clinical Prediction Rules, Adenotonsillectomy and Children With Obstructive Sleep Apnea: What's Next?
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

Characterizing Sleepiness: Are We Drawing the Right Line in the Sand?
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - December 15, 2017 Category: Sleep Medicine Source Type: research

A Patient With Rapidly Progressing Early-Onset Dementia and Insomnia
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Carbamazepine Improves Apneic Episodes in Congenital Central Hypoventilation Syndrome (CCHS) With a Novel PHOX2B Exon 1 Missense Mutation
We report a child with CCHS who was found to have a novel heterozygous missense variant in exon 1; c.95A> T. Improvement in his apneic episodes was observed following treatment with carbamazepine.Citation:Schirwani S, Pysden K, Chetcuti P, Blyth M. Carbamazepine improves apneic episodes in congenital central hypoventilation syndrome (CCHS) with a novelPHOX2B exon 1 missense mutation.J Clin Sleep Med. 2017;13(11):1359–1362. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Non-24-Hour Sleep-Wake Rhythm Disorder and Melatonin Secretion Impairment in a Patient With Pineal Cyst
We report the case of a 14-year-old girl with a wide non-compressive pineal cyst, associated with the inability to control her sleep-wake schedule. Actigraphic monitoring showed a 24-hour free-running disorder (tau 26.96 hours). A 24-hour serum melatonin curve assay, with concomitant video-polysomnographic and body-core temperature monitoring, was performed. Melatonin curve showed a blunted nocturnal peak, lower total quantity of melatonin, and prolonged melatonin secretion in the morning, with normal temperature profile and sleep parameters. Treatment with melatonin up to 14 mg at bedtime was initiated with complete reali...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Rate My Sleep: Examining the Information, Function, and Basis in Empirical Evidence Within Sleep Applications for Mobile Devices
Conclusions:Sleep apps are increasingly popular, demonstrated by the large number of downloads in the Google Play store. Users favored apps that contained sleep tips; however, these tips and other information in the apps were generally not based on empirical evidence. Future research in the area of sleep apps should consider constructing sleep apps derived from empirical evidence and examining their effectiveness.Citation:Lee-Tobin PA, Ogeil RP, Savic M, Lubman DI. Rate my sleep: examining the information, function, and basis in empirical evidence within sleep applications for mobile devices.J Clin Sleep Med. 2017;13(11):1...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Ocular Manifestations of Obstructive Sleep Apnea
Conclusions:Hypoxia induced by nightly cessation of breathing increases patients' risk of coronary artery disease, heart failure, stroke, and other conditions. As with many maladies detrimental to vascular health, obstructive sleep apnea affects the eye and ocular adnexa. This paper summarizes the current evidence implicating OSA in these ocular maladies and highlights their proposed mechanisms. The authors describe ocular pathology which sleep specialists may encounter. We encourage more aggressive attention to ocular symptoms in patients with sleep apnea to prevent vision-threatening complications. Further research shoul...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Mask Refills as a Measure of PAP Adherence
Study Objectives:Positive airway pressure (PAP) adherence data are a routine aspect of clinical care for obstructive sleep apnea (OSA), but not uniformly available. We hypothesized that mask refills are a measure of PAP adherence.Methods:We measured PAP use over the first 90 days of treatment in 123 patients with OSA. The number and timing of mask refills was assessed over 18 months. Demographic and medical information was obtained from the electronic medical record.Results:Average PAP use in the first week of more than 4 h/d was a predictor of adherence over the first 90 days (P
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

