Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Case Reports
Complex sleep apnea associated with use of nasal expiratory positive airway (nEPAP) device.
Complex sleep apnea syndrome (CompSAS) is characterized by predominant obstructive sleep disordered breathing with evolution of central disordered breathing following exposure to nasal continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea (OSA) patients. We report a case of CompSAS associated with use of a nasal expiratory positive airway (nEPAP, Provent) device. We therefore recommend obtaining objective sleep data to confirm treatment effectiveness of the nEPAP device for OSA prior to long-term prescription. Further research is warranted to understand the underlying pathophysiological mechanisms and risk factors associated with CompSAS.
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Meta Analysis
Blood pressure improvement with continuous positive airway pressure is independent of obstructive sleep apnea severity.
We sought to perform a patient-level meta-analysis using the individual patient data of the trials identified in our previous study-level meta-analysis investigating the effect of positive airway pressure (PAP) treatment for obstructive sleep apnea (OSA) on blood pressure (BP). ⋯ OSA patients with uncontrolled hypertension are likely to gain the largest benefit from PAP in terms of a substantial reduction in BP, even after controlling for disease severity.
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Meta Analysis
Prader Willi syndrome and obstructive sleep apnea: co-occurrence in the pediatric population.
A high prevalence of obstructive sleep apnea (OSA) occurs in children with Prader-Willi syndrome (PWS). Yet, due in part to the relatively small samples previously used, the prevalence of OSA has varied greatly across studies. It is also unclear if factors such as age, gender, body mass index (BMI), or type of genetic imprinting are associated with increased risk for OSA among children with PWS. ⋯ This study confirms the high prevalence of OSA and narcolepsy among children with PWS. Screening for OSA and narcolepsy among children with PWS is recommended. In addition, while adenotonsillectomy was effective in reducing OSA for some children, alternative treatments may need to be considered, given the only moderate response rate.
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Randomized Controlled Trial
Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement.
Previous studies have demonstrated pronounced reduction of REM sleep on the first nights following major surgery which may influence pain, analgesic use, and recovery. This placebo-controlled, randomized, double-blind study set out to evaluate the effect of zolpidem on sleep architecture in an elderly population undergoing fast-track total hip and knee arthroplasty (THA/TKA) with length of stay < 3 days. ⋯ Krenk L; Jennum P; Kehlet H. Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement.
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Randomized Controlled Trial
Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation.
To investigate the effects of botulinum toxin type A (BoNT-A) injection on jaw motor episodes during sleep in patients with or without orofacial pain who did not respond to oral splint treatment. ⋯ Shim YJ; Lee MK; Kato T; Park HU; Heo K; Kim ST. Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation.