Sleep medicine
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The coexistence of obstructive (OSAS) and central sleep apnoea (CSA) and Cheyne-Stokes respiration (CSR) is common in patients with and without underlying heart diseases. CPAP has been shown to improve CSA/CSR by about 50%, but recent data suggest maximal suppression of CSA is important in improving clinical outcomes in heart failure patients. Adaptive servo-ventilation (ASV) effectively suppresses CSA/CSR in heart failure, but only few trials have considered patients with coexisting OSAS and CSA/CSR. ⋯ BiPAP AutoSV was effective in reducing all types of respiratory disturbances in coexisting OSAS and CSA/CSR with and without heart failure. Further studies comparing the long-term clinical efficacy of this device against CPAP are warranted.
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To study the feasibility of using acoustic signatures in snore signals for the diagnosis of obstructive sleep apnea (OSA). ⋯ Acoustic signatures in snore signals carry information for OSA diagnosis, and snore-based analysis might potentially be a non-invasive and inexpensive diagnostic approach for mass screening of OSA.
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Theories as to the function of sleep and dreaming have been with us since the beginning of recorded history. In Ancient Greece and Rome the predominant view of dreams was that they were divine in origin. ⋯ However, it is also in the Greek and Roman writings, paralleling advances in philosophy and natural science, that we begin to see the first rationalistic accounts of dreaming. This paper reviews the evolution of such rational accounts focusing on the influence of Democritus, who provides us with the first rationalistic account of dreaming in history, and Aristotle, who provides us with the most explicit account of sleep and dreaming in the ancient world.
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Randomized Controlled Trial Comparative Study
Titration procedures for nasal CPAP: automatic CPAP or prediction formula?
The best method for titration of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea (OSA) syndrome has not yet been established. The 90th or 95th percentiles of the pressure titrated over time by automatic CPAP (A-CPAP) have been recommended as reference for prescribing therapeutic fixed CPAP (F-CPAP). We compared A-CPAP to F-CPAP, which was determined by a common prediction formula. ⋯ We confirm that F-CPAP set by prediction formula is not worse in terms of AHI control than A-CPAP. On average, F-CPAP parallels Pmean and P50 but not P95. However, due to imprecise matching, individual F-CPAP values cannot be derived from Pmean or P50.