A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance
Mindfulness-based therapies (MBTs) are increasingly being investigated as a treatment for insomnia and general sleep disturbance, but significant gaps remain in the evidence base. In this article, the authors present (1) a unifying psychological process model that relates mindfulness to sleep; (2) a systematic review of the literature reporting on trials of MBTs for insomnia and sleep disturbance, which includes an assessment of quality of trial reporting, adaptation of MBTs for sleep, and whether mindfulness practice was associated with effects observed; and (3) a meta-analysis of MBTs for insomnia and sleep disturbance c...
Source: Sleep Medicine Clinics - April 1, 2019 Category: Sleep Medicine Authors: Joshua A. Rash, Victoria A.J. Kavanagh, Sheila N. Garland Source Type: research

Cognitive Behavioral Therapy for Insomnia and Acute Insomnia
The term “acute insomnia” has been part of the language of sleep medicine since the late 1970s. Despite that, a comprehensive research agenda on the topic has only recently been advanced. This has prevented a clinical viewpoint on the assessment and management of acute insomnia. Although there is a cogni tive behavioral therapy for insomnia focused intervention, designed to circumvent the transition from acute insomnia to insomnia disorder, the results from trials undertaken have been variable and limited by small sample sizes. There is much work to be done regarding the assessment, diagnosis, and m anagement o...
Source: Sleep Medicine Clinics - April 1, 2019 Category: Sleep Medicine Authors: Jason G. Ellis Source Type: research

Cognitive Behavioral Therapy for Insomnia (CBT-i) in School-Aged Children  and Adolescents
Insomnia is one of the most prevalent sleep disorders in school-aged children and adolescents. Although cognitive behavioral therapy for insomnia (CBT-i) is the first-line treatment for adults, and existing studies show promising effects also for children and adolescents, the number of randomized controlled trials in younger age groups is rather small. CBT-i techniques for school-aged children and adolescents include bedtime shifts (including sleep restriction), stimulus control, thought challenging, psychoeducation, and relaxation techniques. The integration of parents, especially in school-aged children with insomnia, is...
Source: Sleep Medicine Clinics - April 1, 2019 Category: Sleep Medicine Authors: Julia Dewald-Kaufmann, Ed de Bruin, Gradisar Michael Source Type: research

Brief Behavioral Treatment of Insomnia
Cognitive behavioral treatment for insomnia (CBTI) is an effective treatment of insomnia; however, there are insufficient CBTI providers for the 10% to 25% of the population who have insomnia. Brief behavioral treatment for insomnia (BBTI) is a 4-session manualized treatment paradigm administrable in medical settings by nonpsychologist health professionals. BBTI is effective in reducing symptoms of insomnia, such as sleep onset latency, wake after sleep onset, and sleep efficiency. In some cases, BBTI resulted in full remission from insomnia. Ongoing clinical trials are further testing the efficacy of BBTI using alternativ...
Source: Sleep Medicine Clinics - April 1, 2019 Category: Sleep Medicine Authors: Heather E. Gunn, Joshua Tutek, Daniel J. Buysse Source Type: research

Cognitive Behavioral Therapy for Insomnia in Patients with Medical and Psychiatric Comorbidities
“Insomnia is highly comorbid with other mental health and medical conditions and adversely affects quality of life and daytime functioning. Cognitive behavioral therapy for insomnia (CBT-I) is a safe and efficacious treatment for insomnia in the context of various comorbid conditions. In this arti cle, the authors outline considerations for delivering CBT-I in patients with the most common co-occurring medical and mental health conditions, review the evidence for CBT-I in these populations as well as special considerations for its application, and highlight future areas for research in the ar ea of CBT-I for comorbid...
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Greta B. Raglan, Leslie M. Swanson, John Todd Arnedt Source Type: research

Delivering Cognitive Behavioral Therapy for Insomnia in Military Personnel and Veterans
Insomnia is commonly reported by military populations, especially those with comorbid mental and physical health conditions. Co-occurring conditions result in an altered presentation of insomnia symptoms, and complicate provision of cognitive-behavioral therapy for insomnia (CBT-I), requiring supplementary assessment or modifications to traditional techniques. CBT-I has consistently demonstrated positive outcomes for active-duty service members and veterans, even in the context of significant comorbidities such as post-traumatic stress disorder, depression, sleep apnea, and chronic pain. Despite its promise, studies of CBT...
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Monica R. Kelly, Ruth Robbins, Jennifer L. Martin Source Type: research

