Sleep medicine
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Editorial Comment
Treatment-emergent central sleep apnea at high altitude.
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Randomized Controlled Trial
Effect of below-the-knee compression stockings on severity of obstructive sleep apnea.
Overnight fluid shift from the legs to the neck may narrow the upper airway and contribute to obstructive sleep apnea (OSA) pathogenesis. We hypothesized that below-the-knee compression stockings will decrease OSA severity in a general OSA population by decreasing daytime leg fluid accumulation and overnight fluid shift and increasing upper-airway size. ⋯ These observations suggest that in, a general OSA population, below-the-knee compression stockings decrease OSA severity modestly via attenuation of overnight fluid shift and consequent upper-airway dilatation.
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Sleep disturbance is reported to be frequent in epilepsy. The role of comorbidity, which is frequently accompanied by sleep disturbance, has not been investigated. The present study assessed sleep disorders and circadian rhythm in patients with epilepsy, in whom relevant comorbidity was carefully excluded. ⋯ The present study demonstrated that chronic sleep disturbance is not increased in patients with well-controlled epilepsy without relevant comorbidity. This supports comorbidity and insufficient seizure control as major contributors of sleep disturbance in epilepsy.
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Efficient treatments to phase-advance human circadian rhythms are needed to attenuate circadian misalignment and the associated negative health outcomes that accompany early-morning shift work, early school start times, jet lag, and delayed sleep phase disorder. This study compared three morning bright-light exposure patterns from a single light box (to mimic home treatment) in combination with afternoon melatonin. ⋯ A 30-min morning bright-light exposure with afternoon melatonin is an efficient treatment to phase-advance human circadian rhythms.
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Observational Study
Sleep apnea and periodic leg movements in the first year after spinal cord injury.
Sleep disturbances are frequently reported by patients with spinal cord injury (SCI). Studies have shown an increased incidence of sleep-disordered breathing (SDB) and periodic leg movements during sleep (PLMS) in people with stable long-term SCI. ⋯ This study confirms a high frequency of SDB and PLMS in SCI patients in the first year following injury. Independently from possible sub-acute and chronic clinical variables, the level and the completeness of the spinal cord lesion are the main factors associated respectively with an early development of SDB and PLMS.