Sleep
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Sleep deprivation is believed to worsen obstructive sleep apnea (OSA). We assessed the effect of acute sleep deprivation on polysomnography in a cohort of subjects with mild OSA and a cohort of subjects without OSA. ⋯ Acute sleep deprivation did not worsen most OSA parameters as measured by polysomnography. A lower minimum oxygen saturation in mild OSA subjects after sleep deprivation may be important in patients with significant cardiorespiratory disease. More research is needed to assess whether daytime performance and function (eg, driving, sleepiness) is more greatly impaired in OSA subjects who are sleep deprived, compared to normal subjects who are sleep deprived.
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To assess the prevalence of sleep-disordered breathing in a nonselected group of children with Down syndrome and to determine significant predisposing factors for this condition. ⋯ The prevalence of sleep-disordered breathing in children with Down syndrome is very high, particularly in boys. Tonsillar hyperplasia may play a role in the pathophysiology of sleep-disordered breathing in these patients. Adenoid hyperplasia, obesity, and congenital heart disease were not important risk factors for sleep-disordered breathing.
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To help practitioners avoid adverse perioperative events in patients with obstructive sleep-disordered breathing. ⋯ Scientific literature regarding the perioperative risk and best management techniques for OSAHS patients is scanty and of limited quality. There is insufficient information to develop an AASM standards of practice recommendation. Therefore, the Clinical Practice Review Committee (CPRC) used the available data to make this statement based upon a consensus of clinical experience and published peer-reviewed medical evidence. Important components of the perioperative management of OSAHS patients include a high degree of clinical suspicion, control of the airway throughout the perioperative period, judicious use of medications, and appropriate monitoring. Further research is needed to define the magnitude of risk and optimal perioperative care.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, double-blind clinical trial comparing continuous positive airway pressure with a novel bilevel pressure system for treatment of obstructive sleep apnea syndrome.
To obtain efficacy, objective compliance, and self-assessment data from obstructive sleep apnea syndrome (OSAS) patients treated with continuous positive airway pressure (CPAP) or a novel bilevel (NBL) therapy. ⋯ The NBL appeared to be as effective as CPAP for the treatment of OSAS but offered no advantages in patients receiving first-time therapy for OSAS.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A multicenter, placebo-controlled trial of melatonin for sleep disturbance in Alzheimer's disease.
To determine the safety and efficacy of 2 dose formulations of melatonin for the treatment of insomnia in patients with Alzheimer's disease. ⋯ Based on actigraphy as an objective measure of sleep time, melatonin is not an effective soporific agent in people with Alzheimer's disease.