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A Tejera-Vaquerizo, J J Meléndez, E Nagore
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January 29, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Saadoun Bin-Hasan, Aleksandar Videnovic, Kiran Maski
STUDY OBJECTIVES: Compare nocturnal REM sleep without atonia (nRWA) and REM sleep behavior disorder (RBD) between pediatric patients with and without narcolepsy and determine if the nRWA index is a valid diagnostic biomarker for narcolepsy. METHODS: Retrospective cohort study of children ages 6 to 18 years who completed a nocturnal polysomnogram (PSG) and Multiple Sleep Latency Test (MSLT). Our study sample included 11 patients with narcolepsy type 1 (NT1), 6 with narcolepsy type 2 (NT2), 12 with idiopathic hypersomnia (IH), and 11 with subjective hypersomnia (sHS)...
February 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Karin Trimmel, Magdalena Żebrowska, Marion Böck, Andrijana Stefanic, Daniel Mayer, Gerhard Klösch, Eduard Auff, Stefan Seidel
BACKGROUND: Excessive daytime sleepiness (EDS) is the main complaint in many neurological sleep disorders, such as idiopathic hypersomnia, narcolepsy, or obstructive sleep apnea/hypopnea syndrome (OSAS). The validity of the Epworth Sleepiness Scale (ESS) as a screening tool for EDS remains controversial. We therefore investigated (1) the interrelation of the ESS total score and the mean sleep latency (MSL) during the multiple sleep latency test (MSLT) and (2) the diagnostic accuracy of the ESS total score to detect EDS in patients with the chief complaint of subjective EDS...
January 16, 2018: Wiener Klinische Wochenschrift
Elisa Evangelista, Régis Lopez, Lucie Barateau, Sofiene Chenini, Adriana Bosco, Isabelle Jaussent, Yves Dauvilliers
OBJECTIVE: To assess the diagnostic value of extended sleep duration on a controlled 32-hour bed-rest protocol in idiopathic hypersomnia (IH). METHODS: 116 patients with high suspicion of IH (37 clear-cut-IH according to multiple sleep latency test criteria and 79 probable-IH), 32 with hypersomnolence associated with a comorbid disorder (non-IH) and 21 controls underwent a polysomnography, modified-sleep latency tests and a 32-h bed-rest protocol. Receiver operating characteristic curves were used to find optimal total sleep time (TST) cut-off values on various periods that discriminate patients to controls...
January 11, 2018: Annals of Neurology
Younghoon Kwon, Louis Kazaglis, Yeilim Cho, Michael J Howell, Mark W Mahowald
Reliability of mean sleep latency testing (MSLT) over consecutive days in patients with hypersomnia is unknown. We reviewed MSLTs of patients with hypersomnia without cataplexy who underwent our two consecutive MSLT protocol (N=29). Average MSLs were 10.9 and 10.9 minutes for days 1 and 2, respectively. Agreement for pathological hypersomnia (defined as MSL≤8 minutes) between MSLT days showed k=0.85 for all (N=29) and k=0.76 for those without sleep apnea (N=20). In patients with subjective complaints of hypersomnia, a single MSLT is sufficient (vs...
October 2017: Sleep and Biological Rhythms
Yi Liu, Hui Feng, Wenjuan Liu, Hongjing Mao, Yali Mo, Yan Yin, Zhenghe Yu, Lianlian Xu
OBJECTIVE: To compare the difference between acupuncture and estazolam on arousal state in patients of primary insomnia, and to explore its nerve electrophysiology mechanism. METHODS: Sixty-four patients of primary insomnia were randomized into an acupuncture group (32 cases) and a medication group (32 cases). After 3 patients were excluded, 31 cases in the acupuncture group and 30 cases in the medication group were included. Patients in the acupuncture group were treated with acupuncture at Sishencong (EX-HN 1), Anmian (Extra), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6), Shenmai (BL 62) as main acupoints, combined with supporting acupoints, once a day, five times per week, continuously for 4 weeks...
January 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Chad Ruoff, Fabio Pizza, Lynn Marie Trotti, Karel Sonka, Stefano Vandi, Joseph Cheung, Swaroop Pinto, Mali Einen, Narong Simakajornboon, Fang Han, Paul Peppard, Sona Nevsimalova, Giuseppe Plazzi, David Rye, Emmanuel Mignot
STUDY OBJECTIVES: To examine repeatability of Multiple Sleep Latency Test (MSLT) results in narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2) according to the criteria of the International Classification of Sleep Disorders, Third Edition (ICSD-3). METHODS: Repeatability of the MSLT was retrospectively evaluated in NT1 (n = 60) and NT2 (n = 54) cases, and controls (n = 15). All subjects had documented HLA-DQB1*06:02 status and/or hypocretin-1 levels from cerebrospinal fluid...
