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https://www.readbyqxmd.com/read/28802388/adenotonsillectomy-outcomes-in-children-with-sleep-apnea-and-narcolepsy
#1
Sneh Biyani, Tina D Cunningham, Cristina M Baldassari
OBJECTIVE: To identify improvements in daytime sleepiness following adenotonsillectomy in children with non-severe obstructive sleep apnea and narcolepsy. STUDY DESIGN: Case series with chart review over 15 years. SETTING: Tertiary Children's Hospital. SUBJECTS AND METHODS: Children between 6 and 17 years of age with narcolepsy that underwent adenotonsillectomy for non-severe obstructive sleep apnea (OSA) were included...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28796576/antibody-affinity-against-2009-a-h1n1-influenza-and-pandemrix-vaccine-nucleoproteins-differs-between-childhood-narcolepsy-patients-and-controls
#2
Alexander Lind, Eva Freyhult, Anita Ramelius, Tomas Olsson, Lisen Arnheim-Dahlström, Favelle Lamb, Mohsen Khademi, Aditya Ambati, Markus Maeurer, Izaura Lima Bomfim, Katharina Fink, Malin Fex, Carina Törn, Helena Elding Larsson, Åke Lernmark
Increased narcolepsy incidence was observed in Sweden following the 2009 influenza vaccination with Pandemrix(®). A substitution of the 2009 nucleoprotein for the 1934 variant has been implicated in narcolepsy development. The aims were to determine (a) antibody levels toward wild-type A/H1N1-2009[A/California/04/2009(H1N1)] (NP-CA2009) and Pandemrix-[A/Puerto Rico/8/1934(H1N1)] (NP-PR1934) nucleoproteins in 43 patients and 64 age-matched controls; (b) antibody affinity in reciprocal competitive assays in 11 childhood narcolepsy patients compared with 21 age-matched controls; and (c) antibody levels toward wild-type A/H1N1-2009[A/California/04/2009(H1N1)] (H1N1 NS1), not a component of the Pandemrix vaccine...
August 10, 2017: Viral Immunology
https://www.readbyqxmd.com/read/28777182/driving-safety-and-fitness-to-drive-in-sleep-disorders
#3
Jon Tippin, Mark Eric Dyken
Driving an automobile while sleepy increases the risk of crash-related injury and death. Neurologists see patients with sleepiness due to obstructive sleep apnea, narcolepsy, and a wide variety of neurologic disorders. When addressing fitness to drive, the physician must weigh patient and societal health risks and regional legal mandates. The Driver Fitness Medical Guidelines published by the National Highway Traffic Safety Administration (NHTSA) and the American Association of Motor Vehicle Administrators (AAMVA) provide assistance to clinicians...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28777180/sleep-wake-disorders-of-childhood
#4
Suresh Kotagal
PURPOSE OF REVIEW: Sleep-wake disorders occur in 10% to 28% of children and differ somewhat in pathophysiology and management from sleep-wake disorders in adults. This article discusses the diagnosis and management of key childhood sleep disorders. RECENT FINDINGS: The role of sleep in memory consolidation and in the facilitation of learning has been increasingly recognized, even at the toddler stage. Cataplexy, a key feature of narcolepsy type 1, may be subtle in childhood and characterized by transient muscle weakness isolated to the face...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28777172/narcolepsy-and-other-central-hypersomnias
#5
Yves Dauvilliers, Lucie Barateau
PURPOSE OF REVIEW: This article focuses on the clinical presentation, pathophysiology, diagnosis, differential diagnosis, and management of narcolepsy type 1 and narcolepsy type 2, idiopathic hypersomnia, Kleine-Levin syndrome, and other central disorders of hypersomnolence, as defined in the International Classification of Sleep Disorders, Third Edition (ICSD-3). RECENT FINDINGS: In ICSD-3, the names of some central disorders of hypersomnolence have been changed: narcolepsy with cataplexy and narcolepsy without cataplexy have been renamed narcolepsy type 1 and narcolepsy type 2, respectively...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28777171/diagnostic-approach-and-investigation-in-sleep-medicine
#6
Michael H Silber
PURPOSE OF REVIEW: This article provides a clinical approach to the appropriate investigation and diagnosis of sleep disorders commonly seen by neurologists. RECENT FINDINGS: Home sleep apnea testing in appropriate situations can replace laboratory polysomnography in many cases of uncomplicated sleep apnea. Multiple sleep latency tests must be performed meticulously and interpreted in the clinical setting to avoid overdiagnoses of narcolepsy. Human leukocyte antigen testing has limited utility in establishing a diagnosis of narcolepsy because a positive test has low specificity...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28777170/brain-circuitry-controlling-sleep-and-wakefulness
#7
Richard L Horner, John H Peever
PURPOSE OF REVIEW: This article outlines the fundamental brain mechanisms that control sleep-wake patterns and reviews how pathologic changes in these control mechanisms contribute to common sleep disorders. RECENT FINDINGS: Discrete but interconnected clusters of cells located within the brainstem and hypothalamus comprise the circuits that generate wakefulness, non-rapid eye movement (non-REM) sleep, and REM sleep. These clusters of cells use specific neurotransmitters, or collections of neurotransmitters, to inhibit or excite their respective sleep- and wake-promoting target sites...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28771870/the-perception-and-attention-functions-test-battery-as-a-measure-of-neurocognitive-impairment-in-patients-with-suspected-central-disorders-of-hypersomnolence
#8
Markus Ramm, Arsalan Jafarpour, Matthias Boentert, Nelly Lojewsky, Peter Young, Anna Heidbreder
The aim of the current study was to evaluate an attention test as a discriminative tool to measure neurocognitive impairment in patients with disorders of hypersomnolence. Chronic excessive daytime sleepiness is the main symptom in central disorders of hypersomnolence. For diagnostic purposes and treatment evaluation, reliable assessment of excessive daytime sleepiness is required. Thirty-six patients with central disorders of hypersomnolence were compared with 20 healthy controls. All participants performed the 'Perception and Attention Functions' (WAF) of the Vienna Test System...
