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Sleep Medicine Clinics

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https://www.readbyqxmd.com/read/29759278/medications-and-their-effects-on-sleep-and-wake
#1
EDITORIAL
Johan Verbraecken, Jan Hedner
No abstract text is available yet for this article.
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759277/effects-of-chronic-opioid-use-on-sleep-and-wake
#2
REVIEW
Michelle Cao, Shahrokh Javaheri
Chronic use of opioids negatively affects sleep on 2 levels: sleep architecture and breathing. Patients suffer from a variety of daytime sequelae. There may be a bidirectional relationship between poor sleep quality, sleep-disordered breathing, and daytime function. Opioids are a potential cause of incident depression. The best therapeutic option is withdrawal of opioids, which proves difficult. Positive airway pressure devices are considered first-line treatment for sleep-related breathing disorders. New generation positive pressure servo ventilators are increasingly popular as a treatment option for opioid-induced sleep-disordered breathing...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759276/hypnotic-discontinuation-in-chronic-insomnia
#3
REVIEW
Jonathan P Hintze, Jack D Edinger
Patients with chronic insomnia are commonly prescribed hypnotic medications. The long-term effects of chronic hypnotics are not known and discontinuation is encouraged but often difficult to achieve. A gradual taper is preferred to abrupt cessation to avoid rebound insomnia and withdrawal symptoms. Written information provided to the patient about medication discontinuation may be helpful. Cognitive behavioral therapy or behavioral therapies alone can improve hypnotic discontinuation outcomes. There is limited evidence for adjunct medications to assist in hypnotic cessation for insomnia...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759275/sleep-related-drug-therapy-in-special-conditions-children
#4
REVIEW
Nicholas-Tiberio Economou, Luigi Ferini-Strambi, Paschalis Steiropoulos
Sleep disorders in children may lead to neurodevelopmental and neurocognitive deficits; it is important to diagnose and treat them properly. Apart from the existing challenges in diagnosis, another drawback is that few therapies are currently approved. In this article, a comprehensive summary of the most common pediatric sleep disorders, along with the various pharmacologic and nonpharmacologic approaches for their management, is presented. Special attention has been paid to the currently available treatment options for pediatric insomnia, obstructive sleep apnea, parasomnias, narcolepsy, and restless legs syndrome, and comparisons are made with the corresponding treatment options for sleep disorders in adults...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759274/pharmacologic-treatment-of-sleep-disorders-in-pregnancy
#5
REVIEW
Laura P McLafferty, Meredith Spada, Priya Gopalan
Pregnancy often predisposes women to new-onset sleep disturbances, as well as exacerbations of preexisting sleep disorders. The goals of treating perinatal sleep disorders include the promotion of restorative sleep and the benefits it brings to both mother and fetus. The prescribing of any sleep aid in pregnancy must include consideration of the risks and benefits for both the patient and her fetus. Although data on the perinatal use of sleep aids is limited, there may be effects on fetal development, timing and duration of delivery, and postnatal outcomes...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759273/drugs-used-in-circadian-sleep-wake-rhythm-disturbances
#6
REVIEW
Helen J Burgess, Jonathan S Emens
This article focuses on melatonin and other melatonin receptor agonists, and specifically their circadian phase shifting and sleep-enhancing properties. The circadian system and circadian rhythm sleep-wake disorders are briefly reviewed, followed by a summary of the circadian phase shifting, sleep-enhancing properties, and possible safety concerns associated with melatonin and other melatonin receptor agonists. The recommended use of melatonin, including dose and timing, in the latest American Academy of Sleep Medicine Clinical Practice Guidelines for the treatment of intrinsic circadian rhythm disorders is also reviewed...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759272/pharmacologic-and-nonpharmacologic-treatment-of-restless-legs-syndrome
#7
REVIEW
Galia V Anguelova, Monique H M Vlak, Arthur G Y Kurvers, Roselyne M Rijsman
This article provides an updated practical guide for the treatment of primary restless legs syndrome (RLS). Articles that appeared after the American Academy of Neurology guideline search were reviewed according to the same evidence rating schedule. We found limited evidence for nonpharmacologic treatment options. In moderate to severe primary RLS, pharmacologic options may be considered, including iron suppletion, an α2δ ligand, a dopamine agonist, a combination of an α2δ ligand and a dopamine agonist, or oxycodone/naloxone...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759271/drug-therapy-in-obstructive-sleep-apnea
