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Sleep Medicine Clinics

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https://www.readbyqxmd.com/read/28477780/sleep-and-the-heart-what-s-next
#1
EDITORIAL
Rami N Khayat
No abstract text is available yet for this article.
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477779/non-mask-based-therapies-for-central-sleep-apnea-in-patients-with-heart-failure
#2
REVIEW
Robin Germany
Central sleep apnea is common in heart failure and contributes to morbidity and mortality. Symptoms are often similar to those associated with heart failure and a high index of suspicion is needed. Testing is typically done in the sleep laboratory, but home testing equipment can distinguish between central and obstructive events. Treatments are limited. Mask-based therapies have been the primary treatment. Oxygen has some data but lacks long-term studies. Neurostimulation of the phrenic nerve is a new technology that has demonstrated improvement...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477778/device-therapy-for-sleep-disordered-breathing-in-patients-with-cardiovascular-diseases-and-heart-failure
#3
REVIEW
Winfried Randerath, Simon Herkenrath
Pathophysiologic components of upper airway obstruction, reduced tidal volume, and disturbed respiratory drive characterize sleep-disordered breathing. Positive airway pressure (PAP) devices address these components by stabilizing the upper airways (continuous PAP), applying air volumes and mandatory breaths (bilevel PAP), or counterbalancing ventilation (adaptive servoventilation). Although PAP therapies have been shown to improve breathing disturbances, daytime symptoms, and left ventricular function in obstructive sleep apnea and cardiovascular diseases, the effects on mortality are controversial, especially in heart failure and central sleep apnea...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477777/sleep-disordered-breathing-and-arrhythmia-in-heart-failure-patients
#4
REVIEW
Henrik Fox, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
Heart failure (HF) treatment remains complex and challenging, with current recommendations aiming at consideration and treatment of comorbidities in patients with HF. Sleep-disordered breathing (SDB) and arrhythmia come into play, as both are associated with quality of life deterioration, and morbidity and mortality increase in patients with HF. Interactions of these diseases are versatile and may appear intransparent in daily practice. Nevertheless, because of their importance for patients' condition and prognosis, SDB and arrhythmia individually, but also through interaction on one another, necessitate attention, following the fact that treatment is requested and desired considering latest research findings and outcomes...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477776/central-sleep-apnea-in-patients-with-congestive-heart-failure
#5
REVIEW
James A Rowley, M Safwan Badr
Central sleep apnea and Cheyne-Stokes respiration are commonly observed breathing patterns during sleep in patients with congestive heart failure. Common risk factors are male gender, older age, presence of atrial fibrillation, and daytime hypocapnia. Proposed mechanisms include augmented peripheral and central chemoreceptor sensitivity, which increase ventilator instability during both wakefulness and sleep; diminished cerebrovascular reactivity and increased circulation time, which impair the normal buffering of Paco2 and hydrogen ions and delay the detection of changes in Paco2 during sleep; and rostral fluid shifts that predispose to hypocapnia...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477775/a-practical-approach-to-the-identification-and-management-of-sleep-disordered-breathing-in-heart-failure-patients
#6
REVIEW
Rami Kahwash, Rami N Khayat
Sleep-disordered breathing (SDB) is a major health problem affecting much of the general population. Although SDB is responsible for rapid progression of heart failure (HF) and the worsening morbidity and mortality, advanced HF state is associated with accelerated development of SDB. In the face of recent developments in SDB treatment and availability of effective therapeutic options known to improve quality of life, exercise tolerance, and heart function, most HF patients with SDB are left unrecognized and untreated...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477774/rehabilitation-of-cardiovascular-disorders-and-sleep-apnea
#7
REVIEW
Behrouz Jafari
Obstructive sleep apnea (OSA) is present in more than 50% of patients referred to cardiac rehabilitation units. However, it has been under-recognized in patients after stroke and heart failure. Those with concurrent OSA have a worse clinical course. Early treatment of coexisting OSA with continuous positive airway pressure (CPAP) results in improved rehabilitation outcomes and quality of life. Possible mechanisms by which CPAP may improve recovery include decreased blood pressure fluctuations associated with apneas, and improved left ventricular function, cerebral blood flow, and oxygenation...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477773/sleep-and-the-cardiovascular-system-in-children
