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Sleep Medicine Clinics

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https://www.readbyqxmd.com/read/29412993/sleep-in-older-adults-challenges-and-opportunities
#1
EDITORIAL
Cathy A Alessi, Jennifer L Martin
No abstract text is available yet for this article.
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412987/sleep-and-cognition-in-older-adults
#2
REVIEW
Joseph M Dzierzewski, Natalie Dautovich, Scott Ravyts
Increased age is associated with normative declines in both sleep and cognitive functioning. Although there are some inconsistencies in the literature, negative sleep changes are associated with worse cognitive functioning. This negative relationship holds true across normal-sleeping older adults, older adults with insomnia, older adults with sleep disordered breathing, cognitively healthy older adults, and older adults with dementia. There are mixed results regarding potential benefits of sleep treatments on cognitive functions; however, this line of research deserves added attention because the potential mechanisms of action are likely distinct from other interventions to improve cognition...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412986/psychiatric-illness-and-sleep-in-older-adults-comorbidity-and-opportunities-for-intervention
#3
REVIEW
Michael R Nadorff, Christopher W Drapeau, Wilfred R Pigeon
This article reviews the literature examining the association between sleep disorders and psychopathology among older adults. Similar to the younger adult literature, the authors found that sleep disorders are robustly associated with anxiety, depression, dementia, and suicidal behavior in late life. Clinical implications and opportunities for intervention are discussed.
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412985/chronic-medical-conditions-and-sleep-in-the-older-adult
#4
REVIEW
Saban-Hakki Onen, Fannie Onen
Demographic changes in developed countries are leading to an aging population with a high prevalence of chronic medical conditions, disability, and sleep disorders. Evidence suggests that medical conditions and comorbid sleep disorders interact. This article aims to review frequently encountered medical conditions and examine their consequences on sleep in the older adult, and to review the possible impact of sleep disturbances on these common medical conditions. These medical conditions include pain, falls, cancer, and chronic heart failure...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412984/neurodegenerative-disorders-and-sleep
#5
REVIEW
Raman K Malhotra
Sleep disorders are commonly found in cerebral degenerative disorders. The sleep disorders may be caused by the primary symptoms of the neurologic disease or may result from damage to sleep-controlling centers in the brain. Common sleep disorders found in this population include insomnia, hypersomnia, sleep apnea, restless legs syndrome, circadian rhythm disorders, and rapid eye movement sleep behavior disorder. The latter disorder can present years before other neurologic symptoms or signs are present, serving as a precursor of neurodegenerative conditions...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412983/parasomnias-and-sleep-related-movement-disorders-in-older-adults
#6
REVIEW
Alex Iranzo
Parasomnias and sleep-related movement disorders are important problems in older adults. Sleep paralysis is rare, but may occur in families. In a minority of patients with disorders of arousal, the episodes persist until the age of 70. Zolpidem and other medications may induce sleepwalking and sleep-related eating. Most patients with idiopathic rapid eye movement (REM) sleep behavior disorder eventually develop Parkinson's disease or dementia with Lewy bodies. Anti-IgLON5 disease includes abnormal behaviors in NREM and REM sleep...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412982/circadian-rhythm-sleep-wake-disorders-in-older-adults
#7
REVIEW
Jee Hyun Kim, Jeanne F Duffy
The timing, duration, and consolidation of sleep result from the interaction of the circadian timing system with a sleep-wake homeostatic process. When aligned and functioning optimally, this allows wakefulness throughout the day and a long consolidated sleep episode at night. Mismatch between the desired timing of sleep and the ability to fall and remain asleep is a hallmark of the circadian rhythm sleep-wake disorders. This article discusses changes in circadian regulation of sleep with aging; how age influences the prevalence, diagnosis, and treatment of circadian rhythm sleep-wake disorders; and how neurologic diseases in older patients affect circadian rhythms and sleep...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412981/apnea-in-older-adults
#8
REVIEW
Susmita Chowdhuri, Pragnesh Patel, M Safwan Badr
Sleep-disordered breathing (SDB) is a highly prevalent chronic disease in older adults. A growing body of evidence demonstrates that SDB in older adults is linked to many adverse cardiovascular, neurocognitive, and metabolic sequelae. However, several unanswered questions remain regarding the diagnosis, consequences, and treatment of SDB in older adults. This review presents the current evidence pertaining to the management of SDB in older adults and identifies crucial gaps in knowledge that need further investigation...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412980/insomnia-in-the-older-adult
#9
REVIEW
Glenna S Brewster, Barbara Riegel, Philip R Gehrman
Although insomnia is not a normal part of the aging process, its prevalence increases with age. Factors such as medications and medical and psychiatric disorders can increase the risk for insomnia. To diagnose insomnia, it is important for older adults to complete comprehensive sleep and health histories. Cognitive-behavioral therapy for insomnia, which includes stimulus control, sleep restriction, sleep hygiene, and cognitive therapy, is the recommended first-line treatment of insomnia and is more effective than medications for the long-term management of insomnia...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412979/sleep-in-hospitalized-older-adults
#10
REVIEW
Nancy H Stewart, Vineet M Arora
Hospitalization is a period of acute sleep deprivation for older adults owing to environmental, medical, and patient factors. Although hospitalized patients are in need of adequate rest and recovery during acute illness, older patients face unique risks owing to acute sleep loss during hospitalization. Sleep loss in the hospital is associated with worse health outcomes, including cardiometabolic derangements and an increased risk of delirium. Because older patients are at risk of polypharmacy and medication side effects, a variety of nonpharmacologic interventions are recommended first to improve sleep loss for hospitalized older adults...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412978/sleep-and-long-term-care