A Randomized Crossover Trial Evaluating Continuous Positive Airway Pressure Versus Mandibular Advancement Device on Health Outcomes in Veterans With Posttraumatic Stress Disorder
Study Objectives:Despite the overall improvement in posttraumatic stress disorder (PTSD) symptomatology with continuous positive airway pressure (CPAP) therapy, adherence to CPAP is far worse in veterans with PTSD compared to the general population with obstructive sleep apnea (OSA). The aim of this study was to compare the efficacy, adherence, and preference of CPAP versus mandibular advancement device (MAD) and the effect of these treatments on health outcomes in veterans with PTSD.Methods:Forty-two subjects with PTSD and newly diagnosed OSA by polysomnography were treated in a randomized, crossover trial of 12 weeks wit...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Perfectionism and Polysomnography-Determined Markers of Poor Sleep
Conclusions:This pattern of results suggests that high levels of perfectionism may predispose individuals to sleep disturbances in the context of acute stressors. Thus, the influence of perfectionism on poor sleep should be further investigated to improve treatment.Citation:Johann AF, Hertenstein E, Kyle SD, Baglioni C, Feige B, Nissen C, Riemann D, Spiegelhalder K. Perfectionism and polysomnography-determined markers of poor sleep.J Clin Sleep Med. 2017;13(11):1319–1326. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Neurodevelopmental Outcomes at Two Years of Age for Premature Infants Diagnosed With Neonatal Obstructive Sleep Apnea
Conclusions:The median score for cognitive, language, and motor scores for preterm infants with neonatal OSA were within one standard deviation of the published norm. Mean end-tidal CO2, independent of AHI, may serve as a biomarker for predicting poor cognitive outcome in preterm infants with neonatal OSA.Commentary:A commentary on this article appears in this issue on page 1233.Citation:Bandyopadhyay A, Harmon H, Slaven JE, Daftary AS. Neurodevelopmental outcomes at two years of age for premature infants diagnosed with neonatal obstructive sleep apnea.J Clin Sleep Med. 2017;13(11):1311–1317. (Source: Journal of Clin...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Improving Sleep Quality Assessment Using Wearable Sensors by Including Information From Postural/Sleep Position Changes and Body Acceleration: A Comparison of Chest-Worn Sensors, Wrist Actigraphy, and Polysomnography
Conclusions:Combination of sleep postural/position changes and body acceleration improved detection of sleep/wake epochs compared to wrist acceleration alone. The chest sensors also improved estimation of sleep parameters of interest with stronger agreement with PSG. Our findings may expand the application of wearable sensors to clinically assess sleep outside of a sleep laboratory.Citation:Razjouyan J, Lee H, Parthasarathy S, Mohler J, Sharafkhaneh A, Najafi B. Improving sleep quality assessment using wearable sensors by including information from postural/sleep position changes and body acceleration: a comparison of ches...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Lemborexant, A Dual Orexin Receptor Antagonist (DORA) for the Treatment of Insomnia Disorder: Results From a Bayesian, Adaptive, Randomized, Double-Blind, Placebo-Controlled Study
Conclusions:Lemborexant doses ranging from 2.5–10 mg provided efficacy for the treatment of insomnia while minimizing next-morning residual sleepiness.Clinical Trial Registration:Title: A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Bayesian Adaptive Randomization Design, Dose Response Study of the Efficacy of E2006 in Adults and Elderly Subjects With Chronic Insomnia; URL:https://clinicaltrials.gov/ct2/show/NCT01995838; Identifier: NCT01995838Citation:Murphy P, Moline M, Mayleben D, Rosenberg R, Zammit G, Pinner K, Dhadda S, Hong Q, Giorgi L, Satlin A. Lemborexant, a dual orexin recepto...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Differences in Sleep Patterns and Problems by Race in a Clinical Sample of Black and White Preschoolers
