Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Cheyne Stokes Breathing (CSB), a form of central sleep apnea is often found in medical illnesses such as heart failure, stroke or renal failure. Adaptive servo-ventilation (ASV) has been reported to be an effective treatment of CSB in heart failure. However, there are no reports about using ASV for idiopathic CSB, which is not associated with heart failure or other serious medical problems. ⋯ A trial of ASV for patients with idiopathic CSB is recommended if they do not have improvement in sleep respiration or daytime performance on CPAP and/or oxygen.
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To assess, in individuals referred for evaluation of obstructive sleep apnea, the potential clinical significance of brief versus longer arousals from sleep. ⋯ Individuals with obstructive sleep apnea experience frequent respiratory event associated cortical arousals, many of which are greater than 15 seconds in duration. These longer arousals, which, in this study, constituted 18.4% of all arousals and accounted for 37.5% of the total arousal time, correlate more closely with the ESS than does the frequency or time attributable to the more numerous brief arousals. This suggests that these more-prolonged arousal events may have a greater impact on the restorative aspect of sleep, or on the perception thereof.
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To achieve consensus among pediatric sleep medicine practitioners on recommendations for the advancement of the field in the areas of research, clinical practice, education, and public policy. ⋯ Pediatric sleep medicine is a related, but unique, discipline within the broader field of sleep medicine. Additional research, both basic and clinical, on all aspects of children's sleep is necessary to elucidate the neurophysiologic basis of normal sleep development; to establish a solid foundation for the evaluation, diagnosis, and treatment of pediatric sleep disorders; and to formulate evidence-based public policy in sleep health.
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Sedative medications may be inadvertently prescribed to patients with undiagnosed obstructive sleep apnea (OSA) and may worsen daytime sleepiness. ⋯ Prescription of sedating medications may increase the risk of road accidents in patients with undiagnosed severe OSA, and such prescription practices are less likely to occur in physicians with expertise in sleep medicine.
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This report describes the associations, specificities, sensitivities, and positive likelihood ratios of clinical symptoms to a finding of sleep-disordered breathing (SDB) on polysomnography in children. ⋯ Snoring, excessive daytime sleepiness, and learning problems are each highly specific, but not sensitive, for SDB in 6- to 11-year old children. However, specificities and positive likelihood ratios for the combination of some of these symptoms is sufficiently high to suggest that some children may not require a polysomnogram for the diagnosis of SDB.