Sleep medicine
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Multicenter Study Comparative Study
Benefit and risk of modafinil in idiopathic hypersomnia vs. narcolepsy with cataplexy.
The benefit/risk ratio of modafinil was recently re-evaluated by the European Medicines Agency and was shown to be negative for idiopathic hypersomnia (IH) because of insufficient data. ⋯ Modafinil has an excellent benefit/risk ratio in idiopathic hypersomnia, with or without long sleep time, similar to its effect on narcolepsy/cataplexy.
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Comparative Study
Alterations in pain responses in treated and untreated patients with restless legs syndrome: associations with sleep disruption.
There has been recent interest in characterizing potential abnormalities of pain processing in patients with sleep disorders such as Restless Legs Syndrome (RLS). The aim of this study was to evaluate psychophysical responses to noxious heat and pressure stimuli in both treated and untreated RLS patients, compared to matched controls. ⋯ These findings suggest that central nervous system pain processing may be amplified in RLS, perhaps partially as a consequence of sleep disruption. RLS patients, even those whose symptoms are managed pharmacologically, may be at elevated long-term risk for the development or maintenance of persistent pain conditions. Further studies in larger samples could help to improve the prospects for pain management in RLS patients.
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Comparative Study
Comparison of two servo ventilator devices in the treatment of complex sleep apnea.
Servo ventilation (SV) devices generate positive airway pressure with a variable pressure support that changes in response to a patient's own respiratory output. Two currently available SV devices-VPAP-AdaptSV® and BIPAP-AutoSV®-have been used in treatment of complex sleep apnea (CompSAS), but no side-by-side comparisons are available. ⋯ Our retrospective data indicate that the two servo-ventilation devices are comparable means of controlling complex sleep apnea, and the compliance with them is high.