Cognitive Behavioral Therapies for Insomnia and Hypnotic Medications
This article provides an overview of the evidence-based treatment options of insomnia, looking at short-term and long-term therapeutic outcomes for cognitive behavioral therapies and pharmacologic therapies. Key issues of treatment delivery and implementation are highlighted at the patient and health system levels, and novel approaches for combining and sequencing treatment to maximize therapeutic outcomes for insomnia are discussed. The impact of recent updates of major clinical guidelines and future research directions for the field are discussed. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Janet M.Y. Cheung, Xiao-Wen Ji, Charles M. Morin Source Type: research

Delivering Cognitive Behavioral Therapy for Insomnia in the Real World
This article focuses on 3 key issues in the delivery of CBT-I in the real world. First, where and how should CBT-I be delivered and who should deliver it? Second, who is an appropriate candidate for CBT-I? Third, how do you measure quality care with CBT-I? These issues give rise to targets for future research aimed at improving the implementation science of CBT-I in the real world. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Luis F. Buenaver, Donald Townsend, Jason C. Ong Source Type: research

Cognitive-Behavioral Therapy for Insomnia in Depression
This article reviews the literature on cognitive-behavioral therapy for insomnia in adults and adolescents with depression. Recent research has expanded on previous research, which established that sleep problems are an important predictor of depression and that sleep problems are associated with more severe depression, more suicidality, and worse outcomes for treatment of depression. The relationship between sleep problems and depression is complex, likely bidirectional, and impactful. To further improve the lives of patients with depression who experience insomnia, it will be important to investigate which patients will ...
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Lauren D. Asarnow, Rachel Manber Source Type: research

Online Delivery of Cognitive Behavioral Therapy-Insomnia
This article reviews the current state of research and clinical use of online delivery of cognitive behavioral therapy for insomnia. Strengths and limitations of this treatment modality are discussed, as well as exploration of some of the controversies in the field that are still under exploration. In addition, the article explores future areas of research to test out the role of this treatment as an entry level into a stepped care model of insomnia. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Michelle L. Drerup, Samina Ahmed-Jauregui Source Type: research

Cognitive and Behavioral Therapies for Insomnia: Who Is It for? What ’s New? Where Do We Go from Here?
Psychological and behavioral treatments have been used to treat insomnia for several decades. The first group of behavioral treatments used relaxation strategies, such as progressive muscle relaxation and biofeedback, to reduce physiologic arousal, which was thought to be the cause of insomnia. During the 1970s and 1980s, theory-driven approaches, including stimulus control,1 sleep hygiene,2 and sleep restriction therapy,3 were developed. As research began to implicate the role of cognitive factors (eg, maladaptive beliefs and attitudes about sleep, high effort to sleep) in chronic insomnia,4 techniques aimed at the cognit...
Source: Sleep Medicine Clinics - March 29, 2019 Category: Sleep Medicine Authors: Jason C. Ong Tags: Preface Source Type: research

Cognitive Behavioral Therapy for Insomnia and Women's Health
Differences in sleep for men and women begin at a very early age, with women reporting poorer sleep and having a higher risk for insomnia compared with men. Women are particularly vulnerable to developing insomnia during times of reproductive hormonal change. Sleep across the woman ’s lifespan and special treatment considerations for using cognitive behavioral therapy for insomnia (CBT-I) in women will be addressed in this review. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - March 26, 2019 Category: Sleep Medicine Authors: Sara Nowakowski, Jessica M. Meers Source Type: research

Weight Management in Obstructive Sleep Apnea
This article discusses specific weight loss interventions effective in improving OSA, including lifestyle interventions with dietary modification and physical activity, pharmacotherapy, and bariatric surgery. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Kwang Wei Tham, Phong Ching Lee, Chin Hong Lim Source Type: research

