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Yun Li, Alexandros N Vgontzas, Julio Fernandez-Mendoza, Ilia Kritikou, Maria Basta, Slobodanka Pejovic, Jordan Gaines, Edward O Bixler
STUDY OBJECTIVES: Objective and subjective measures of excessive daytime sleepiness (EDS) are only weakly associated. No study, however, has examined whether these two measures of EDS differ in terms of underlying mechanisms and prognostic value. Pro-inflammatory cytokines, i.e., interleukin-6 (IL-6) appear to promote sleepiness/fatigue, while the stress hormone cortisol promotes vigilance. We hypothesized that objective sleepiness is associated with increased levels of IL-6 and decreased levels of cortisol...
October 10, 2016: Sleep
David T Plante, Laurel A Finn, Erika W Hagen, Emmanuel Mignot, Paul E Peppard
BACKGROUND: Hypersomnolence is common in depression, however longitudinal associations of excessive daytime sleepiness (EDS), long habitual sleep duration, and objective sleep propensity with depressive symptomatology are not well established. METHODS: Data from adults participating in the Wisconsin Sleep Cohort Study who had multiple assessments at 4-year intervals were utilized in analyses. Conditional (intrasubject) logistic regression estimated the likelihood of development of depression and three primary hypersomnolence measures: subjective EDS [Epworth Sleepiness Scale (ESS) >10], habitual sleep duration ≥9h/day, and increased physiological sleep propensity [multiple sleep latency test (MSLT) mean sleep latency <8min]...
October 3, 2016: Journal of Affective Disorders
T A Roehrs, T Roth
BACKGROUND: Given concerns about the abuse liability of hypnotics, this study assessed hyperarousal in people with insomnia and its relation to hypnotic self-administration over 12 months of nightly hypnotic use. METHODS: Ninety-five subjects with insomnia (age 32-64 years) underwent screening nocturnal polysomnogram (NPSG) and Multiple Sleep Latency Test (MSLT) the following day and, then, were randomized to receive zolpidem 10 mg or placebo nightly for 12 months...
July 2016: Sleep Medicine
Yu-Shu Huang, Feng-Yuan Liu, Chin-Yang Lin, Ing-Tsung Hsiao, Christian Guilleminault
The relationship between functional brain images and performances in narcoleptic patients and controls is a new field of investigation. We studied 71 young, type 1 narcoleptic patients and 20 sex- and age-matched control individuals using brain positron emission tomography (PET) images and neurocognitive testing. Clinical investigation was carried out using sleep-wake evaluation questionnaires; a sleep-wake study was conducted with actigraphy, polysomnography, multiple sleep latency test (MSLT), and blood tests (with human leukocyte antigen typing)...
January 19, 2016: Sleep Medicine
Rong Ren, Yun Li, Jihui Zhang, Junying Zhou, Yuanfeng Sun, Lu Tan, Taomei Li, Yun-Kwok Wing, Xiangdong Tang
Subjective daytime sleepiness is considered a significant risk factor of hypertension in patients with obstructive sleep apnea (OSA). In this study, our goal was to examine the joint effect on hypertension of OSA and objective daytime sleepiness measured by the multiple sleep latency test (MSLT). A total of 1338 Chinese patients with OSA and 484 primary snorers were included in the study. All subjects underwent 1 night polysomnography followed by MSLT. The MSLT values were classified into 3 categories: >8 minutes, 5 to 8 minutes, and <5 minutes...
November 2016: Hypertension
M F Madu, M W J M Wouters, A C J van Akkooi
Sentinel node biopsy (SNB) is the most accurate staging tool for melanoma patients. The procedure is indicated especially for intermediate thickness melanoma (pT2/3). SNB can be of value in thin melanoma (>0.75 mm in thickness), with adverse prognostic factors, and in thick melanomas (pT4), although T4 patients are already at high risk of disease progression. Completion lymph node dissection (CLND) after positive SN yields additional non-sentinel lymph nodes (NSNs) in 20% of cases. Several factors are predictive for NSN positivity, such as primary tumor characteristics and SN tumor burden...