#8
REVIEW
Grace R Paul, Swaroop Pinto
Subspecialty pediatric practice provides comprehensive medical care for a range of ages, from premature infants to children, and often includes adults with complex medical and surgical issues that warrant multidisciplinary care. Normal physiologic variations involving different body systems occur during sleep and these vary with age, stage of sleep, and underlying health conditions. This article is a concise review of the cardiovascular (CV) physiology and pathophysiology in children, sleep-disordered breathing (SDB) contributing to CV morbidity, congenital and acquired CV pathology resulting in SDB, and the relationship between SDB and CV morbidity in different clinical syndromes and systemic diseases in the expanded pediatric population...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477772/the-effects-of-insomnia-and-sleep-loss-on-cardiovascular-disease
#9
REVIEW
Meena S Khan, Rita Aouad
Sleep loss has negative impacts on quality of life, mood, cognitive function, and heath. Insomnia is linked to poor mood, increased use of health care resources, decreased quality of life, and possibly cardiovascular risk factors and disease. Studies have shown increase in cortisol levels, decreased immunity, and increased markers of sympathetic activity in sleep-deprived healthy subjects and those with chronic insomnia. The literature shows subjective complaints consistent with chronic insomnia and shortened sleep can be associated with development of diabetes, hypertension, and cardiovascular disease...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28477771/sleep-architecture-and-blood-pressure
#10
REVIEW
Behrouz Jafari
Different stages of sleep are associated with significant variability in cardiovascular function, which is mediated by marked changes in balance between 2 components of the autonomic system: parasympathetic and sympathetic. Autonomic control of circulation is essential in ensuring an adequate blood flow to vital organs through constant adjustments of arterial blood pressure, heart rate, and redistribution of blood flow. Fluctuations in components of the autonomic nervous system synchronize with electroencephalographic activity during arousal or different stages of sleep...
June 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159102/the-costly-face-of-sleep-disorders
#11
EDITORIAL
Ana C Krieger
No abstract text is available yet for this article.
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159101/screening-for-obstructive-sleep-apnea-in-patients-with-atrial-fibrillation
#12
REVIEW
Pedro R Genta, Luciano F Drager, Geraldo Lorenzi Filho
Obstructive sleep apnea (OSA) and atrial fibrillation (AF) are common conditions in the adult population and independently associated with increased morbidity and mortality. There is evidence, although not definitive, that OSA independently contributes to AF incidence and recurrence. Full polysomnography is expensive and may not be readily available to diagnose all patients with OSA and AF. Several patients with OSA do not present the classical signs and symptoms of OSA, impairing the accuracy of screening questionnaires for OSA...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159100/social-and-economic-impacts-of-managing-sleep-hypoventilation-syndromes
#13
REVIEW
Dianne M Augelli, Ana C Krieger
Hypoventilation during sleep is often an early indicator of the development of respiratory failure. Alterations in ventilation are more pronounced during sleep and often present before the onset of daytime symptoms. This article discusses the most common sleep-related hypoventilatory disorders and recommended treatment approaches for obesity hypoventilation, chronic obstructive pulmonary disease, and neuromuscular disorders. Accurate diagnosis and appropriate treatment is of paramount importance because of the impact on individual health outcomes and overall cost of health care delivery...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159099/neurologic-diseases-and-sleep
#14
REVIEW
Daniel A Barone, Sudansu Chokroverty
Sleep disorders and neurologic illness are common and burdensome in their own right; when combined, they can have tremendous negative impact at an individual level as well as societally. The socioeconomic burden of sleep disorders and neurologic illness can be identified, but the real cost of these conditions lies far beyond the financial realm. There is an urgent need for comprehensive care and support systems to help with the burden of disease. Further research in improving patient outcomes in those who suffer with these conditions will help patients and their families, and society in general...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159098/reducing-the-clinical-and-socioeconomic-burden-of-narcolepsy-by-earlier-diagnosis-and-effective-treatment
