Sleep medicine
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There is little information on diagnostic rates or treatment correlates of insomnia in real-world practice. Study objectives were to identify the 1-year prevalence, psychotropic pharmacotherapy and clinical correlates of diagnosed insomnia, nationally in the Veterans Health Administration (VHA). ⋯ The diagnosis of insomnia is associated with the filling of more psychotropic prescriptions, net of the presence of psychiatric co-morbidity in national VHA administrative data, and the prevalence of diagnosed insomnia is lower than that found in systematic surveys of the general population, a potential impediment to optimal treatment.
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The aim of this study was to characterize health-care utilization, costs, and productivity in a large population of patients diagnosed with narcolepsy in the United States. ⋯ Narcolepsy was found to be associated with substantial personal and economic burdens, as indicated by significantly higher rates of health-care utilization and medical costs in this large US group of narcolepsy patients.
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The Pittsburgh Sleep Quality Index (PSQI) is used extensively to assess subjective sleep disturbance in cancer populations. Although previous studies on the PSQI suggested a better fit for a two- or three-factor model than the original one-factor model, none accounted for the indicator-specific effect between sleep duration and habitual sleep efficiency. This study evaluated the PSQI's dimensionality and its convergent validity with cancer-related psychopathological states in female breast cancer patients. ⋯ The results support the PSQI's original unidimensional structure, demonstrating that the PSQI global score is a valid and parsimonious measure for assessing and screening sleep dysfunction in cancer patients.
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Observational Study
Vitamin D levels and obstructive sleep apnoea in children.
Obstructive sleep apnoea (OSA) is a common health problem in children. African American (AA) and obese children have higher prevalence of OSA, and are also at a higher risk of reduced vitamin D levels. We hypothesised that OSA would be associated with lower levels of plasma 25-hydroxyvitamin D (25(OH)D) and increase in the risk of metabolic dysfunction and systemic inflammation. ⋯ 25(OH)D levels are reduced in paediatric OSA, in AA children and in obese children, particularly when all are present, and may play a role in modulating the degree of insulin resistance and systemic inflammation. The short-term and long-term significance of reduced 25(OH)D in paediatric OSA remains undefined.
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The aim of our study was to evaluate the importance of sleep recordings and stimulus-related evoked potentials (EPs) in patients with prolonged disorders of consciousness (DOCs) by correlating neurophysiologic variables with clinical evaluation obtained using specific standardized scales. ⋯ PSG recordings have proved to be a reliable tool in the neurophysiologic assessment of patients with prolonged DOCs, correlating more adequately than EPs with the clinical evaluation and the level of consciousness. The main contribution to higher clinical scores was determined by the concomitant presence of REM sleep and sleep spindles. PSG recordings may be considered inexpensive, noninvasive, and easy-to-perform examinations to provide supplementary information in patients with prolonged DOCs.