Positional Therapy for Positional Obstructive Sleep Apnea
Positional therapy appears to be an attractive strategy for many patients with positional obstructive sleep apnea (OSA). However, under the American Academy of Sleep Medicine OSA guidelines, positional therapy is considered as only an alternative therapy, because previous research has demonstrated poor treatment tolerance and adherence. Recent technological advances have renewed interest in positional therapy, with the invention of new sophisticated vibratory positional therapy devices. These devices have shown great promise with efficacy, markedly improved patient tolerance, and long-term adherence. We review the literatu...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Mok Yingjuan, Wong Hang Siang, Tan Kah Leong Alvin, Hsu Pon Poh Source Type: research

Establishing a Patent Nasal Passage in Obstructive Sleep Apnea
The role of the nose in the pathophysiology and treatment of sleep-disordered breathing (SDB) has not been fully understood and might have been underestimated. In the Staring resistor model, the nose is regarded as a passive and noncollapsible tube, but recent studies have shown that the nose might participate more in the pathophysiology of SDB as anatomic, neuromuscular, and respiratory factors than previously reported, which might imply the nose is an active noncollapsible tube. The roles of nasal treatments for OSA are not only the reduction of AHI, but also the improvement of subjective symptoms, sleep quality, and CPA...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Chiba Shintaro, Chan-Soon Park Source Type: research

Genioglossus Advancement and Hyoid Surgery
The structure and dimensions of the mandible, tongue, and hyoid complex are important variables in the pathophysiology of obstructive sleep apnea at the hypopharyngeal level. Genioglossus advancement is based on mandibular osteotomy, which brings the genioglossus muscle (GGM) forward and prevents posterior collapse during sleep. The genioglossus advancement technique has recently undergone several modifications; each has attempted to minimize surgical morbidity while improving the incorporation and advancement of the GGM. The hyoid bone has been of interest in sleep apnea and apnea-related surgical procedures because of it...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Yau Hong Goh, Victor Abdullah, Sung Wan Kim Source Type: research

Oral Appliances in the Management of Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a multifactorial condition, and an interdisciplinary approach to diagnosis forms the basis for effective treatment planning. Craniofacial structure and attached soft tissues and muscles play a central role in OSA. Evidence-based studies demonstrate the effectiveness of oral appliances for mandibular advancement and tongue stabilization in managing OSA, and current clinical standards of practice recommend the use of oral appliances to treat OSA when patients cannot tolerate continuous positive airway pressure (CPAP). Although effective, oral appliances are less predictable in managing OSA co...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Jing Hao Ng, Mimi Yow Source Type: research

The Role of the Revised Stanford Protocol in Today's Precision Medicine
Whereas the original Stanford protocol relied on a tiered approach to care to avoid unnecessary surgery, it did not address the issue of surgical relapse, a common concern among sleep medicine specialists. With 3 decades of experience since the original 2-tiered Powell-Riley protocol was introduced and the role of evolving skeletal techniques and upper airway stimulation, we are pleased to present our current protocol. This update includes emphasis on the facial skeletal development with impact on function including nasal breathing, and the incorporation of upper airway stimulation. The increased versatility of palatophary...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Stanley Yung-Chuan Liu, Michael Awad, Robert Riley, Robson Capasso Source Type: research

Sleep-Disordered Breathing, Orofacial Growth, and Prevention of Obstructive Sleep Apnea
Abnormal breathing during sleep is related to intrinsic and extrinsic factors that are present early in life. Investigation of fetal development and early-in-life orofacial growth allows recognition of risk factors that lead to change in upper airway patency, which leads to abnormal upper airway resistance, abnormal inspiratory efforts, and further increase in resistance and progressive narrowing of the collapsible upper airway. Such evolution can be recognized by appropriate clinical evaluation, specific polysomnographic patterns, and orofacial imaging. Recognition of the problems should lead to appropriate treatments and...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Christian Guilleminault, Shannon S. Sullivan, Yu-shu Huang Source Type: research

Anatomic and Pathophysiologic Considerations in Surgical Treatment of Obstructive Sleep Apnea
Evaluation of the upper airway is key for a successful surgical management. Proper evaluation can be done only with a good understanding of the anatomy and pathophysiology of the upper airway. The authors discuss surgical anatomy from a soft tissue and bony perspective in detail along with its clinical implications. The complex interaction among pharyngeal dilator tone, arousal threshold, respiratory control instability, and changes in lung volume during sleep play an important role in obstructive sleep apnea. Because all the anatomic and physiologic characteristics discussed have genetic predisposition, gene therapy may p...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Srinivas Kishore Sistla, Vijaya Krishnan Paramasivan, Vikas Agrawal Source Type: research