#15
REVIEW
Michael Thorpy, Anne Marie Morse
The burden of narcolepsy is likely the result of 2 main aspects: the clinical difficulties and disability incurred as a direct effect of the disorder and the socioeconomic burden. The clinical burden includes the symptoms, diagnosis, comorbidities, treatment, and even mortality that can be associated with narcolepsy. Lifelong therapy is necessary for these patients. Effective treatment results in long-term benefits from both patient and societal perspectives by improving clinical outcomes, potentially enabling improved education and increased employment and work productivity, and quality of life...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159097/hypersomnia-evaluation-treatment-and-social-and-economic-aspects
#16
REVIEW
Prabhjyot Saini, David B Rye
Most central disorders of hypersomnolence are conditions with poorly understood pathophysiologies, making their identification, treatment, and management challenging for sleep clinicians. The most challenging to diagnose and treat is idiopathic hypersomnia. There are no FDA-approved treatments, and off-label usage of narcolepsy treatments seldom provide benefit. Patients are largely left on their own to alleviate the compound effects of this disorder on their quality of life. This review covers the major points regarding clinical features and diagnosis of idiopathic hypersomnia, reviews current evidence supporting the available treatment options, and discusses the psychosocial impact and effects of idiopathic hypersomnia...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159096/the-cost-of-insomnia-and-the-benefit-of-increased-access-to-evidence-based-treatment-cognitive-behavioral-therapy-for-insomnia
#17
REVIEW
Sarah A Reynolds, Matthew R Ebben
Insomnia is a highly prevalent, often chronic condition, which is left untreated or not treated according to recommended guidelines in most cases. This results in high health and financial burdens to society. The cost of untreated insomnia and the prevailing reliance on sedative-hypnotic use as a first-line treatment are evaluated in this article. The cost-benefit potential of cognitive behavioral therapy for insomnia is also assessed.
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159095/sleep-in-the-aging-population
#18
REVIEW
Brienne Miner, Meir H Kryger
There are normal changes to sleep architecture throughout the lifespan. There is not, however, a decreased need for sleep and sleep disturbance is not an inherent part of the aging process. Sleep disturbance is common in older adults because aging is associated with an increasing prevalence of multimorbidity, polypharmacy, psychosocial factors affecting sleep, and certain primary sleep disorders. It is also associated with morbidity and mortality. Because many older adults have several factors from different domains affecting their sleep, these complaints are best approached as a multifactorial geriatric health condition, necessitating a multifaceted treatment approach...
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159094/socioeconomic-impact-of-pediatric-sleep-disorders
#19
REVIEW
Kin M Yuen, Rafael Pelayo
Pediatric disorders tend to affect the immediate support unit, adults and children. High costs for direct consumption of medical care are offset by early diagnosis and treatment of pediatric sleep disorders. Pediatric sleep disorders are underdiagnosed and undertreated. Attention-deficit/hyperactivity disorder may result from insufficient or fragmented sleep. Delaying school start time resulted in decreased car crashes in teen drivers and improved mood.
March 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28159093/legal-and-regulatory-aspects-of-sleep-disorders
#20
REVIEW
Saiprakash B Venkateshiah, Romy Hoque, Lourdes M DelRosso, Nancy A Collop
Sleep disorders may interact with the law, making awareness important. Insufficient sleep and obstructive sleep apnea (OSA) are prevalent and associated with excessive sleepiness. Patients with excessive sleepiness may have civil or criminal liability if they fall asleep and cause a motor vehicle accident. Awareness of screening and treatment of OSA is increasing in certain industries. Parasomnia associated sleep-related violence represents a challenge to clinicians, who may be called on to consider parasomnia as a contributing, mitigating, or exculpatory factor in criminal proceedings...
March 2017: Sleep Medicine Clinics
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