Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Randomized Controlled Trial Comparative Study
Accurate position monitoring and improved supine-dependent obstructive sleep apnea with a new position recording and supine avoidance device.
Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supine-avoidance therapies are inherently uncomfortable, and treatment adherence is poor and difficult to monitor objectively. This study evaluated the efficacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. ⋯ This new position monitoring and supine alarm device records sleep position accurately and improves OSA but not snoring in patients with supine-predominant OSA.
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To validate the ApneaLINK (AL) as an accurate tool for determining the presence of obstructive sleep apnea (OSA) in an at-risk sleep clinic population in a home test environment. ⋯ The AL home test is an accurate alternative to PSG in sleep clinic populations at risk for moderate and severe OSA.
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Comparative Study
Membrane level of omega-3 docosahexaenoic acid is associated with severity of obstructive sleep apnea.
Patients with obstructive sleep apnea (OSA) are at increased risk of cardiovascular disease (CVD). The omega-3 fatty acid docosahexaenoic acid (DHA) is a major component of neural tissues, and supplementation with fish oils improves autonomic tone and reduces risk for CVD. A link between low DHA status and less mature sleep patterns was observed in newborns. ⋯ These findings suggest that disordered membrane fatty acid patterns may play a causal role in OSA and that the assessment of RBC DHA levels might help in the diagnosis of OSA. The effects of DHA supplementation on OSA should be explored.
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Comparative Study
Factors that may influence the classification of sleep-wake by wrist actigraphy: the MrOS Sleep Study.
Total sleep time (TST), sleep efficiency (SE), sleep latency (SOL) and wake after sleep onset (WASO) assessed by actigraphy gathered in 3 different modes were compared to polysomnography (PSG) measurements to determine which mode corresponded highest to PSG. Associations of measurement error for TST (PSG-actigraphy) with demographics, medical history, exam data, and sleep characteristics were examined. ⋯ Sleep parameters from the PIM and TAT modes of actigraphy corresponded reasonably well to PSG in this population, with the PIM mode correlating highest. Systematic measurement error was observed within subgroups with different sleep characteristics.
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Case Reports
Effect of continuous positive airway pressure on an atrial arrhythmia in a patient with mild obstructive sleep apnea.
Cardiac arrhythmias have been reported in up to half of individuals with obstructive sleep apnea (OSA) and have been proposed to be one of the factors contributing to their increased mortality. Several studies have demonstrated evidence of an association between OSA and a number of cardiac arrhythmias. The mechanisms of arrhythmogenesis in OSA may be due to enhanced vagal output triggered by a combination of apnea and hypoxemia. This case demonstrates a dose-dependent reduction in atrial ectopy with increasing continuous positive airway pressure (CPAP) in the setting of mild sleep apnea.