#11
REVIEW
Lichuan Ye, Kathy C Richards
Long-term care (LTC) involves a range of support and services for people with chronic illness and disabilities who can not perform activities of daily living independently. Poor sleep increases the risk of LTC placement, and sleep disturbance is extremely common among LTC residents. The identification and management of sleep disturbance in LTC residents is a vital, but perhaps underappreciated, aspect of offering high-quality care for this already compromised population. This review describes the nature and consequences of sleep disturbances in LTC, clinical assessment and management of sleep disturbances in LTC, and implications for future research and clinical practice...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412977/sleep-and-nocturia-in-older-adults
#12
REVIEW
Camille P Vaughan, Donald L Bliwise
Older adults frequently experience nocturia and sleep disturbance concurrently, and problems with sleep resulting from nocturia are a major factor accompanying the bother associated with nocturia. A multicomponent treatment strategy is usually warranted. Initial treatment includes lifestyle modification and behavioral treatment with consideration of pelvic floor muscle exercise-based therapy. Early evidence suggests that behavioral treatment results in similar nocturia reductions compared with the most frequently used drug therapies...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412976/sleep-in-normal-aging
#13
REVIEW
Junxin Li, Michael V Vitiello, Nalaka S Gooneratne
Sleep patterns change with aging, independent of other factors, and include advanced sleep timing, shortened nocturnal sleep duration, increased frequency of daytime naps, increased number of nocturnal awakenings and time spent awake during the night, and decreased slow wave sleep. Most of these changes seem to occur between young and middle adulthood; sleep parameters remain largely unchanged among healthy older adults. The circadian system and sleep homeostatic mechanisms become less robust with normal aging...
March 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108617/the-development-of-positive-airway-pressure-technology-and-applications-faster-than-space-travel
#14
EDITORIAL
Lee K Brown, Shahrokh Javaheri
No abstract text is available yet for this article.
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108616/future-of-positive-airway-pressure-technology
#15
REVIEW
Karin G Johnson, David M Rapoport
This article discusses the future of positive airway pressure (PAP) technology. The focus is on (1) technology improvements in the delivery of PAP; (2) improvements in PAP algorithms; and (3) improvements in PAP informatics. Current limitations of PAP technology and whether technological improvements are sufficient to PAP are discussed.
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108615/noninvasive-positive-pressure-ventilatory-support-begins-during-sleep
#16
REVIEW
John R Bach
The goal of sleep doctors has been to titrate away apneas and hypopneas using noninvasive ventilation, a term that has become synonymous with continuous positive airway pressure and bilevel positive airway pressure at the lowest effective bilevel settings. It is now time to appreciate noninvasive ventilatory support as an alternative to invasive mechanical ventilation. This article discusses mechanisms of action, two paradigms, and ancillary techniques for noninvasive ventilatory support.
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108614/noninvasive-mechanical-ventilation-in-acute-ventilatory-failure-rationale-and-current-applications
#17
REVIEW
Antonio M Esquinas, Maly Oron Benhamou, Alastair J Glossop, Bushra Mina
Noninvasive ventilation plays a pivotal role in acute ventilator failure and has been shown, in certain disease processes such as acute exacerbation of chronic obstructive pulmonary disease, to prevent and shorten the duration of invasive mechanical ventilation, reducing the risks and complications associated with it. The application of noninvasive ventilation is relatively simple and well tolerated by patients and in the right setting can change the course of their illness.
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108613/obesity-hypoventilation-syndrome-choosing-the-appropriate-treatment-of-a-heterogeneous-disorder
#18
REVIEW
Amanda J Piper, Ahmed S BaHammam, Shahrokh Javaheri
The obesity hypoventilation syndrome (OHS) is associated with significant morbidity and increased mortality compared with simple obesity and eucapnic obstructive sleep apnea. Accurate diagnosis and commencement of early and appropriate management is fundamental in reducing the significant personal and societal burdens this disorder poses. Sleep disordered breathing is a major contributor to the developmental of sleep and awake hypercapnia, which characterizes OHS, and is effectively addressed through the use of positive airway pressure (PAP) therapy...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108612/sleep-disordered-breathing-caused-by-chronic-opioid-use-diverse-manifestations-and-their-management
#19
REVIEW
Susmita Chowdhuri, Shahrokh Javaheri
Opioid-induced sleep disordered breathing presents a therapeutic predicament with the increasing incidence of prescription opioid use for noncancer chronic pain in the United States. Central sleep apnea with a Biot or cluster breathing pattern is characteristic of polysomnography studies; however, long-term clinical outcomes and the impact of therapy remain unknown. Novel ampakine-based therapies are being investigated. Randomized controlled trials with therapies that target the underlying pathophysiologic mechanisms of opioid-induced sleep disordered breathing are required...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29108611/positive-airway-pressure-therapy-for-hyperventilatory-central-sleep-apnea-idiopathic-heart-failure-cerebrovascular-disease-and-high-altitude
#20
REVIEW
Shahrokh Javaheri, Lee K Brown
Central sleep apnea (CSA) and Hunter-Cheyne-Stokes breathing (HCSB) are caused by failure of the pontomedullary pacemaker generating breathing rhythm. CSA/HCSB may complicate several disorders causing recurrent arousals and desaturations. Common causes of CSA in adults are congestive heart failure, stroke, and chronic use of opioids; opioids have hypoventilatory effects. Diagnosis and treatment of hyperventilatory CSA may improve quality of life, and, when associated with heart failure or cerebrovascular disease, reduce morbidity and perhaps mortality...
December 2017: Sleep Medicine Clinics
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