Sleep & breathing = Schlaf & Atmung
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Randomized Controlled Trial
Assessment of the test-retest reliability of laboratory polysomnography.
When conducting a treatment intervention study, it is assumed that a level of reliability can be obtained from the measurement tool such that the outcome can be reasonably assessed. ⋯ In this study, the reliability of a single-night PSG in measuring treatment outcome was compromised as a result of the large night-to-night variability of subjects' obstructive sleep apnea (OSA). Studies employing the AHI as an outcome need to be adequately powered with respect to the inherent night-to-night variability in the measurement. When assessing treatment intervention outcomes, there may be benefit from the acquisition and averaging of multiple nights of data in order to mitigate the inherent night-to-night variability of OSA and improve the accuracy of the outcome assessment.
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Randomized Controlled Trial
Mandibular advancement splint titration in obstructive sleep apnoea.
Mandibular advancement splints (MAS) allowing self-adjustment may be better tolerated, but the optimum titration protocol needs systematic study. ⋯ In selected patients, titratable MAS improved or resolved OSA in the majority of patients and was well tolerated. PSG-based feedback at 3 weeks allowed objective confirmation of efficacy and increased device use but did not result in greater improvement in AHI or symptoms. Neither titration method was significantly superior for us to provide firm endorsement. However, we recommend a follow-up sleep study to confirm MAS efficacy.
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Subjects on methadone maintenance for drug addiction have been reported to have central sleep apnea (CSA). However, there are few reports of disordered breathing in patients receiving opioids for chronic pain. ⋯ Treatment of opioid-associated CSA with BLV corrected nocturnal hypoxemia and reduced sleep fragmentation. Randomized controlled trials, with objective measures of daytime function, are recommended in opioid-induced CSA patients.
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The prevalence of sleep breathing disorders in patients with congestive heart failure is relevantly high. According to historical studies Cheyne-Stokes respiration is an oscillatory ventilation during sleep in up to 40% of patients with congestive heart failure. During the last decade the medical treatment of congestive heart failure has been improved. The aim of this investigation was to analyze the prevalence of Cheyne-Stokes respiration in patients with congestive heart failure and modern medical treatment. ⋯ Thus, no significant change of Cheyne-Stokes prevalence could be found in our modern treated severe congestive heart failure collective.
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Randomized Controlled Trial
Pulse transit time for scoring subcortical arousal in infants with obstructive sleep apnea.
An altered autonomic control and response to respiratory events during sleep have been reported in infants with obstructive sleep apnea but appropriate methods are not established. We assessed the feasibility of pulse transit time (PTT) in detecting subcortical arousals in eight infants (median age 7 days) suffering from the Pierre Robin sequence and obstructive sleep apnea. ⋯ The feasibility of PTT in scoring apnea-related subcortical arousals in infants may be questionable. However, scoring spontaneous PTT arousals may be an approach for assessing sleep disruption in infants with obstructive sleep apnea.