Sleep
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This report describes clinical outcomes and threshold levels of respiratory disturbance index (RDI) associated with sleep-disordered breathing in children participating in the Tucson Children's Assessment of Sleep Apnea study. ⋯ The Tucson Children's Assessment of Sleep Apnea study has shown that there are values of RDI based on polysomnography that correspond to an increased rate of clinical symptoms in children ages 6 to 11 years.
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Obstructive sleep apnea syndrome is associated with a marked increase in the risk for cardiovascular disease. Increased oxidative stress and leukocyte adhesiveness have been implicated as fundamental pathophysiologic mechanisms underlying the increased susceptibility in these patients. Haptoglobin is an antioxidant and immunomodulatory protein encoded by 2 alleles with profoundly different biophysical and biochemical properties. We therefore sought to determine if the haptoglobin phenotype was a determinant of cardiovascular disease in patients with obstructive sleep apnea syndrome. ⋯ These results suggest that haptoglobin phenotype is an important risk factor in determining susceptibility to cardiovascular disease in obstructive sleep apnea syndrome, which may be mediated by the decreased antioxidant and antiinflammatory actions of the haptoglobin 2 allelic protein product.
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To examine the hypothesis that respiratory events in obstructive sleep apnea syndrome (OSAS) end in arousal not detected by conventional electroencephalographic (EEG) leads. ⋯ The addition of a single frontal lead (Fz) yields additional respiratory-related arousal information that appears physiologically relevant. Future studies are needed to assess clinical relevance to the evaluation and treatment of sleep-disordered breathing.
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To determine whether the brain stem can independently support the processes of rapid eye movement sleep rebound and pressure that follow deprivation. ⋯ Rebound in rapid eye movement sleep after deprivation cannot be sustained by the brain stem alone; in contrast, rapid eye movement sleep pressure persisted in the decerebrate cat, demonstrating that this process does not depend on descending forebrain influences. This indicates that rebound and pressure are 2 different components of the recovery process after rapid eye movement sleep deprivation and that, as such, are likely controlled by different mechanisms.
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Review Comparative Study
The role of actigraphy in the study of sleep and circadian rhythms.
In summary, although actigraphy is not as accurate as PSG for determining some sleep measurements, studies are in general agreement that actigraphy, with its ability to record continuously for long time periods, is more reliable than sleep logs which rely on the patients' recall of how many times they woke up or how long they slept during the night and is more reliable than observations which only capture short time periods. Actigraphy can provide information obtainable in no other practical way. It can also have a role in the medical care of patients with sleep disorders. ⋯ In conclusion, the latest set of research articles suggest that in the clinical setting, actigraphy is reliable for evaluating sleep patterns in patients with insomnia, for studying the effect of treatments designed to improve sleep, in the diagnosis of circadian rhythm disorders (including shift work), and in evaluating sleep in individuals who are less likely to tolerate PSG, such as infants and demented elderly. While actigraphy has been used in research studies for many years, up to now, methodological issues had not been systematically addressed in clinical research and practice. Those issues have now been addressed and actigraphy may now be reaching the maturity needed for application in the clinical arena.