Sleep medicine
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Randomized Controlled Trial Comparative Study
The efficacy of three different mask styles on a PAP titration night.
This study compared the efficacy of three different masks, nasal pillows, nasal masks and full face (oronasal) masks, during a single night of titration with continuous positive airway pressure (CPAP). ⋯ CPAP applied with either nasal mask was effective in treating mild, moderate, and severe sleep apnea. The oronasal mask required significantly higher pressures in subjects with moderate to severe disease. Therefore, when changing from a nasal to an oronasal mask, a repeat titration is required to ensure effective treatment of sleep apnea, especially in patients with moderate to severe disease.
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Overnight increases in neck circumference - attributed to rostral fluid displacement - correlate with the severity of obstructive sleep apnea (OSA). No studies were found investigating the relationship between OSA severity and recumbence-related immediate changes in neck circumference. We evaluated the relationship of OSA severity with immediate recumbence-related and overnight changes in neck circumference in obese and nonobese subjects. ⋯ Correlation of AHI with the immediate increase in neck circumference on assuming recumbence indicates that fast components of tissue displacement, besides overnight fluid displacement, may have implications in the pathogenesis of OSA.
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Comparative Study
Sleepiness and fatigue following traumatic brain injury.
To compare individuals with traumatic brain injury (TBI) to healthy controls (CTLs) on measures of sleepiness, fatigue, and sleep, and explore correlates of sleepiness and fatigue separately for each group. ⋯ Fatigue appeared to be a more prominent symptom than sleepiness when assessed between 1 and 11 years after TBI. Participants with TBI used compensatory strategies such as increasing time spent in bed and daytime napping in this sample. Future research should document the time course of sleepiness and fatigue after TBI and investigate treatment options.
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To evaluate the efficacy and side effect profile of sodium oxybate in the treatment for narcolepsy-cataplexy in the pediatric age group. ⋯ Sodium oxybate is effective in alleviating sleepiness and cataplexy in childhood onset narcolepsy-cataplexy. The therapeutic response was sustained over time, and without development of tolerance. Forty percent of the subjects experienced adverse effects.