Prevention, Screening, and Treatments for Obstructive Sleep Apnea: Beyond Positive Airway Pressure (PAP)
The description of obstructive sleep apnea (OSA) syndrome in the 1970s was followed by the first wave of academic research to understand the pathophysiology of sleep-related abnormal breathing and upper airway obstruction, to determine its extent in the general population, and its many dire medical consequences and associations. This was followed quickly by the description of positive airway pressure (PAP) in 1981 to treat it and a second wave of academic research describing various single-modality treatments, including surgical modifications of the upper airway, oral appliances, weight management, and myofunctional therap...
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Song Tar Toh Tags: Preface Source Type: research

Prevention, Screening, and Treatments for Obstructive Sleep Apnea: Beyond Positive Airway Pressure (PAP)
SLEEP MEDICINE CLINICS (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Authors: Song Tar Toh Source Type: research

Copyright
ELSEVIER (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Source Type: research

Forthcoming Issues
Cognitive-Behavioral Therapies for Insomnia (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Source Type: research

Contributors
TEOFILO LEE-CHIONG Jr, MD (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Source Type: research

Contents
Song Tar Toh (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - January 30, 2019 Category: Sleep Medicine Source Type: research

Holistic Management of Obstructive Sleep Apnea
A holistic approach is pertinent in managing obstructive sleep apnea (OSA). It goes beyond integrated multidisciplinary assessment and management in the hospital setting. Although clinicians should be aware of different treatment modalities and adjunctive measures, proactive management of OSA is as important. The future of OSA management lies in identifying patients at risk of developing OSA and developing strategy to prevent OSA from taking root. It involves active screening of patients with OSA and treating them and identifying patients with OSA with high risk of preventable serious morbidity and death and intervening ea...
Source: Sleep Medicine Clinics - December 5, 2018 Category: Sleep Medicine Authors: Song Tar Toh, Chu Qin Phua, Shaun Loh Source Type: research

Maxillomandibular Rotational Advancement
Obstructive sleep apnea is a medical syndrome with multifactorial pathophysiology. Surgery can be the primary treatment option when anatomic factors are identified with narrowing at specific or general levels of pharyngeal airway. The surgeries are directed to the etiologic anatomic structure to achieve greatest effectiveness. Body weight, Mallampati scale, and tonsil grade are key evaluations to select effective surgical procedures. Surgical weight reduction, maxillomandibular advancement, and pharyngeal soft tissue surgeries are considered for the patient with obesity, maxillomandibular retrognathism, and tonsillar hyper...
Source: Sleep Medicine Clinics - December 4, 2018 Category: Sleep Medicine Authors: Clement Cheng-Hui Lin, Po-fang Wang, Shaun Ray Han Loh, Hung Tuan Lau, Sam Sheng-Ping Hsu Source Type: research

Addressing the Tone and Synchrony Issue During Sleep
Upper airway stimulation is a novel therapy for patients suffering from obstructive sleep apnea who are incompliant toward continuous positive airway pressure therapy. Evidence supporting the effectiveness of this therapy with regard to the treatment of disordered breathing, subjective daytime impairment, and its effect on sleep characteristics has increased. Information on the subjective sensation of the stimulation of the hypoglossal nerve could be gathered as more patients are implanted and knowledge of different aspects of the therapy is increasing. Comparisons between upper airway stimulation therapy and other surgica...
Source: Sleep Medicine Clinics - December 3, 2018 Category: Sleep Medicine Authors: Clemens Heiser, Benedikt Hofauer Source Type: research

Drug-Induced Sleep Endoscopy in Treatment Options Selection
Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airway collapse during sleep. We review drug-induced sleep endoscopy in adults, including its indications, technique, evaluation of upper airway collapse, and clinical application. Drug-induced sleep endoscopy is useful to improve treatment options selection for patients with obstructive sleep apnea, especially for those who are unable to accept or tolerate continuous positive airway pressure therapy. Owing to a lack of standardization for drug-induced sleep endoscopy, it is difficult to compare the published literature from differ...
Source: Sleep Medicine Clinics - December 3, 2018 Category: Sleep Medicine Authors: Khai Beng Chong, Andrea De Vito, Claudio Vicini Source Type: research

