Sleep
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Expiratory changes in pressure: flow ratio during sleep in patients with sleep-disordered breathing.
The size of the upper airway is smallest during sleep, at the end of expiration. This may favor upper-airway collapse in patients with obstructive sleep apnea. In the respiratory cycles preceding obstructive events during sleep, our hypothesis is that upper-airway resistance (UAR) increased earlier during expiration prior to changes occurring during inspiration. ⋯ Increases in the expiratory UAR occurred earlier than during inspiration in the cycles preceding upper-airway collapse in patients with sleep apnea. This finding suggested an important role of the expiratory phase in promoting upper-airway collapse and is in accordance with the inspiratory pharyngeal instability occurring when lowering the expiratory pressure in patients with obstructive sleep apnea.
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To define the clinical and polysomnographic features of a distinct variant of obstructive sleep-disordered breathing that is remarkably mild during rapid eye movement (REM) sleep. ⋯ This variant of sleep apnea may reflect a dominant component of respiratory instability and periodic breathing coupled with upper-airway obstruction. Its existence questions the conventional practice of calculating global respiratory indexes. Besides positive airway pressure, measures to treat periodic breathing may be required.
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We sought to assess the predictive validity of parental report of snoring and other behaviors by comparing such reports with objective findings from overnight polysomnography for the evaluation of sleep-disordered breathing in 2 nonclinical samples, namely, at-risk preschoolers and an older group reflective of the general community. Predictive validity of snoring alone and a score based on multiple child behaviors were compared to outcome at different levels of severity of sleep-disordered breathing. ⋯ Scores derived from parental-report questionnaires of children's snoring and other sleep and wake behaviors can be used as surrogate predictors of snoring or sleep-disordered breathing in children. However, design and interpretation should consider age, risk status, and the purpose of the screening assessment.
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To investigate the relationship between the presence of a television set, a gaming computer, and/or an Internet connection in the room of adolescents and television viewing, computer game playing, and Internet use on the one hand, and time to bed, time up, time spent in bed, and overall tiredness in first- and fourth-year secondary-school children on the other hand. ⋯ Concerns about media use should not be limited to television. Computer game playing and Internet use are related to sleep behavior as well. Leisure activities that are unstructured seem to be negatively related to good sleep patterns. Imposing more structure (eg, end times) might reduce impact.
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Obstructive sleep apnea syndrome (OSA) is associated with an increased rate of cardiovascular morbidity, which has been suggested to be related to oxidative stress. The present study investigated the concentration of lipid peroxidation biomarkers in patients with OSA in comparison with nonapneic controls and the effects of treatment with nasal continuous positive airway pressure (nCPAP) on these biomarkers. ⋯ These results support the existence of an increased state of oxidative stress in OSA and its possible involvement in cardiovascular morbidity.