Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Randomized Controlled Trial Multicenter Study Controlled Clinical Trial
Exploratory polysomnographic evaluation of pregabalin on sleep disturbance in patients with epilepsy.
To evaluate the effects of adjunctive pregabalin 300 mg/day versus placebo on polysomnographic (PSG) variables in patients with well controlled partial seizures and subjectively reported sleep disturbance. ⋯ This exploratory pilot study suggests that pregabalin may improve sleep continuity in patients with clinically relevant sleep disturbance. The effect on disturbed sleep appears independent of seizure control. The effects of pregabalin on disturbed sleep and seizures and their interrelationships warrant further study.
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Comparative Study
Chronic opioid use is a risk factor for the development of central sleep apnea and ataxic breathing.
Chronic opioid therapy for pain management has increased dramatically without adequate study of potential deleterious effects on breathing during sleep. ⋯ There is a dose-dependent relationship between chronic opioid use and the development of a peculiar pattern of respiration consisting of central sleep apneas and ataxic breathing. Although potentially significant, the clinical relevance of these observations remains to be established.
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To evaluate the prevalence and natural history of sleepiness following traumatic brain injury. ⋯ Sleepiness is common following traumatic injury, particularly TBI, with more severe injuries resulting in greater sleepiness. Sleepiness improves in many patients, particularly those with TBI. However, about a quarter of TBI subjects and non-cranial trauma control subjects remained sleepy 1 year after injury.
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Determine prevalence and consequences of sleepiness and sleep disorders after traumatic brain injury (TBI). ⋯ There is a high prevalence of sleep disorders (46%) and of excessive daytime sleepiness (25%) in subjects with TBI. Sleepy subjects may be more impaired than comparable non-sleepy TBI subjects, yet be unaware of problems. Given the high prevalence of OSA (23%), PTH (11%), and narcolepsy (7%) in this population, there is a clinical indication for NPSG and MSLT.
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To examine the spectrum of sleep disorders in patients with chronic traumatic brain injury (TBI) and determine if the severity of sleep disorder is related to severity of chronic TBI. ⋯ The results of this study demonstrate that a full spectrum of common sleep disorders occurs in patients with chronic TBI. The severity of chronic TBI as measured by GAF scores is correlated with some of the measures of sleep disruption but not others, indicating a complex and multifactorial pathogenesis.