Sleep & breathing = Schlaf & Atmung
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This study examined the effects of various factors that might influence the fraction of oxygen in inspired air (FiO (2)) in a human and in a model system during nasal positive pressure treatments. ⋯ In patients using nasal positive pressure therapy, variables of pressure, leak around the mask, and the site of oxygen delivery determine the inspired oxygen concentration when giving oxygen supplementation.
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To assess an uncontrolled, open-label trial of sleep-disordered breathing (SDB) treatment on two different samples of chronic insomnia patients. ⋯ In one small sample of chronic insomnia patients with SDB, objective measures of insomnia, arousal, and sleep improved during one night of CPAP titration. In a second small sample, validated measures of insomnia, sleep quality, and sleep impairment demonstrated clinical cures or near-cures after combined CBT and SDB therapies. These pilot results suggest a potential value in researching the pathophysiological relationships between SDB and chronic insomnia, which may be particularly relevant to patients with refractory insomnia.
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We report a 38-year-old man with obstructive sleep apnea whose sleep-disordered breathing was substantially reduced by sleep in the supine, "knees-up" position, relative to his sleep in the customary supine, "knees-down" position. No obvious anatomic or pathophysiologic alterations explained this phenomenon. ⋯ Potential mechanisms underlying such improvement, including alterations in upper airway/lung volume dependence and venous supply to upper airway vasculature, are discussed. This manipulation could be an important adjunctive treatment for a subset of obstructive sleep apnea patients demonstrating such an effect.
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Enuresis, the involuntary release of urine during sleep, is one of the most common disorders of childhood. More common in boys than girls, this condition is characterized by night-time wetting in the presence of normal urinalysis and physical examination. ⋯ Treatment of long-standing chronic enuresis by orthodontic appliances could be used more frequently to give relief to those not responding to conventional treatment. Mandibular advancement therapy is especially beneficial in the treatment of enuretic patients presenting with anteroposterior skeletal discrepancies.