Contents
Matthew R. Ebben (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - November 2, 2022 Category: Sleep Medicine Source Type: research
Racial Differences in Positive Airway Pressure Adherence in the Treatment of Sleep Apnea
Although data are limited, studies suggest on average lower positive airway pressure use in Black, indigenous, and people of color (BIPOC) compared with Whites in most but not all studies. Most of these observational studies are certainly limited by confounding by socioeconomic status and other unmeasured factors that likely contribute to differences. The etiology of these observed disparities is likely multifactorial, due in part to financial limitations, differences in sleep opportunity, poor sleep quality due to environmental disruptions, and so forth. These disparities in sleep health are likely related to chronic ineq...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Martha E. Billings, Anna M. May Source Type: research
Cost-Effectiveness of Continuous Positive Airway Pressure Therapy Versus Other Treatments of Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a common disorder that is increasing in prevalence, both in the United States and worldwide. Continuous positive airway pressure (CPAP), the gold-standard treatment for OSA, is cost-effective from both a payer and societal perspective. Alternative treatments of OSA, including oral appliance therapy, various surgeries, and hypoglossal nerve stimulation have also been evaluated from a cost-effectiveness perspective although results are less consistent. Some studies directly compare these alternative therapies with CPAP. This review will discuss the available literature for cost-effectiveness ...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Jeremy A. Weingarten Source Type: research
Use of Positive Airway Pressure in the Treatment of Hypoventilation
This article reviews the pathophysiology of sleep-related hypoventilation, discusses situations where treatment with continuous positive airway pressure is feasible and briefly outlines noninvasive ventilation modes and settings for the treatment of common sleep-related hypoventilation disorders. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Annie C. Lajoie, Marta Kaminska Source Type: research
Best Predictors of Continuous Positive Airway Pressure Adherence
About half of continuous positive airway pressure (CPAP)-treated patients are adherent, substantially affecting efficacy. A limitation to understanding predictors of adherence is the lack of a singular definition. Univariate analyses have suggested an array of factors that are statistically significant and reflect disease pathophysiology, clinical features, demographic characteristics, device-related variables, and psychological factors, but whether differences are clinically meaningful is unclear. There have been limited applications of multiple regression to compare the relative influence of multiple variables. This revi...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Terri E. Weaver Source Type: research
Comorbid Insomnia and Sleep Apnea
Comorbid insomnia and sleep apnea (COMISA) is a highly prevalent and debilitating condition that is more difficult to treat compared with insomnia alone or sleep apnea alone. Approximately 30% to 50% of sleep clinic patients with sleep apnea report comorbid insomnia symptoms. Comorbid insomnia is associated with lower adherence to positive airway pressure therapy for obstructive sleep apnea. Management approaches that include targeted treatments for both insomnia and sleep apnea lead to the best treatment outcomes for patients with COMISA. Therefore, sleep clinics should incorporate insomnia and COMISA management pathways ...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Alexander Sweetman, Leon Lack, Megan Crawford, Douglas M. Wallace Source Type: research
Obstructive Sleep Apnea and Positive Airway Pressure Usage in Populations with Neurological Disease
Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep, with a worldwide estimate of 936 million sufferers. Treatments of OSA include continuous positive airway pressure (CPAP), weight loss, positional therapy, oral appliances, positive upper airway pressure, oro-maxillofacial surgery, hypoglossal nerve stimulation, and bariatric surgery, and others, with CPAP being the most commonly prescribed treatment. In this review, the neurologic conditions of stroke, cognitive decline, epilepsy, and migraines will be discussed as they relate to OSA. Addition...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Daniel A. Barone, Alan Z. Segal Source Type: research
Cognitive Complaints and Comorbidities in Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is highly prevalent sleep disorder that causes sleep fragmentation, frequent awakenings, and intermittent hypoxia. Both OSA and cognitive decline increase in prevalence with factors such as increasing age and body mass. Multiple areas of cognition can be affected, including attention, executive function, memory, as well as emotional functioning through direct effects on brain health. Although positive airway pressure therapy has shown to improve some aspects of cognitive functioning, it does not fully alleviate all cognitive complaints. Inclusion of complementary approaches to comorbidities as...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Michelle Vardanian, Lisa Ravdin Source Type: research
Outcomes Data for Continuous Positive Airway Pressure Treatment
This article reviews what has been proven about clinical outcomes, and what is likely if not completely proven. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Steven H. Feinsilver Source Type: research
A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance Moving Toward Processes of Change
MBTs are increasingly being investigated as a viable treatment of insomnia or sleep disturbance. To date, 13 trials published since 2010 suggest that MBTs are efficacious for improving symptoms of insomnia and sleep quality relative to psychological placebos and inactive control conditions with medium to large effects. Limited evidence suggests that these effects are sustained at 3-month follow-up. Despite this, limited data were collected evaluating the empirically supported mechanisms or processes of change. The authors propose a testable model in the psychological process model of sleep that they hope will advance the n...