Myofunctional Therapy
Myofunctional therapy (MFT) has been reported to be an alternative treatment to obstructive sleep apnea (OSA), but compliance and long-term outcome in the children were considered as an issue. A prospective study was performed on age-matched children submitted to MFT or to a functional oral device used during sleep (passive MFT) and compared with no-treatment control group. Compliance is a major problem of MFT, and MFT will have to take into consideration the absolute need to have continuous parental involvement in the procedure for pediatric OSA. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 29, 2018 Category: Sleep Medicine Authors: Shih-Chieh Hsu, Yu-Shu Huang, Christian Guilleminault, Li-Chuan Chuang Source Type: research

Palatal Surgery for Obstructive Sleep Apnea
Although continuous positive airway pressure is the first-line and gold-standard management for obstructive sleep apnea (OSA), surgery is the only mainstream treatment without the use of a device. Palatal surgery is the paragon and core value among various sleep surgeries in treating snoring and OSA. It has transformed from radical excision to functional reconstruction. The integrated treatment of palatal surgery includes reconstruction of airway, restoration of airflow and rehabilitation of muscle. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 29, 2018 Category: Sleep Medicine Authors: Hsueh-Yu Li Source Type: research

Volumetric Tongue Reduction for Obstructive Sleep Apnea
Surgery for obstructive sleep apnea/hypopnea syndrome (OSA) is not a substitute for continuous positive airway pressure (CPAP) but is a salvage procedure for those who failed CPAP and other conservative therapies and therefore have no other options. The hypopharyngeal/tongue base procedures for the treatment of OSA are usually challenging to most sleep surgeons. In recent years, several procedures for OSA patients with hypopharyngeal obstructions have been developed to achieve higher response rates with decreased postoperative morbidities. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 29, 2018 Category: Sleep Medicine Authors: Hsin-Ching Lin, Michael Friedman Source Type: research

Transoral Robotic Surgery for Obstructive Sleep Apnea
Nocturnal upper airway collapse often involves the obstruction at the tongue base. Several surgical procedures have been developed in recent years to address this area in continuous positive airway pressure-nonadherent patients and include hyolingual advancement, tongue suture suspension, and various lingual resection techniques. Traditional tongue base resection is generally done either via a transcervical technique or transorally with an endoscope for visualization. Each of these approaches has significant potential limitations. The unsurpassed visualization, dexterity, and control provided by the Da Vinci Surgical Syste...
Source: Sleep Medicine Clinics - November 29, 2018 Category: Sleep Medicine Authors: Claudio Vicini, Filippo Montevecchi Source Type: research

The Evolution of Oral Appliance Therapy for Snoring and Sleep Apnea
This article explains the innovations of the previous 200  years and how they laid the groundwork for OAT today. The expansion of this treatment over the past 40 years has been explosive and evidence based. The future will be linked to changes in the medical field, continued research on appliance design, and development of personalized medicine that will appropriately identify therapy options. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Authors: B. Gail Demko Source Type: research

Obstructive Sleep Apnea ’s Connections with Clinical Dentistry
Adding airway services to a dental practice disrupts scheduling, examinations, treatment planning, billing, and team roles. Problems connected with the airway can be addressed with more precise therapy and better prognosis while building confidence between the patient and the dental team. Each team member must understand the connections between airway problems and patient health and be able to talk about it with confidence. If the entire team supports the inclusion of airway therapy into the service mix, patients will feel well cared for and rewards to the office will be plentiful. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Authors: Steve Carstensen Source Type: research

Controversies in Obstructive Sleep Apnea Surgery
This article explores controversies surrounding airway evaluation, definition of successful treatment, and surgical management of the CPAP intolerant patient with moderate to severe OSA. Controversies specific to maxillomandibular advancement (MMA) are also discussed. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Authors: Carolyn C. Dicus Brookes, Scott B. Boyd Source Type: research

Skeletal Surgery for Obstructive Sleep Apnea
Multilevel surgery has been established as the mainstay of treatment for the surgical management of obstructive sleep apnea (OSA). Combined with uvulopalatopharyngoplasty, tongue-base surgeries, including the genioglossus advancement (GA), sliding genioplasty, and hyoid myotomy and suspension, have been developed to target hypopharyngeal obstruction. Total airway surgery consisting of maxillomandibular advancement (MMA) with/without GA has shown significant success. Skeletal procedures for OSA with or without a palatal procedure is a proven technique for relieving airway obstruction during sleep. A case study demonstrating...
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Authors: Jos é E. Barrera Source Type: research