#8
REVIEW
Jan Hedner, Ding Zou
There are several reasons to develop a pharmacologic remedy in obstructive sleep apnea (OSA); but so far, there is no generally effective drug available. Previous attempts to find a drug in OSA therapy were serendipity driven in small pilot trials. There is growing literature on phenotyping pathophysiologic mechanisms of OSA that may be exploited in strategic drug development programs. The current review addresses potential pitfalls encountered in previous studies and highlights several drug candidates under development in the field...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759270/drugs-used-in-parasomnia
#9
REVIEW
Paola Proserpio, Michele Terzaghi, Raffaele Manni, Lino Nobili
Patient education and behavioral management represent the first treatment approaches to the patient with parasomnia, especially in case of disorders of arousal (DOA). A pharmacologic treatment of DOA may be useful when episodes are frequent and persist despite resolution of predisposing factors, are associated with a high risk of injury, or cause significant impairment, such as excessive sleepiness. Approved drugs for DOA are still lacking. The most commonly used medications are benzodiazepines and antidepressants...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759269/drugs-used-in-narcolepsy-and-other-hypersomnias
#10
REVIEW
Gert Jan Lammers
Narcolepsy and idiopathic hypersomnia cannot be cured; all available treatments are symptomatic. It is of paramount importance for patients, and their relatives, to be informed about the consequences of these chronic diseases and to become ready to accept the consequences of the diagnosis before starting any treatment. This facilitates the implementation of behavioral modifications and the proper use of medication to decrease the disease burden. A supportive social environment (eg, family members, friends, employer, colleagues, and patient support groups) is instrumental...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759268/prescription-drugs-used-in-insomnia
#11
REVIEW
Sylvie Dujardin, Angelique Pijpers, Dirk Pevernagie
The scope of this article is to review the effects on sleep of prescription drugs that are commonly prescribed for chronic insomnia in adults. The following groups are discussed: benzodiazepines and its receptor agonists, the dual orexin receptor antagonist suvorexant, melatonin and its receptor agonists, sedating antidepressants, and antipsychotics. Together with the neurobiologic and pharmacologic properties of these drugs, clinical effects are described, including subjective and objective effects on sleep duration, continuity, and architecture...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759267/drug-induced-sleep-disordered-breathing-and-ventilatory-impairment
#12
REVIEW
Ludger Grote
This article describes current knowledge about drug entities that have the potential to induce, aggravate, or modify sleep-disordered breathing. The drug effects on sleep-disordered breathing may vary by patient age, gender, and comorbidity. In general, the clinical relevance of drug-induced sleep-disordered breathing is increasing in sleep medicine and the evidence in the field is growing in parallel.
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759266/drug-induced-insomnia-and-excessive-sleepiness
#13
REVIEW
Ann Van Gastel
Psychotropic and nonpsychotropic drugs, which may induce or aggravate insomnia and/or daytime sleepiness, are discussed. These central nervous system effects are possible from the interactions of a drug with any of the many neurotransmitters or receptors that are involved in sleep and wakefulness. Multiple interactions between disease, sleep, comorbid sleep disorders, and direct or indirect influences of pharmacologic agents are possible. Awareness of these effects is important to adapt treatment and reach optimal results for every patient...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29759265/sleep-wake-neurochemistry
#14
REVIEW
Sebastian C Holst, Hans-Peter Landolt
The regulated alternations between wakefulness and sleep states reflect complex behavioral processes, orchestrated by distinct neurochemical changes in brain parenchyma. No single neurotransmitter or neuromodulator controls the sleep-wake states in isolation. Rather, fine-tuned interactions within organized neuronal circuits regulate waking and sleep states and drive their transitions. Structural or functional dysregulation and medications interfering with these ensembles can lead to sleep-wake disorders and exert wanted or unwanted pharmacological actions on sleep-wake states...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29412993/sleep-in-older-adults-challenges-and-opportunities
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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