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Sleep Medicine Clinics

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https://www.readbyqxmd.com/read/28778245/hypersomnolence
#1
EDITORIAL
Ahmed S BaHammam
No abstract text is available yet for this article.
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778244/hypersomnolence-and%C3%A2-traffic-safety
#2
REVIEW
Ravi Gupta, Seithikurippu R Pandi-Perumal, Aljohara S Almeneessier, Ahmed S BaHammam
Many people die or become disabled because of motor vehicle accidents. Scientific data suggest that sleepy drivers or those driving at odd hours are more likely to make driving mistakes. Patients with obstructive sleep apnea and narcolepsy have been found to exhibit higher rates of falling asleep while driving. Treatment enhances the vigilance of these drivers. Tests measuring the extent of daytime sleepiness or drowsiness while driving can help identify at-risk drivers. There is a need to develop clear regulations governing periodic assessment of drivers' risks of falling asleep at the wheel, especially commercial drivers...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778243/nonpharmacologic-management-of-excessive-daytime-sleepiness
#3
REVIEW
Matthew R Ebben
Unlike other reviews written on this topic, the focus of this article is primarily on nonpharmacologic treatments for daytime sleepiness that is not secondary to other medical or psychological conditions. To provide an appropriate background on primary excessive daytime sleepiness, what is considered optimal sleep in terms of sleep duration, sleep insufficiency, and sleep need is discussed in detail. This discussion is followed by an examination of the behavioral strategy of banking sleep. After briefly discussing behavioral interventions for sleepiness associated with narcolepsy, a new behavioral method of treating daytime somnolence is proposed and described...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778242/pharmacologic-management-of-excessive-daytime-sleepiness
#4
REVIEW
Shinichi Takenoshita, Seiji Nishino
Excessive daytime sleepiness (EDS) is related to medical and social problems, including mental disorders, physical diseases, poor quality of life, and so forth. According to the International Classification of Sleep Disorders, Third Edition, diseases that result from EDS are narcolepsy type 1, narcolepsy type 2, idiopathic hypersomnia, hypersomnia due to a medical disorder, and others. EDS is usually treated using amphetamine-like central nervous system stimulants or modafinil and its R-enantiomer, armodafinil, wake-promoting compounds unrelated to amphetamines; a variety of new drugs are under development...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778241/hypersomnia-in-neurodegenerative-diseases
#5
REVIEW
Sushanth Bhat, Sudhansu Chokroverty
Hypersomnia is a common complaint in many patients with neurodegenerative diseases and a major cause of decreased quality of life. This article discusses the prevalence and factors associated with hypersomnia in patients with a variety of neurodegenerative diseases affecting the central nervous system, including tauopathies, synucleinopathies, and other conditions. Common nocturnal sleep problems that may result in daytime hypersomnia are delineated. A clinical approach to hypersomnia in patients with neurodegenerative diseases, recommended diagnostic testing, and available treatment options are also discussed...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778240/sleepiness-in-the-elderly
#6
REVIEW
Dora Zalai, Arina Bingeliene, Colin Shapiro
Excessive daytime sleepiness has pathologic causes and numerous adverse consequences; therefore, it requires medical attention in older adults. Excessive sleepiness in older adults is often multifactorial and may signal an underlying sleep disorder, chronic medical condition, undiagnosed mood disorder, or side effects of medications. It is associated with increased risk for cognitive decline and dementia in the elderly. Excessive sleepiness often requires a multi-method assessment in this age group. It is pertinent to take a systematic, step-by-step treatment approach geared toward the underlying cause, and to treat sleepiness directly, when the cause cannot be eliminated to prevent adverse outcomes...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778239/sleepiness-in-adolescents
#7
REVIEW
Roah A Merdad, Hammam Akil, Siraj Omar Wali
Sleepiness and sleep deprivation among adolescents are increasingly being recognized as a public health concern. Many of the determinants of this growing problem lie beyond the biomedical scope of explanation. In this article, the authors begin with a review of the prevalence and consequences of sleepiness in adolescents and then present the approach to a sleepy adolescent and the underlying cause. The topic is discussed from clinical as well as public health perspectives.