Source: Sleep Medicine Clinics - September 7, 2022 Category: Sleep Medicine Authors: Joshua A. Rash, Victoria A.J. Kavanagh, Sheila N. Garland Source Type: research
Pharmacologic and Nonpharmacologic Treatment of Restless Legs Syndrome
This article provides an updated practical guide for the treatment of primary RLS in adults. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 7, 2022 Category: Sleep Medicine Authors: Galia V. Anguelova, Monique H.M. Vlak, Arthur G.Y. Kurvers, Roselyne M. Rijsman Source Type: research
Chronic Opioid Use and Sleep Disorders
Opioid medications are considered a significant component in the multidisciplinary management of chronic pain. In the past two decades, the use of opioid medications has dramatically risen in part because of an increased awareness by health care providers to treat chronic pain more effectively. In addition, patients are encouraged to seek treatment. The release of a sentinel joint statement in 1997 by the American Academy of Pain Medicine and the American Pain Society in a national effort to increase awareness and support the treatment of chronic pain has undoubtedly contributed to the opioid crisis. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 7, 2022 Category: Sleep Medicine Authors: Shahrokh Javaheri, Michelle Cao Source Type: research
Drug-Induced Insomnia and Excessive Sleepiness
Undesirable side effects of insomnia and/or sleepiness may occur with many prescribed drugs, psychotropics as well as non-psychotropics. These central nervous system effects can be explained by the interactions of the drug with any of the numerous neurotransmitters and receptors that are involved in sleep and wakefulness. Also a close - sometimes bidirectional - relationship between disease and (disturbed) sleep/wakefulness is often present e.g. in chronic pain; drug effects may lead this vicious circle in both ways. Besides the importance for health and quality of life, effects on sleep or waking function can be a potenti...
Source: Sleep Medicine Clinics - September 7, 2022 Category: Sleep Medicine Authors: Ann Van Gastel Source Type: research
Pharmacologic Management of Excessive Daytime Sleepiness
Excessive daytime sleepiness (EDS) is defined as “irresistible sleepiness in a situation when an individual would be expected to be awake, and alert.” EDS has been a big concern not only from a medical but also from a public health point of view. Patients with EDS have the possibility of falling asleep even when they should wake up and concent rate, for example, when they drive, play sports, or walk outside. In this article, clinical characteristics of common hypersomnia and pharmacologic treatments of each hypersomnia are described. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 7, 2022 Category: Sleep Medicine Authors: Taisuke Ono, Shinichi Takenoshita, Seiji Nishino Source Type: research
Sleep-Related Drug Therapy in Special Conditions
This article summarizes the current therapeutic management of sleep disorders in children, bearing in mind the absence of evidence-based guidelines on this topic. (Source: Sleep Medicine Clinics)
Source: Sleep Medicine Clinics - September 7, 2022 Category: Sleep Medicine Authors: Nicholas-Tiberio Economou, Luigi Ferini-Strambi, Paschalis Steiropoulos Source Type: research