Conclusions:In contrast to community-based research, Black and White children showed similar sleep patterns. However, there were differences by race in referral questions and diagnoses. Findings suggest the need to consider caregiver perceptions and other sociocultural factors that may contribute to differential rates of presentation for sleep services, as well as potential health disparities in this regard.Citation:Williamson AA, Rubens SL, Patrick KE, Moore M, Mindell JA. Differences in sleep patterns and problems by race in a clinical sample of black and white preschoolers.J Clin Sleep Med. 2017;13(11):1281–1288. ...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Nocturnal Desaturation is Associated With Neurological Deterioration Following Ischemic Stroke: A Retrospective Observational Study
Study Objectives:The mechanism of early neurological deterioration (END) in patients with stroke remains unclear. We assessed the relationship between nocturnal oxygen desaturation (NOD) in the stroke unit (SU) and END, especially occurring at nighttime, following acute stroke.Methods:A retrospective analysis was performed on a total of 276 patients with ischemic stroke who were admitted to the SU between July 2013 and June 2015. The oxygen desaturation index was calculated from pulse oximetry data sampled every 1 minute during 9 hours on the first night (10:00 PM to 7:00 AM) after admission, and NOD was defined as oxygen ...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Prevalence of Cardiac Arrhythmias in Asian Patients With Obstructive Sleep Apnea: A Singapore Sleep Center Experience
Study Objectives:Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Cardiac arrhythmias are common in patients with OSA. However, the prevalence and significance of cardiac arrhythmias in Asian patients with OSA are not well studied. The aim of this study is to determine the prevalence of cardiac arrhythmias in patients with OSA in Singapore and to evaluate possible factors that may predispose patients with OSA to arrhythmias.Methods:A retrospective study of 2,019 patients was carried out from January 2011 to December 2012 at a sleep center in a tertiary medical center. Of th...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Impact of Sleep-Disordered Breathing Treatment on Quality of Life Measures in a Large Clinic-Based Cohort
This study aims to report the effect of positive airway pressure (PAP) therapy on quality of life (QoL) measures in the clinical sleep-disordered breathing (SDB) population.Methods:We examined general QoL measures assessed by European Quality of Life-5D (EQ-5D) and sleep-specific QoL by examining Functional Outcomes of Sleep Questionnaire (FOSQ) scores before and after PAP therapy retrospectively in a clinical SDB population using paired and two-samplet tests. Age and socioeconomic status (SES) effect modification on pre-PAP QoL measures were investigated utilizing the interaction terms.Results:A total of 2,027 patients wi...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Night-to-Night Sleep Variability in Older Adults With Chronic Insomnia: Mediators and Moderators in a Randomized Controlled Trial of Brief Behavioral Therapy (BBT-I)
Study Objectives:Sleep variability is a clinically significant variable in understanding and treating insomnia in older adults. The current study examined changes in sleep variability in the course of brief behavioral therapy for insomnia (BBT-I) in older adults who had chronic insomnia. Additionally, the current study examined the mediating mechanisms underlying reductions of sleep variability and the moderating effects of baseline sleep variability on treatment responsiveness.Methods:Sixty-two elderly participants were randomly assigned to either BBT-I or self-monitoring and attention control (SMAC). Sleep was assessed b...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Distinct Patterns of Hyperpnea During Cheyne-Stokes Respiration: Implication for Cardiac Function in Patients With Heart Failure
Study Objectives:In heart failure (HF), we observed two patterns of hyperpnea during Cheyne-Stokes respiration with central sleep apnea (CSR-CSA): a positive pattern where end-expiratory lung volume remains at or above functional residual capacity, and a negative pattern where it falls below functional residual capacity. We hypothesized the negative pattern is associated with worse HF.Methods:Patients with HF underwent polysomnography. During CSR-CSA, hyperpnea, apnea-hyperpnea cycle, and lung to finger circulation times (LFCT) were measured. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrati...
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Infants Sleep for Brain
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Sleep Apnea and Nocturnal Cardiac Arrhythmia: Understanding Differences Across Ethnicity
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