January 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Lauren M Postlewait, Clara R Farley, Alexandra M Seamens, Nina Le, Monica Rizzo, Maria C Russell, Michael C Lowe, Keith A Delman
BACKGROUND: Limited data exist characterizing complications after axillary lymphadenectomy for melanoma. With high rates of complications reported after dissection for breast cancer and data suggesting that completion lymphadenectomy may have limited therapeutic benefit, this study characterized morbidity to facilitate clinical decision-making. METHODS: Using a broad definition for complications, patients who underwent axillary dissection for melanoma at a single center (from 2003 to 2015) were assessed through retrospective chart review...
February 2018: Annals of Surgical Oncology
Demeke Geremew, Ania Rahimi-Golkhandan, Khosro Sadeghniiat-Haghighi, Yadollah Shakiba, Ahmad Khajeh-Mehrizi, Bita Ansaripour, Maryam Izad
Narcolepsy is a rare, disabling disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis. Several studies demonstrated its association with HLA-DQB1*0602 in various ethnic groups. Our study aimed to determine the prevalence of HLA-DQB1*0602 allele in Iranian patients with narcolepsy and assess its predictive parameters for diagnosing narcolepsy. In addition, car accidents and job problems were assessed among narcoleptic patients. We studied 44 narcoleptic patients, 30 patients with other types of excessive daytime sleepiness (EDS)  and 50 healthy age and sex matched individuals in this case-control study...
October 2017: Iranian Journal of Allergy, Asthma, and Immunology
Yoo Hyun Um, Tae-Won Kim, Jong-Hyun Jeong, Ho-Jun Seo, Jin-Hee Han, Sung-Min Kim, Ji Hyun Song, Seung-Chul Hong
STUDY OBJECTIVES: Narcolepsy is a chronic disorder with numerous adverse long-term consequences including increased obesity, high mortality rates, and decreased quality of life. With emerging attention to the long-term course of the disorder and importance of accurate diagnosis, the diagnostic stability of the Multiple Sleep Latency Test (MSLT)-the mostly frequently used test to identify narcolepsy-is often challenged. METHODS: In this study, we compared the baseline and follow-up demographic characteristics and body mass index (BMI) of patients with narcolepsy type 1...
November 1, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Raja B Khan, Thomas E Merchant, Zsila S Sadighi, Mercedes S Bello, Zhaohua Lu, April Sykes, Merrill S Wise, Valerie M Crabtree, Jennifer Zabrowski, Andrea Simmons, Mary E Clark, Belinda N Mandrell
Daytime sleepiness is recognized in childhood brain tumor survivors. Our objective was to determine prevalence, risk factors for PSG/MLST proven hypersomnia/narcolepsy, and response to stimulants in childhood brain tumor survivors. Standard PSG/MSLT criteria were used to diagnose hypersomnia/narcolepsy. Medical records of brain tumor survivors having undergone a PSG/MSLT were reviewed for the diagnostic code of hypersomnia/narcolepsy. Survivors with hypersomnia/narcolepsy were matched with 2-3 survivors without reported hypersomnia/narcolepsy by age at tumor diagnosis, gender, and time from tumor diagnosis...
November 8, 2017: Journal of Neuro-oncology
Régis Lopez, Anis Doukkali, Lucie Barateau, Elisa Evangelista, Sofiene Chenini, Isabelle Jaussent, Yves Dauvilliers
Study Objectives: To assess the test-retest reliability of the polysomnography-multiple sleep latency test (PSG-MSLT) diagnostic classification and measures and to study the determinants of its variability in patients with narcolepsy type 1 (NT1) or with noncataplectic central disorders of hypersomnolence (NCHS): type 2 (NT2), idiopathic hypersomnia (IH), and unspecified hypersomnolence (unspecified excessive daytime sleepiness [UnsEDS]). Methods: PSG-MSLT in drug-free conditions was administered twice (median interval of 1...
December 1, 2017: Sleep
T Murer, L L Imbach, M Hackius, R N Taddei, E Werth, R Poryazova, Y V Gavrilov, S Winkler, D Waldvogel, C R Baumann, P O Valko
Objective: Multiple sleep onset rapid eye movement (R) periods (SOREMPs) and a mean sleep latency ≤8min on the multiple sleep latency test (MSLT) are diagnostic criteria of narcolepsy (NC), but occur also in other conditions with increased sleep pressure, including insufficient sleep syndrome (ISS), sleep disordered breathing (SDB) or Parkinson's disease (PD). These false positives are common, may create diagnostic uncertainty, and highlight the need for complementary MSLT measures with high specificity for narcolepsy...