Dental Sleep Medicine
SLEEP MEDICINE CLINICS (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Authors: Jamison R. Spencer Source Type: research

Copyright
ELSEVIER (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Source Type: research

Forthcoming Issues
Prevention, Screening and Treatments for Obstructive Sleep Apnea: Beyond Positive Airway Pressure (PAP) (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Source Type: research

Contributors
TEOFILO LEE-CHIONG Jr, MD (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Source Type: research

Contents
Jamison R. Spencer (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Source Type: research

CME Accreditation Page
(Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 3, 2018 Category: Sleep Medicine Source Type: research

Transcranial Magnetic Stimulation
The aim of this article is to introduce transcranial magnetic stimulation (TMS) to dental practitioners and to explain its use in obstructive sleep apnea (OSA) and sleep bruxism (SB). In these 2 sleep disorders, TMS has proven to be a useful tool to explore pathophysiological pathways and disease mechanisms, and in a more limited way, to recruit upper airway muscles in OSA and reduce muscle activity and pain intensity in SB. Although promising, research using TMS in these conditions is still very limited and future investigations should be conducted before its clinical application can be considered. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 26, 2018 Category: Sleep Medicine Authors: Herrero Babiloni A, Louis De Beaumont, Gilles J. Lavigne Source Type: research

Pediatric Considerations for Dental Sleep Medicine
Pediatric obstructive sleep apnea (OSA) is a serious medical condition with numerous health consequences. Dentists are well suited to recognize and provide medical referrals for pediatric patients at risk for OSA. Timely dental sleep medicine interventions may improve signs and symptoms of OSA in growing children. Orthodontic and dentofacial orthopedic treatment may decrease obstructive respiratory events in some pediatric patients. Palatal expansion may be part of a comprehensive orthodontic treatment plan to correct a malocclusion and treat OSA. Orthognathic surgery, mandibular advancement devices, and oropharyngeal exer...
Source: Sleep Medicine Clinics - September 26, 2018 Category: Sleep Medicine Authors: Thomas R. Stark, Manuel Pozo-Alonso, Raj Daniels, Macario Camacho Source Type: research

Clinical Evaluation for Oral Appliance Therapy
This article outlines the steps dentists must take before treating obstructive sleep apnea patients with oral appliance therapy. It describes a proper clinical examination, the appropriate appliance for specific cases, patient discussion points, and the necessary history and consent forms. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 26, 2018 Category: Sleep Medicine Authors: Cameron A. Kuehne Source Type: research

Beyond Blowing: Oral Appliance Therapy, Surgery, and Transcranial Magnetic Stimulation
It has been my pleasure to act as editor of this issue of Sleep Medicine Clinics. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 25, 2018 Category: Sleep Medicine Authors: Jamison R. Spencer Tags: Preface Source Type: research

Avoiding and Managing Oral Appliance Therapy Side Effects
There is a serious need to consider all potential side effects thoughtfully before commencing individual treatment with oral appliance therapy. Although many of these side effects are self-limiting, easily corrected, or innocuous, others are difficult or impossible to correct and can affect the patient in serious ways. As this field evolves, new information is discovered, and new products are introduced at a rather rapid pace, continuing education and prudent practice are critical to ethical care in the practice of dental sleep medicine. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 18, 2018 Category: Sleep Medicine Authors: Thomas G. Schell Source Type: research

Oral Appliance Therapy and Temporomandibular Disorders
This article focuses on clinical examination to assist in maintaining stable function between jaw posture, muscle function, and temporomandibular joint stability. It describes a simple and understandable approach for assessment and management of common temporomandibular symptoms arising as side effects from use of mandibular advancement device therapy for obstructive sleep apnea. Follow-up visits are necessary to assess efficacy of sleep oral devices. An interdisciplinary approach is necessary for better treatment outcome. Qualified dentists offering this therapy should be educated and gain knowledge about diagnosis, preve...
Source: Sleep Medicine Clinics - September 18, 2018 Category: Sleep Medicine Authors: Noshir R. Mehta, Leopoldo P. Correa Source Type: research