August 24, 2016: European Journal of Surgical Oncology
Christopher A Kosky, Anastasios Bonakis, Arthee Yogendran, Gihan Hettiarachchi, Paul I Dargan, Adrian J Williams
STUDY OBJECTIVES: Drugs and psychoactive substances can cause sleepiness and when undetected, may lead to over diagnosis of central hypersomnias. We performed urine drug testing using gas chromatography-mass spectrometry in adults undergoing multiple sleep latency testing (MSLT) for a suspected central hypersomnia. We examined how the drug test results modified the treating physician's diagnosis. METHODS: One hundred eighty-six consecutive patients with a suspected central hypersomnia who underwent clinical assessment, MSLT and urine drug testing by gas chromatography-mass spectrometry were retrospectively studied...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Richard A Sater, Mark Gudesblatt, Kiren Kresa-Reahl, David W Brandes, Pamela Sater
BACKGROUND: Patients with multiple sclerosis (MS) have higher rates of fatigue, mood disturbance, and cognitive impairments than healthy populations. Disease-modifying agents may affect sleep. Although patients taking natalizumab often show improvement in fatigue during the first year of therapy, the mechanism behind this effect is unknown. The aim of the NAPS-MS study was to investigate whether natalizumab affected objective measures of sleep as determined by polysomnography (PSG) and multiple sleep latency testing (MSLT) in patients with MS with fatigue or sleepiness initiating therapy...
July 2016: International Journal of MS Care
Catalina Mosquera, Haily S Vora, Nasreen Vohra, Timothy L Fitzgerald
BACKGROUND: Multicenter selective lymphadenectomy trial 1 (MSLT-I) defined the prognostic and potential therapeutic values of sentinel lymph node biopsy (SLNB) for intermediate-thickness melanoma. The role of completion lymphadenectomy (CLND) is, however, unclear and the subject of the ongoing MSLT-II trial. METHODS: From 2003 to 2012, patients with tumors 1-4 mm thick with positive SLNB were identified in the Surveillance Epidemiology and End Results Program registry...
July 27, 2016: Annals of Surgical Oncology
Bochen Cao
BACKGROUND: In the past three decades, the elderly population in the United States experienced increase in life expectancy (LE) and disability-free life expectancy (LE(ND)), but decrease in life expectancy with disability (LE(D)). Smoking and obesity are two major risk factors that had negative impacts on these trends. While smoking prevalence continues to decline in recent decades, obesity prevalence has been growing and is currently at a high level. This study aims to forecast the healthy life expectancy for older adults aged 55 to 85 in the US from 2011 to 2040, in relation to their smoking and obesity history...
2016: Population Health Metrics
Yan-Wen Luo, Huan Yu, Lu-Hua Yuan, Guo-Xing Zhu
BACKGROUND: Kleine-Levin syndrome (KLS) is a rare sleep disorder characterized by recurrent episodes of hypersomnia. Polysomnographic (PSG) researches of KLS have been reported only in few publications in the past decades. This study aimed to investigate the characteristics of PSG of KLS. METHODS: This study, which was conducted from March 2010 to July 2014, included seven patients diagnosed with KLS in the Sleep and Wake Disorder Center of Huashan Hospital, Fudan University (Shanghai, China)...
July 5, 2016: Chinese Medical Journal
Chad Ruoff, David Rye
Narcolepsy is a chronic neurological disease manifesting as difficulty with maintaining continuous wake and sleep. Clinical presentation varies but requires excessive daytime sleepiness (EDS) occurring alone or together with features of rapid-eye movement (REM) sleep dissociation (e.g., cataplexy, hypnagogic/hypnopompic hallucinations, sleep paralysis), and disrupted nighttime sleep. Narcolepsy with cataplexy is associated with reductions of cerebrospinal fluid (CSF) hypocretin due to destruction of hypocretin peptide-producing neurons in the hypothalamus in individuals with a specific genetic predisposition...
July 20, 2016: Current Medical Research and Opinion
Laura Dunne, Pallavi Patel, Emily L Maschauer, Ian Morrison, Renata L Riha
BACKGROUND: Narcolepsy is a chronic primary sleep disorder, characterized by excessive daytime sleepiness and sleep dysfunction with or without cataplexy. Narcolepsy is uncommon, with a low prevalence rate which makes it difficult to diagnose definitively without a complex series of tests and a detailed history. The aim of this study was to review patients referred to a tertiary sleep centre who had been labelled with a diagnosis of narcolepsy prior to referral in order to assess if the diagnosis was accurate, and if not, to determine the cause of diagnostic misattribution...
