Sleep medicine
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The principal aim of this study was to, for the first time, examine the relationship between insomnia and perceived disability among workers with mild traumatic brain injury (mTBI)/concussion. ⋯ Greater attention should be given to the diagnosis and management of insomnia in persons with mTBI/concussion.
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The International Restless Legs Scale (IRLS) is the most widely used of the scales rating the severity of restless legs syndrome/Willis-Ekbom disease (RLS/WED). It has been well validated and is the primary end point for most of the therapeutic and nontherapeutic studies of RLS/WED. It has excellent psychometric properties, although it does not capture the severity of RLS under a wide variety of circumstances and times of day. Moreover, the IRLS has a large placebo effect. ⋯ At present, we view the RLS-6 not as a replacement for the IRLS but as a supplement, as each scale provides information not captured by the other.
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Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular disease because of its associated autonomic nervous and vascular regulatory dysfunctions. We tested the hypothesis that the multiscale entropy (MSE) approach to heart rate variability analysis may be used for evaluating OSA severity through simultaneous assessment of these abnormalities. ⋯ The results demonstrated significant severity-dependent deterioration in autonomic and vascular regulatory function in patients with OSA as reflected in the reductions in MEISS and MEILS, respectively, and notable improvement after CPAP treatment. The MEI obtainable through PSG may indicate not only OSA severity and physiological status but also therapeutic outcome for OSA patients.
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Assess efficacy and tolerability of gabapentin enacarbil (GEn) in adults with severe primary restless legs syndrome (RLS). ⋯ GEn (600 mg or 1200 mg) once daily significantly improved RLS symptoms and consequences of these symptoms in severe primary RLS. The most frequent TEAEs were somnolence and dizziness.
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Insomnia has not been explored as it relates to recovery after mild traumatic brain injury (mTBI). We aimed to evaluate the prevalence of insomnia among Ontario workers with delayed recovery from mTBI, and its relationship with sociodemographic, TBI- and claim-related, behavioral, and clinical factors. ⋯ Insomnia is common in persons with delayed recovery from mTBI, and is significantly associated with potentially modifiable clinical and nonclinical variables. Care of persons with brain injury requires greater attention with regard to the diagnosis and management of insomnia and associated disorders.