Prognostic Significance of Fluctuations in End-Expiratory Lung Volume in Hunter-Cheyne-Stokes Breathing
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - November 14, 2017 Category: Sleep Medicine Source Type: research

What Can Tweets Tell Us About a Person's Sleep?
(Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Sleep-Related Rhythmic Movement Disorder and Obstructive Sleep Apnea in Five Adult Patients
We report a case series of 5 adults with sleep-related rhythmic movement disorder, 4 of whom had a previous history of SRRMs in childhood. SRRMs mostly occurred in consolidated sleep, in association with pathological respiratory events, predominantly longer ones, especially during stage R sleep, and recovered in 1 patient with continuous positive airway pressure therapy. We hypothesize that sleep apneas may act as a trigger of rhythmic motor events through a respiratory-related arousal mechanism in genetically predisposed subjects.Citation:Chiaro G, Maestri M, Riccardi S, Haba-Rubio J, Miano S, Bassetti CL, Heinzer RC, Man...
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

CPAP Treats Enuresis in Adults With Obstructive Sleep Apnea
We describe a case series of 5 adult patients in whom OSA was diagnosed by laboratory polysomnography, who presented with enuresis that resolved after treatment with continuous positive airway pressure (CPAP). All cases occurred in the setting of obesity, in addition to other known risk factors for urinary incontinence and enuresis. OSA was diagnosed as severe in all but one case, which was mild. One patient noted recurrence of enuresis that coincided with malfunction of his CPAP machine. There is growing evidence that CPAP therapy may alleviate OSA and enuresis in adults with both conditions. Clinicians should routinely a...
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Clinical Use of a Home Sleep Apnea Test: An American Academy of Sleep Medicine Position Statement
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. It is the position of the American Academy of Sleep Medicine (AASM) that only a physician can diagnose medical conditions such as OSA and primary snoring. Throughout this statement, the term“physician” refers to a medical provider who is licensed to practice medicine. A home sleep apnea test (HSAT) is an alternative to polysomnography for the diagnosis of OSA in uncomplicated adults presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. It is also the position of ...
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children
Introduction:The purpose of this position paper is to establish the American Academy of Sleep Medicine's (AASM) position on the use of a home sleep apnea test (HSAT) for the diagnosis of obstructive sleep apnea (OSA) in children (birth to 18 years of age).Methods:The AASM commissioned a task force of 8 experts in sleep medicine to review the available literature on the use of an HSAT to diagnose OSA in children. The task force developed the position statement based on a thorough review of these studies and their clinical expertise. The AASM Board of Directors approved the final position statement.Position Statement:Use of ...
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Improving PTSD Symptoms and Preventing Progression of Subclinical PTSD to an Overt Disorder by Treating Comorbid OSA With CPAP
Conclusions:CPAP treatment reduces total PCL score and NMF in veterans with PTSD and OSA. Those with overt PTSD respond to even lower CPAP compliance, whereas non-PTSD patients require higher compliance to achieve any symptom improvement. Poor CPAP compliance results in increased PCL score in non-PTSD veterans and may lead to overt PTSD if the OSA remains undertreated.Commentary:A commentary on this article appears in this issue on page 1121.Citation:Ullah MI, Campbell DG, Bhagat R, Lyons JA, Tamanna S. Improving PTSD symptoms and preventing progression of subclinical PTSD to an overt disorder by treating comorbid OSA with...
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Sleep Overnight Monitoring for Apnea in Patients Hospitalized with Heart Failure (SOMA-HF Study)
Conclusions:We conclude that high-resolution pulse oximetry is a simple and cost-effective screening tool for SDB in CHF patients admitted to the hospital. Such screening approaches may be valuable for large-scale implementation and for the optimal design of interventional trials.Citation:Sharma S, Mather PJ, Chowdhury A, Gupta S, Mukhtar U, Willes L, Whellan DJ, Malhotra A, Quan SF. Sleep overnight monitoring for apnea in patients hospitalized with heart failure (SOMA-HF Study).J Clin Sleep Med. 2017;13(10):1185–1190. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Meeting ACGME and ABMS Quality Improvement Requirements in a Sleep Medicine Fellowship Program
Conclusions:A QI curriculum can successfully be implemented into a 12-month sleep medicine fellowship to increase sleep medicine fellows' QI knowledge and confidence, meet ACGME and MOC requirements, and contribute to care of patients with sleep disorders.Citation:Shelgikar AV, Priddy C, Van Harrison R. Meeting ACGME and ABMS quality improvement requirements in a sleep medicine fellowship program.J Clin Sleep Med. 2017;13(10):1177–1183. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Insomnia in Pregnancy Is Associated With Depressive Symptoms and Eating at Night
Conclusions:Depressive symptoms and night eating are key factors related to insomnia developed during pregnancy.Citation:Wołyńczyk-Gmaj D, Różańska-Walędziak A, Ziemka S, Ufnal M, Brzezicka A, Gmaj B, Januszko P, Fudalej S, Czajkowski K, Wojnar M. Insomnia in pregnancy is associated with depressive symptoms and eating at night.J Clin Sleep Med. 2017;13(10):1171–1176. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research

Non-REM Sleep Instability in Children With Primary Monosymptomatic Sleep Enuresis
Conclusions:The findings of this study indicate the presence of a significant disruption of sleep microstructure (CAP) in children with sleep enuresis, supporting the hypothesis of a higher arousal threshold.Citation:Soster LA, Alves RC, Fagundes SN, Lebl A, Garzon E, Koch VH, Ferri R, Bruni O. Non-REM sleep instability in children with primary monosymptomatic sleep enuresis.J Clin Sleep Med. 2017;13(10):1163–1170. (Source: Journal of Clinical Sleep Medicine : JCSM)
Source: Journal of Clinical Sleep Medicine : JCSM - October 31, 2017 Category: Sleep Medicine Source Type: research