Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
-
Our objective was to evaluate a portable device (Somté, Compumedics, Australia), which incorporates 2 neurophysiological channels (electroencephalography and electrooculography) with cardiorespiratory monitoring for the diagnosis of obstructive sleep apnea (OSA). ⋯ These data suggest that Somté is an effective device to identify sleep and respiratory variables in patients with suspected OSA.
-
Randomized Controlled Trial Multicenter Study
Diagnosis and Treatment of Sleep Apnea in patients' homes: the rationale and methods of the "GoToSleep" randomized-controlled trial.
The "Diagnosis and Treatment of Sleep Apnea in Cerebrovascular Disease" (GoToSleep) study is evaluating a strategy to improve the diagnosis and treatment of sleep apnea among veterans with stroke or transient ischemic attack (TIA) who also have hypertension. Specifically, the GoToSleep study was designed to overcome some of the barriers that exist within the Veterans Health Administration (VHA) to the timely diagnosis and treatment of sleep apnea by using ambulatory home-based polysomnography and auto-titrating continuous positive airway pressure (CPAP) to reduce the reliance on laboratory-based sleep studies. ⋯ This manuscript provides the rationale for 4 key components of the design of the GoToSleep trial: the inclusion of patients with cerebrovascular disease and hypertension without the use of a measure of daytime sleepiness as an eligibility criterion; the use of portable polysomnography and auto-titrating CPAP in patients' homes rather than using sleep laboratory polysomnography with fixed pressure CPAP; the analytic approach to evaluating change in blood pressure in the context of change in antihypertensive medications; and the use of a usual care control group.
-
Randomized Controlled Trial
Randomized, double-blind clinical trial of two different modes of positive airway pressure therapy on adherence and efficacy in children.
To determine the effects of bilevel positive airway pressure with pressure release technology (Bi-Flex) on adherence and efficacy in children and adolescents compared to standard continuous positive airway pressure (CPAP) therapy. We hypothesized that Bi-Flex would result in improved adherence but similar efficacy to CPAP. ⋯ Both CPAP and Bi-Flex are efficacious in treating children and adolescents with OSAS. However, adherence is suboptimal with both methods. Further research is required to determine ways to improve adherence in the pediatric population.
-
In order to provide a comprehensive estimate of the health risks for OSA patients, we analyzed multiple outcomes and independent predictors of these outcomes in an OSA population evaluated and followed at one sleep center. ⋯ Mortality and cardiovascular event outcomes were predicted by demographics and cardiovascular disease history more commonly than by OSA severity. OSA severity was an important predictor of mortality in male and young OSA patients. CPAP use appeared protective in older and male severe OSA patients.
-
Case Reports
Unilateral hemidiaphragm weakness is associated with positional hypoxemia in REM sleep.
Patients with unilateral diaphragmatic paralysis (UDP) have been reported to have varied respiratory symptoms and often reduced lung function. We sought to describe the polysomnographic respiratory characteristics in patients with UDP without obstructive sleep apnea. ⋯ Patients with UDP demonstrate position-dependent hypopneas in REM sleep with frequent desaturations.