Sleep medicine reviews
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Sleep medicine reviews · Aug 2014
Meta AnalysisAttention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis.
A relationship between attention deficit hyperactivity disorder (ADHD) and sleep disordered breathing (SDB) in children and adolescents has been suggested by some authors. Yet, this topic remains highly controversial in the literature. A meta-analysis was conducted in order to examine the extent of relationship between SDB and ADHD symptoms in pediatric populations and whether there are differences in ADHD symptoms pre- versus post-adenotonsillectomy in pediatric populations. ⋯ The findings of this meta-analysis suggest that ADHD symptoms are related to SDB and improve after adenotonsillectomy. Therefore, patients with ADHD symptomatology should receive SDB screening. Treatment of comorbid SDB should be considered before medicating the ADHD symptoms if present.
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Sleep medicine reviews · Aug 2014
ReviewUnattended home-based polysomnography for sleep disordered breathing: current concepts and perspectives.
Recently, portable sleep recording devices became an accepted alternative to polysomnography (PSG) for obstructive sleep apnea (OSA) diagnosis in patients with a high pre-test probability of moderate to severe OSA but home polysomnography (H-PSG) was not recommended because there were insufficient data. The present review has analysed six prospective randomized crossover studies comparing H-PSG to in-lab PSG. These studies convincingly showed that H-PSG allows complete sleep evaluation. ⋯ Recently, remotely attended H-PSG via telemonitoring has been tested and may reduce H-PSG failure rate. In conclusion, H-PSG can be used to rule-in and rule out OSA in suspected patients, even in the presence of co-morbidities and is an alternative when simplified sleep testing is negative. Future developments should target simplification of technical aspects of H-PSG, together with remote monitoring, in order to obtain good quality H-PSG performed in adequate conditions.