June 23, 2016: Sleep & Breathing, Schlaf & Atmung
Sonia Meza-Vargas, Eleni Giannouli, Magdy Younes
INTRODUCTION: The utility of multiple sleep latency tests (MSLTs) is limited to determining sleep onset latency (SOL) and rapid eye movement sleep latency. The odds ratio product (ORP) is a continuous index of sleep depth with values of 0, 1.0, and 2.5 reflecting very deep sleep, light sleep, and full wakefulness, respectively. We determined the time course of sleep depth during MSLT naps expecting that this would enhance the test's clinical utility. METHODS: Thirty MSLTs (150 naps) were performed for excessive somnolence...
2016: Nature and Science of Sleep
Linda E Nugent, Kenneth A Wallston
Modified social learning theory (MSLT) applied to health predicts that health behavior is a multiplicative function of health value and perceptions of control over health. The self-management behaviors of persons with Type 2 diabetes mellitus, internal diabetes locus of control (IDLC), diabetes self-efficacy (DSE), and health value (HV) were assessed with an index of diabetes self-care activities in 107 patients receiving insulin. Multiple regression analysis showed DSE as the only MSLT construct that correlated with the index of diabetes self-care behaviors (β = ...
June 4, 2016: Journal of Behavioral Medicine
Alexander C J van Akkooi, Michael B Atkins, Sanjiv S Agarwala, Paul Lorigan
Wide local excision is considered routine therapy after initial diagnosis of primary melanoma to reduce local recurrences, but it does not impact survival. Sentinel node staging is recommended for melanomas of intermediate thickness, but it has also not demonstrated any indisputable therapeutic effect on survival. The prognostic value of sentinel node staging has been long established and is therefore considered routine, especially in light of the eligibility criteria for adjuvant therapy (trials). Whether completion lymph node dissection after a positive sentinel node biopsy improves survival is the question of current trials...
2016: American Society of Clinical Oncology Educational Book
Simone Ribero, Eugenio Sportoletti Baduel, Simona Osella-Abate, Emi Dika, Pietro Quaglino, Franco Picciotto, Giuseppe MACRIPò, Veronique Bataille
The management of melanoma is constantly evolving. New therapies and surgical advances have changed the landscape over the last years. Since being introcuced by Dr Donald Morton, the role of sentinel lymph node has been debated. In many melanoma centres, sentinel node biopsy is not a standard of care for melanoma above 1 mm in thickness. The results of the MSLT-II trial are not available for a while and in the meantime, this procedure is offered as a prognostic indicator as it has been shown to be very useful for assessing risk of relapse...
June 1, 2016: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Taeko Sasai-Sakuma, Katsunori Kikuchi, Yuichi Inoue
OBJECTIVE: This study investigates obstructive sleep apnea syndrome (OSAS) prevalence among Japanese occupational drivers and factors associated with a pathological level of objective daytime sleepiness. METHODS: Portable monitoring device (PMD) screening was applied to 2389 Japanese male public transportation traffic drivers. Nocturnal polysomnography (n-PSG) and multiple sleep latency tests (MSLT) were administered to subjects with apnea-hypopnea index (AHI) at least 15 on PMD...
May 2016: Journal of Occupational and Environmental Medicine
Panagis Drakatos, Sean Higgins, Iain Duncan, Kate Bridle, Sam Briscoe, Guy D Leschziner, Brian D Kent, Adrian J Williams
Rapid eye movement sleep (REM) presents with a characteristic erratic breathing pattern. We investigated the feasibility of using respiration, derived from respiratory inductance plethysmography (RIP), in conjunction with chin electromyography, electrocardiography and pulse oximetry to facilitate the identification of REM sleep (RespREM) during nocturnal polysomnography (NPSG) and Multiple Sleep Latency Testing (MSLT). The Cohen's weighted kappa for the presence of REM and its duration in 20 consecutive NPSGs, using RespREM and compared to the current guidelines, ranged between 0...
August 2016: Respiratory Physiology & Neurobiology
Favelle Lamb, Alexander Ploner, Katharina Fink, Markus Maeurer, Peter Bergman, Fredrik Piehl, Daniel Weibel, Pär Sparén, Lisen Arnheim Dahlström
OBJECTIVES: To investigate disease history before A(H1N1)pdm09 vaccination as a risk factor for narcolepsy. METHODS: Case-control study in Sweden. Cases included persons referred for a Multiple Sleep Latency Test between 2009 and 2010, identified through diagnostic sleep centres and confirmed through independent review of medical charts. Controls, selected from the total population register, were matched to cases on age, gender, MSLT-referral date and county of residence...
2016: PloS One
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