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778238/sleepiness-in-children-an-update
#8
REVIEW
Gustavo Antonio Moreira, Marcia Pradella-Hallinan
Sleep is essential for children's learning, memory processes, school performance, and general well-being. The prevalence of sleepiness in children is approximately 4%. Reductions of sleep duration have daytime consequences, including sleepiness, behavior problems, cognitive deficits, poor school performance, inflammation, and metabolic dysfunction. Chronic pain, movement disorders, and sleep-disordered breathing also may lead to daytime somnolence, inattention, hyperactivity, oppositional behaviors, and mood dysregulation...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778237/depression-and-hypersomnia-a-complex-association
#9
REVIEW
Régis Lopez, Lucie Barateau, Elisa Evangelista, Yves Dauvilliers
Hypersomnolence is a clinically defined syndrome characterized by the association of prolonged nocturnal sleep, impaired arousal quality, and sleep inertia. Hypersomnolence is the major feature of central hypersomnias and is frequently reported in various mood disorders, such as major depressive disorder, bipolar disorder, or seasonal affective disorder. Assessment of hypersomnolence is challenging in depressed patients, with objective tests often in the normal range despite a high level of sleepiness complaint...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778236/drug-induced-hypersomnolence
#10
REVIEW
J F Pagel
Daytime somnolence is among the most commonly reported drug side effects. The United States has the highest rate of motor vehicular accident (MVA) deaths with sedating drug use a factor in more than 30%. Sedating drug use extends beyond drugs of abuse to sedating medications. This paper presents pharmacodynamics, performance and driving tests, and MVAs for somnolence inducing agents classified as hypnotics, sedatives, and/or sedation as a side effect. This classification, based on the drug tendency to induce next-day sedation after nighttime use, can be cogently used by prescribers, pharmacists, regulatory agencies, and in direct to consumer marketing...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778235/sleep-disordered-breathing-and-excessive-daytime-sleepiness
#11
REVIEW
Ken He, Vishesh K Kapur
Sleep-related breathing disorders include obstructive sleep apnea (OSA), central sleep apnea, sleep-related hypoventilation, and sleep-related hypoxemia. Excessive daytime sleepiness (EDS) is frequently reported by patients with OSA but is not invariably present. The efficacy of positive airway pressure therapy in improving EDS is well established for OSA, but effectiveness is limited by suboptimal adherence. Non-OSA causes of sleepiness should be identified and treated before initiating pharmacotherapy for persistent sleepiness despite adequately treated OSA...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778234/neuroimaging-of-narcolepsy-and-kleine-levin-syndrome
#12
REVIEW
Seung Bong Hong
Narcolepsy is a chronic neurologic disorder with the abnormal regulation of the sleep-wake cycle, resulting in excessive daytime sleepiness, disturbed nocturnal sleep, and manifestations related to rapid eye movement sleep, such as cataplexy, sleep paralysis, and hypnagogic hallucination. Over the past decade, numerous neuroimaging studies have been performed to characterize the pathophysiology and various clinical features of narcolepsy. This article reviews structural and functional brain imaging findings in narcolepsy and Kleine-Levin syndrome...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778233/the-known-unknowns-of-kleine-levin-syndrome-a-review-and-future-prospects
#13
REVIEW
Saad M Al Suwayri, Ahmed S BaHammam
Kleine-Levin syndrome (KLS) is a rare, homogeneous, debilitating sleep disorder characterized by episodic hypersomnia, cognitive impairment, and behavioral changes. The etiology, pathophysiology, and optimal management of KLS remain uncertain. We identify the 5 key areas requiring urgent attention: KLS immunopathogenesis studies, next-generation genetics, multimodal functional imaging, biomarker discovery, and clinical drug trials. A centralized registry of afflicted individuals must be established. Disease uniformity should make the identification of associated genetic or imaging biomarkers easier, but clinical efforts require laboratory-based research to model the disease and generate preclinical data for clinical translation...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778232/idiopathic-hypersomnia
#14
REVIEW
Lynn Marie Trotti
