Sleep medicine reviews
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Sleep medicine reviews · Oct 2013
ReviewObstructive sleep apnoea and schizophrenia--a research agenda.
Schizophrenia is associated with significantly increased physical morbidity and mortality particularly secondary to cardiometabolic disorders. In people with schizophrenia, rates of obesity and the metabolic syndrome are high compared to the general population. Whilst the weight gain secondary to antipsychotic medication is largely to blame, other factors include inactivity, poor diet and possibly the illness itself. ⋯ Available data suggest increased rates of sleep apnoea in schizophrenia and that psychotic symptoms may improve when co-morbid sleep apnoea is treated. Health practitioners may be unaware of the need to screen for sleep apnoea in patients with schizophrenia and the disorder may be significantly under-recognised. Research is required to clarify the epidemiology, consequences and management of sleep apnoea in association with schizophrenia.
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Sleep medicine reviews · Jun 2013
ReviewObstructive sleep apnea and hypertrophic cardiomyopathy: a common and potential harmful combination.
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease and is characterized by large and asymmetric septal and left ventricle hypertrophy. HCM is a cause of disability, including heart failure, atrial fibrillation, and sudden death, with an annual mortality varying from 1% to 6%. Obstructive sleep apnea (OSA) is extremely common among patients with established cardiovascular disease, including hypertension and atrial fibrillation and when present may contribute to worse cardiovascular outcome. ⋯ The presence of OSA among patients with HCM is independently associated with worse structural and functional impairment of the heart, including atrial and aorta enlargement, worse New York Heart Association functional class, and worse quality of life. The prevalence of atria fibrillation, an independent marker of mortality among patients with HCM, is significantly higher (∼four times) in the presence of OSA. Therefore, the recognition of OSA is a new area of research that may impact the management of patients with HCM.
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Sleep medicine reviews · Apr 2013
The reciprocal interaction between obesity and obstructive sleep apnoea.
Obesity is a significant risk factor in the pathogenesis of obstructive sleep apnoea (OSA) altering airway anatomy and collapsibility, and respiratory control. The association between obesity and OSA has led to an increasing focus on the role of weight loss as a potential treatment for OSA. To date, most discussion of obesity and OSA assumes a one-way cause and effect relationship, with obesity contributing to the pathogenesis of OSA. ⋯ OSA has a potential role in the development and reinforcement of obesity via changes to energy expenditure during sleep and wake periods, dietary habits, the neurohormonal mechanisms that control satiety and hunger, and sleep duration arising from fragmented sleep. Thus, there is emerging evidence that OSA itself feeds back into a complex mechanism that leads either to the development or reinforcement of the obese state. Whilst current evidence does not confirm that treatment of OSA directly influences weight loss, it does suggest that the potential role OSA plays in obesity and weight loss deserves further research.
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Sleep medicine reviews · Dec 2012
ReviewInterventions with a sleep outcome for children with cerebral palsy or a post-traumatic brain injury: a systematic review.
The purpose of this study was to conduct a systematic literature review on interventions for sleep problems in children (aged 0-12 years) with cerebral palsy (CP) or traumatic brain injury (TBI). The literature describes sleep disorders as common in both conditions. Criteria were expanded to include interventions for other medical conditions where sleep was measured as an outcome. ⋯ No studies using melatonin studied CP patients exclusively. The one study where sleep was measured as a secondary outcome for TBI was of limited value. In conclusion, more well-designed studies are necessary to advance evidence-based treatments in the area of sleep problems for these chronic pediatric conditions.