Sleep
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Randomized Controlled Trial
Effects of armodafinil on simulated driving and alertness in shift work disorder.
Forty-one percent of shift workers report dozing while driving. This study tested whether armodafinil improves driving simulator performance in subjects with shift work disorder (SWD). A primary outcome was performance late in the shift when workers are typically driving home. ⋯ Armodafinil 150 mg early in the night shift improves driving simulator performance in SWD. Effects on sleepiness, cognition, and driving were found up to 9.5 h post-ingestion, during the critical time when many night workers are driving home.
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Randomized Controlled Trial Multicenter Study
Effectiveness of home single-channel nasal pressure for sleep apnea diagnosis.
Home single-channel nasal pressure (HNP) may be an alternative to polysomnography (PSG) for obstructive sleep apnea (OSA) diagnosis, but no cost studies have yet been carried out. Automatic scoring is simpler but generally less effective than manual scoring. ⋯ Clinicaltrials.gov identifier: NCT01347398.
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Clinical Trial
Quality-adjusted life-years gain and health status in patients with OSAS after one year of continuous positive airway pressure use.
To estimate the health utility score and quality-adjusted life-years (QALY) index of obstructive sleep apnea syndrome (OSAS) in patients over 1 y of continuous positive airway pressure (CPAP) treatment. ⋯ This study showed a significant QALY/patient gain after 1 y of regular CPAP use. In addition, BP normalization was associated with higher QALY gain. Thus, utility studies can provide more complete analyses of the total benefits of CPAP treatment in patients with OSAS and should be encouraged.
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The basal forebrain cholinergic system is involved in cognitive processes that require an attentive state, an increased level of arousal, and/ or cortical activation associated with low amplitude fast EEG activity. The activity of most neurons in the basal forebrain cholinergic space is tightly correlated with the cortical EEG and the activity state. While most cholinergic neurons fire maximally during waking and REM sleep, the activity of other types of basal forebrain neurons vastly differs across different arousal and sleep states. Numerous studies have suggested a role for the basal forebrain cholinergic neurons in eliciting cortical activation and arousal. However, the intricate local connectivity within the region requires the use of cell-specific manipulation methods to demonstrate such a causal relationship. ⋯ Our results show that optogenetic activation of BF cholinergic neurons during NREM sleep is sufficient to elicit cortical activation and facilitate state transitions, particularly transitions to wakefulness and arousal, at a time scale similar to the activation induced by other subcortical systems. Our results provide in vivo cell-specific demonstration for the role of basal forebrain cholinergic system in induction of wakefulness and arousal.