Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Restless leg syndrome in different types of demyelinating neuropathies: a single-center pilot study.
to determine the prevalence of restless legs syndrome (RLS) in a cohort of patients with demyelinating neuropathies. ⋯ our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-center retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicenter studies are probably needed to clarify the real meaning of the association between RLS and neuropathy.
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Is the treatment of obstructive sleep apnea (OSA) with mandibular advancement device (MAD) similar in health outcomes to continuous positive airway pressure (CPAP) in the short term (one month health outcomes)? ⋯ The study was supported by Project Grant 457557, Practitioner Fellowship 202916 (R.R.G.), Health Professional Fellowship 571179, and CIRUS Postdoctoral Fellowship (C.L.P.) from the Australian National Health and Medical Research Council. ResMed Inc. donated all continuous positive airway pressure equipment for the trial. SomnoMed Ltd. donated all oral appliances for the trial and an unrestricted grant of A$60,000 to support the study.
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Adaptive servoventilation devices are marketed to overcome sleep disordered breathing with apneas and hypopneas of both central and obstructive mechanisms often experienced by patients with chronic heart failure. The clinical efficacy of these devices is still questioned. ⋯ The tested devices reacted as expected to the disordered breathing events, but not sufficiently to normalize the breathing flow. The device-scored results should be used with caution to judge efficacy, as their validity depends upon the initial settings.
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Sleep disordered breathing (SDB) is common in patients with chronic heart failure secondary to non-valvular heart disease; however, the prevalence and characteristics of SDB in patients with rheumatic valvular heart disease (RVHD) are unclear. This study was designed to determine the prevalence, characteristics, and risk factors for SDB in RVHD patients. ⋯ Patients with RVHD had a high prevalence of SDB (predominantly CSA). RVHD patients with SDB, particularly those who had CSA, manifested more severe symptoms and greater impairment of cardiac function. Assessments of clinical manifestations of cardiac dysfunction may be important for predicting the risk factors for SDB.
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In obstructive sleep apnea (OSA), arousals generally occur at apnea termination and help restore airflow. However, timing of arousals in central sleep apnea (CSA) has not been objectively quantified, and since arousals can persist even when CSA is alleviated, may not play the same defensive role as they do in OSA. We hypothesized that arousals following central events would occur longer after event termination than following obstructive events and would be related to circulation time. ⋯ In HF patients with CSA, apnea-to-arousal latency is longer than in those with OSA, and arousals usually follow resumption of airflow. These observations provide evidence that arousals are less likely to act as a protective mechanism to facilitate resumption of airflow following apneas in CSA than in OSA.