Sleep medicine
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Randomized Controlled Trial Comparative Study
Comparison of manual titration and automatic titration based on forced oscillation technique, flow and snoring in obstructive sleep apnea.
Continuous positive airway pressure (CPAP) treatment in obstructive sleep apnea syndrome (OSAS) requires pressure titration usually performed during attended in-hospital polysomnography. This manual titration procedure is not well standardized. The aim of the study was to ascertain whether a new automatic titration device is as effective as standard manual titration in determining constant CPAP pressure. ⋯ Automatic titration effectively predicts constant CPAP pressure for long-term treatment when performed during an attended polysomnography. Careful evaluation of raw data and polysomnography recording is mandatory before choosing a fixed CPAP pressure after automatic titration.
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Controlled Clinical Trial
Nasal continuous positive airway pressure treatment reduces systemic oxidative stress in patients with severe obstructive sleep apnea syndrome.
To evaluate whether nasal continuous positive airway pressure (nCPAP) reduces oxidative stress in patients with severe obstructive sleep apnea (OSA) syndrome. ⋯ Patients with severe OSA syndrome presented increased systemic oxidative stress. A single night of nCPAP treatment significantly reduced the levels of oxidative stress in patients with severe OSA syndrome, and this reduction was maintained at least after two months of nCPAP treatment.
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Comparative Study Clinical Trial
An investigation of the validity of the Lifeshirt in comparison to standard polysomnography in the detection of obstructive sleep apnea.
Due to the cost and waiting times for traditional sleep studies, there is great interest in finding alternatives for the diagnosis of sleep apnea. Several alternatives exist, including ambulatory devices. Our laboratory utilized one such device, a form-fitting vest called the Lifeshirt, and compared its accuracy to that of polysomnography (PSG). ⋯ The Lifeshirt compared favorably with PSG and could be used with considerable confidence for the screening of patients with suspected obstructive sleep apnea.
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Sleep and vigilance disorders are among the most commonly reported symptoms following a concussion. The aim of the study was thus to investigate the effects of sport-related concussions on subjective and objective sleep quality. ⋯ In spite of the subjective complaints in sleep quality of concussed athletes, no change was observed in objective sleep characteristics. However, concussions were associated with an increase in delta and a reduction in alpha power in the waking EEG. Sport-related concussions are thus associated with wakefulness problems rather than sleep disturbances.
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Sleep apnea occurs in up to 50% of patients with end-stage renal disease and is improved by nocturnal hemodialysis. We hypothesized that its pathogenesis is related to changes in chemoreflex responsiveness. ⋯ Improvement of sleep apnea following conversion from conventional to nocturnal hemodialysis is associated with a decrease in chemoreflex responsiveness. This finding suggests that increased chemoreflex responsiveness contributes to the pathogenesis of sleep apnea in some patients with end-stage renal disease.