Sleep medicine
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To assess the reliability, validity, and responsiveness of the International Restless Legs Syndrome Study Group's rating scale (the International Restless Legs Scale (IRLS)) (V2.0), using pooled data from two matching, placebo-controlled studies of ropinirole for treating Restless Legs Syndrome (RLS). ⋯ The IRLS total score, symptoms, and symptoms impact subscales are reliable, valid, and responsive in a clinical trial setting.
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Obstructive sleep apnea (OSA) is a condition with serious medical and psychosocial consequences. However, poor adherence with nasal continuous positive airway pressure (CPAP) treatment limits the effectiveness of treatment. Behavior change factors offer one avenue of research to better understand the correlates of CPAP adherence. ⋯ The results suggest that social-cognitive factors may be associated with CPAP adherence in experienced CPAP users. The principal advantage to these theory-driven and empirically validated factors is that they are modifiable and can provide the basis for effective interventions to increase CPAP adherence.
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Excessive daytime sleepiness (EDS) is a major consequence of sleep-disordered breathing (SDB) in adults. In snoring children, spontaneous and respiratory arousals display reciprocal interactions, allowing for development of a new quantitative measure, the sleep pressure score (SPS), which provides intra-polysomnographic estimates of sleep pressure/disruption. The aim of the present study was to assess the interactions between respiratory and spontaneous arousals in adults with suspected SDB, and to examine whether the SPS and the Epworth sleepiness scale (ESS) are correlated. ⋯ As in children, snoring adults exhibit reciprocal interactions between respiratory and spontaneous arousals that can also be expressed as a single quantitative measure, the SPS, which is highly dependent on the severity of SDB and could possibly serve as a more reliable index of sleep disruption, considering that the ESS is unrelated to either SPS or AHI.
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Individuals with obstructive sleep-disordered breathing (OSDB) commonly report symptoms of depression; however, the percentage of individuals with major depressive disorder (MDD) who experience OSDB is less clear. This study aimed to examine OSDB in a sample of individuals with MDD, unselected for sleep-related complaints, along a continuum of ventilatory and hypoxic abnormalities. ⋯ These results suggest that OSDB may play a more important role in MDD than previously recognized. OSDB may contribute to or exacerbate the condition of someone predisposed to MDD, and the treatment of OSDB may ameliorate or possibly prevent depressive symptoms.
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This study compared the effects of caffeine in patients with primary insomnia and normal volunteers. The main goal was to determine the differences in sensitivity to caffeine between the groups. We investigated the effects on daytime sleep of placebo or caffeine after a night of total sleep deprivation (SD). We hypothesized that insomniacs would be more affected by caffeine, which would suggest a change in adenosine receptor (number or sensitivity) in primary insomniacs. ⋯ Patients with insomnia had a higher sensitivity to the diurnal awakening effect of caffeine even after one night of SD. This suggests that changes in the adenosine receptors could, in part, be responsible for the hyperarousal state that has been reported in primary insomnia.