Idiopathic hypersomnia (IH) is a chronic neurologic disorder of daytime sleepiness, accompanied by long sleep times, unrefreshing sleep, difficulty in awakening, cognitive dysfunction, and autonomic symptoms. The cause is unknown; a genetic predisposition is suggested. Autonomic, inflammatory, or immune dysfunction has been proposed. Diagnosis involves a clinical history and objective testing. There are no approved treatments for IH, but modafinil is typically considered first-line. A substantial fraction of patients with IH are refractory or intolerant to standard treatments, and different treatment strategies using novel therapeutics are necessary...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778231/sleepiness-in-narcolepsy
#15
REVIEW
Jun Zhang, Fang Han
Narcolepsy represents the best understood disorder of excessive daytime sleepiness (EDS). EDS presents in 100% of patients with narcolepsy; it is usually the first and the most disabling symptom, which varies in aspects, such as onset age, severity, and clinical characteristics. Early recognition of this symptom leads to early diagnosis and intervention. A diagnosis of narcolepsy is based on clarifying EDS through history, subjective evaluation using questionnaires, and objective measurement, including nocturnal polysomnography followed by a daytime multiple sleep latency test...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778230/subjective-and-objective-assessment-of-hypersomnolence
#16
REVIEW
Brian James Murray
This article describes clinical approaches to assessing sleepiness. Subjective sleep scales are used in clinical settings but have significant limitations. Likewise, objective tools may have prohibitive expense, and practical administration considerations may prohibit regular use. Gold standard tests include the multiple sleep latency test and maintenance of wakefulness test. These studies are criticized for a variety of reasons but are useful in appropriate clinical context. New tools suggest novel ways to assess sleepiness and will likely be more prominent in clinical assessments over time...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778229/evaluation-of-the-sleepy-patient-differential-diagnosis
#17
REVIEW
Renee Monderer, Imran M Ahmed, Michael Thorpy
Excessive daytime sleepiness is defined as the inability to maintain wakefulness during waking hours, resulting in unintended lapses into sleep. It is important to distinguish sleepiness from fatigue. The evaluation of a sleep patient begins with a careful clinical assessment that includes a detailed sleep history, medical and psychiatric history, a review of medications, as well as a social and family history. Physical examination should include a general medical examination with careful attention to the upper airway and the neurologic examination...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778228/genetic-markers-of-sleep-and-sleepiness
#18
REVIEW
Namni Goel
The circadian clock interacts with the sleep homeostatic drive in humans. Chronotype and sleep parameters show substantial heritability, underscoring a genetic component to these measures. This article reviews the genetic underpinnings of chronotype and of sleep, including sleepiness, sleep quality and latency, and sleep timing and duration in healthy adult sleepers, drawing on candidate gene and genome-wide association studies. Notably, both circadian and noncircadian genes associate with individual differences in chronotype and in sleep parameters...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778227/the-immune-basis-of%C3%A2-narcolepsy-what-is-the-evidence
#19
REVIEW
Shahrad Taheri
Narcolepsy is a chronic neurologic sleep disorder. Type 1 narcolepsy (narcolepsy-cataplexy) is associated with the destruction of lateral hypothalamic hypocretin neurons. It is thought that the loss of hypocretin neurons is autoimmune mediated. This is because of the close relationship between type 1 narcolepsy and HLA DQB1∗0602 and the onset of narcolepsy at a young age. Evidence suggests that streptococcal and H1N1 influenza infections (and H1N1 vaccination) may be involved in the pathogenesis of narcolepsy...
September 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28778226/neurobiological-basis-of-hypersomnia
#20
REVIEW
Yoshihiro Urade
Narcolepsy is the most well-characterized hypersomnia in both clinical and basic research fields. Narcolepsy is caused by degeneration of hypocretin-producing neurons in the hypothalamus. Although hypocretin receptor antagonists have been developed as sleep-inducing drugs, a high dose of suvorexant, a hypocretin receptor antagonist, inhibits gene expression of prepro-hypocretin to induce narcoleptic attack in wild-type mice. Prostaglandin D2 is the most potent endogenous sleep-promoting substance. Overproduction of prostaglandin D2 is involved in hypersomnia in patients with mastocytosis and African sleeping sickness or in mice after a pentylenetetrazole-induced seizure...
September 2017: Sleep Medicine Clinics
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