October 23, 2017: Sleep
David Terkelsen, Jacob Tolstrup, Camilla Hundahl Johnsen, Ole Lund, Helle Kiellberg Larsen, Peder Worning, Magnus Unemo, Henrik Westh
We describe a multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Denmark, 2017. Whole genome sequencing of the strain GK124 identified MSLT ST1903, NG-MAST ST1614 and all relevant resistance determinants including similar penA resistance mutations previously described in ceftriaxone-resistant gonococcal strains. Although treatment with ceftriaxone 0.5 g plus azithromycin 2 g was successful, increased awareness of spread of gonococcal strains threatening the recommended dual therapy is crucial...
October 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Luciana B M Godoy, Luciana Palombini, Dalva Poyares, Cibele Dal-Fabbro, Thaís Moura Guimarães, Priscila Calixto Klichouvicz, Sergio Tufik, Sonia Maria Togeiro
Objectives: To evaluate the long term effects of an oral appliance on clinical symptoms, respiratory sleep parameters, sleep quality and sustained attention in patients with Upper Airway Resistance Syndrome (UARS) compared with placebo. Methods: This study was a randomized placebo-controlled clinical trial. Thirty UARS patients were randomized in two groups: placebo and mandibular advancement device (MAD) groups. UARS criteria were presence of sleepiness (Epworth Sleepiness Scale ≥ 10) and/or fatigue (Modified Fatigue Impact Scale ≥ 38) associated with an apnea/hypopnea index (AHI) ≤ 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time...
October 17, 2017: Sleep
Henriette Koch, Logan Douglas Schneider, Laurel A Finn, Eileen B Leary, Paul E Peppard, Erika Hagen, Helge Bjarup Dissing Sorensen, Poul Jennum, Emmanuel Mignot
Study Objectives: To determine whether defining two subtypes of sleep-disordered breathing (SDB) events-with or without hypoxia-results in measures that are more strongly associated with hypertension and sleepiness. Methods: A total of 1022 participants with 2112 nocturnal polysomnograms from the Wisconsin Sleep Cohort were analyzed with our automated algorithm, developed to detect breathing disturbances and desaturations. Breathing events were time-locked to desaturations, resulting in two indices-desaturating (hypoxia-breathing disturbance index [H-BDI]) and nondesaturating (nonhypoxia-breathing disturbance index [NH-BDI]) events-regardless of arousals...
November 1, 2017: Sleep
Christine M Walsh, Leslie Ruoff, Kathleen Walker, Alaisa Emery, Jonathan Varbel, Elissaios Karageorgiou, Phi N Luong, Irida Mance, Hilary W Heuer, Adam L Boxer, Lea T Grinberg, Joel H Kramer, Bruce L Miller, Thomas C Neylan
Objectives: To elucidate the unique sleep and waking characteristics in progressive supranuclear palsy (PSP), a neurodegenerative disease associated with motor deficits and dementia that largely affects the brainstem and thalamic regions. Methods: A total of 20 PSP and 16 healthy older adult controls participated in this study. The participants underwent an overnight polysomnography and multiple sleep latency test (MSLT) the following day. Prior to the MSLT last trial, they were asked to complete the Stanford Sleepiness Scale...
November 1, 2017: Sleep
Eve J Denton, Maree Barnes, Tom Churchward, Melinda Jackson, Allison Collins, Matthew T Naughton, Eli Dabscheck
PURPOSE: Excessive daytime sleepiness (EDS) is a debilitating symptom which occurs commonly in both primary sleep and mood disorders. The prevalence of mood disorders in patients with EDS, evaluated objectively with a mean sleep latency test (MSLT), has not been reported. We hypothesize that mood disorders are highly prevalent in patients being investigated for EDS. This study aims to report the prevalence of mood disorder in the MSLT population and investigate the association between mood disorder and objective and subjective scores of sleepiness...
October 9, 2017: Sleep & Breathing, Schlaf & Atmung
Alexander M M Eggermont, Reinhard Dummer
The spectacular outcomes of the phase III trials regarding nivolumab versus ipilimumab in fully resected stage IIIB/C-IV and of the combination of dabrafenib (D) plus trametinib (T) in BRAF-mutant stage III patients demonstrate that effective treatments in advanced melanoma are also highly effective in the adjuvant setting. In 2016, an overall survival benefit with adjuvant high-dose ipilimumab was demonstrated, and the European Organisation for Research and Treatment of Cancer trial 1325 comparing pembrolizumab versus placebo will complete the picture in the early 2018...
November 2017: European Journal of Cancer
Francesca Ginatempo, Pietro Pirina, Francesco Melis, Franca Deriu
It has been reported that during and/or after acute trigeminal nerve stimulation (TNS) a state of sedation, decreased attention and vigilance, with a tendency to fall asleep, occurs. Whether these effects are due to a hypnotic action of TNS is yet to be demonstrated. This pilot study investigates whether acute TNS affects the latency of sleep using the Multiple Sleep Latency Test (MSLT) in healthy subjects. MSLT was performed in 14 healthy subjects after 20 min of real- and a sham-TNS, delivered in two different sessions...
September 30, 2017: Neurological Sciences
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