Sleep
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To analyze the prevalence of sleep problems in subjects with Chronic rhinosinusitis (CRS) and to determine whether the disease severity of CRS affects sleep quality. ⋯ Sleep problems are highly prevalent among subjects with CRS. The disease severity of CRS negatively affects sleep quality.
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Observational Study
Change in Job Strain as a Predictor of Change in Insomnia Symptoms: Analyzing Observational Data as a Non-randomized Pseudo-Trial.
To examine whether change in job strain leads to change in insomnia symptoms. ⋯ These results suggest that job strain is a modifiable risk factor for insomnia symptoms.
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A number of subjective and objective studies provide compelling evidence of chronic post-concussion changes in sleep, yet very little is known about the acute effects of concussion on sleep quality and quantity. Therefore, the purpose of this prospective pilot study was to use actigraphy to examine the changes in sleep quality and quantity acutely following concussion at home rather than in a hospital or sleep laboratory. ⋯ Individuals with a concussion demonstrated increased nighttime sleep duration variability. This increase persisted at 1 mo post-injury and may be associated with previously documented self-reports of poor sleep quality lasting months and years after a concussion. Additionally, this increase may predispose individuals to numerous negative health outcomes if left untreated.
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Arousals from sleep vary in duration and intensity. Accordingly, the physiological consequences of different types of arousals may also vary. Factors that influence arousal intensity are only partly understood. This study aimed to determine if arousal intensity is mediated by the strength of the preceding respiratory stimulus, and investigate other factors mediating arousal intensity and its role on post-arousal ventilatory and pharyngeal muscle responses. ⋯ Average arousal intensity is independent of the preceding respiratory stimulus. This is consistent with arousal intensity being a distinct trait. Respiratory and pharyngeal muscle responses increase with arousal intensity. Thus, patients with higher arousal intensities may be more prone to respiratory control instability. These findings are important for sleep apnea pathogenesis.
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Randomized Controlled Trial
The Combination of Supplemental Oxygen and a Hypnotic Markedly Improves Obstructive Sleep Apnea in Patients with a Mild to Moderate Upper Airway Collapsibility.
Obstructive sleep apnea (OSA) results from the interaction of several physiological traits; specifically a compromised upper airway anatomy and muscle function, and two key non-anatomical deficits: elevated loop gain and a low arousal threshold. Although continuous positive airway pressure (CPAP) is an efficacious treatment, it is often poorly tolerated. An alternative approach could involve administering therapies targeting the non-anatomic causes. However, therapies (oxygen or hypnotics) targeting these traits in isolation typically improve, but rarely resolve OSA. Therefore, our aim was to determine how the combination of oxygen and eszopiclone alters the phenotypic traits and OSA severity and to assess the baseline phenotypic characteristics of responders/nonresponders to combination therapy. ⋯ ClinicalTrials.gov, ID: NCT01633827.