Journal of clinical sleep medicine : JCSM : official publication of the American Academy of 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.
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Whereas both oxygen therapy and nasal continuous positive airway pressure (CPAP) decrease the apnea-hypopnea index (AHI) in patients with Cheyne-Stokes respiration (CSR) and congestive heart failure (CHF), only nasal CPAP is known to affect the left ventricular ejection fraction (LVEF). We therefore evaluated the effects of 1 month of nocturnal oxygen therapy on LVEF. ⋯ Although 1 month of nocturnal oxygen therapy decreases the AHI in patients with CSR and CHF, there is no improvement in left ventricular function.
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Randomized Controlled Trial
Gabapentin improves sleep in the presence of alcohol.
To evaluate the ability of a single dose of gabapentin to improve sleep disruption caused by alcohol consumption. ⋯ Single-dose gabapentin at bedtime can improve sleep through decreased stage 1 sleep, increased slow-wave sleep, increased sleep efficiency, and decreased arousals. Gabapentin may be useful in the treatment of conditions in which frequent awakenings and decreased sleep efficiency are seen.
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To identify the frequency and duration of those arousals exceeding fifteen seconds in length, in patients with obstructive sleep apnea. ⋯ Patients with obstructive sleep apnea experience frequent respiratory event associated cortical arousals, many of which are greater than fifteen seconds in duration. There is the potential for these more prolonged arousals to be scored as epochs of Wake, which may result in their being reported as contributing to Wake After Sleep Onset (WASO) time, rather than as distinct arousals. This may result in an under-appreciation of both the frequency with which these prolonged arousals may occur, and the potential effect these arousals may have on the severity of the sleep fragmentation.