August 2, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28763482/attention-impairments-and-adhd-symptoms-in-adult-narcoleptic-patients-with-and-without-hypocretin-deficiency
#9
Marco Filardi, Fabio Pizza, Lorenzo Tonetti, Elena Antelmi, Vincenzo Natale, Giuseppe Plazzi
BACKGROUND: Attentional complaints are common in narcolepsy patients and can overlap with daytime sleepiness features. Few studies attempted to characterize attentional domains in narcolepsy leading to controversial results. We aimed to assess the impact of hypocretin deficiency on attentional functioning by comparing performances on the attention network test (ANT) of narcoleptic patients with hypocretin deficiency (narcolepsy type 1-NT1) versus patients without hypocretin deficiency (narcolepsy type 2-NT2) and healthy controls...
2017: PloS One
https://www.readbyqxmd.com/read/28738331/future-perspectives-in-sleep-medicine
#10
Leh-Kiong Anne Huon, Christian Guilleminault
"Sleep Medicine" is now a specialty in its own right. Currently, there is increasing recognition of the very negative impact sleep disorders have on learning, education, safety, and quality of life. Technological advances will help us to break down diagnoses (e.g., narcolepsy has now been subdivided into types 1 and 2, depending upon the hypocretin levels in the spinal fluid) and to discover relationships to other bodily systems (e.g., type 1 narcolepsy potentially being an autoimmune disorder). The modern lifestyle of many, as characterized by a shortening of sleep periods, shift work, jet lag, and the need to be constantly available, means that advances in sleep medicine may result in a major understanding of more balanced "work-rest lifestyle" modifications...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28735916/morbidity-and-mortality-of-middle-aged-and-elderly-narcoleptics
#11
Poul Jennum, Eva Wiberg Thorstensen, Line Pickering, Rikke Ibsen, Jakob Kjellberg
OBJECTIVES: The objective of the study was to evaluate the morbidities and mortality in a national group of middle-aged and elderly narcolepsy patients before and after the first diagnosis of the condition. METHODS: From the Danish National Patient Registry (NPR), 1174 patients (45.1% males) aged 20-59 years and 339 patients (44.8% males) aged 60+ who received a diagnosis of narcolepsy between 1998 and 2014 were compared, respectively, with 4716 and 1353 control citizens matched for age, gender and geography, who were randomly chosen from the Danish Civil Registration System Statistics...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28735675/treatment-of-narcolepsy-and-other-organic-hypersomnias-in-children
#12
REVIEW
Suresh Kotagal
The comprehensive management of chronic disorders such as hypersomnias of childhood requires combining life-style changes with rational pharmacotherapy that is based on treating the symptoms that are most bothersome, the age, comorbidities, and metabolic and endocrine status of the patient. The excessive sleepiness of narcolepsy and idiopathic hypersomnia is best treated with dextroamphetamine or methylphenidate preparations or modafinil/armodafinil. Cataplexy treatment requires sodium oxybate, tricyclic agents, selective norepinephrine reuptake inhibitors or selective serotonin reuptake inhibitors...
June 20, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28728625/parental-fitness-questioned-on-the-grounds-of-narcolepsy-presentation-of-two-cases
#13
Laura Barbero, Annamaria Govi, Fabio Pizza, Giuseppe Plazzi, Francesca Ingravallo
We report two cases of fathers whose parental fitness was questioned during divorce and custody litigation because of narcolepsy type 2 and type 1, respectively. These cases highlighted both the existence of a narcolepsy-related stigma and the need to involve sleep experts in custody assessments when concerns about the parental fitness are related to a sleep disorder, expanding the field of interest of the growing "sleep forensics."
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28726523/investigational-therapies-for-the-treatment-of-narcolepsy
#14
REVIEW
Stefano de Biase, Annacarmen Nilo, Gian Luigi Gigli, Mariarosaria Valente
Narcolepsy is a chronic sleep disorder characterized by a pentad of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations, and disturbed nocturnal sleep. While non-pharmacological treatments are sometimes helpful, more than 90% of narcoleptic patients require a pharmacological treatment. Areas covered: The present review is based on an extensive Internet and PubMed search from 1994 to 2017. It is focused on drugs currently in development for the treatment of narcolepsy...
August 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28724928/on-wakefulness-fluctuations-as-a-source-of-bold-functional-connectivity-dynamics
#15
Ariel Haimovici, Enzo Tagliazucchi, Pablo Balenzuela, Helmut Laufs
Human brain dynamics and functional connectivity fluctuate over a range of temporal scales in coordination with internal states and environmental demands. However, the neurobiological significance and consequences of functional connectivity dynamics during rest have not yet been established. We show that the coarse-grained clustering of whole-brain dynamic connectivity measured with magnetic resonance imaging reveals discrete patterns (dynamic connectivity states) associated with wakefulness and sleep. We validate this using EEG in healthy subjects and patients with narcolepsy and by matching our results with previous findings in a large collaborative database...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28707076/correlation-of-changes-in-patient-reported-quality-of-life-with-physician-rated-global-impression-of-change-in-patients-with-narcolepsy-participating-in-a-clinical-trial-of-sodium-oxybate-a-post-hoc-analysis
#16
Richard K Bogan, Jed Black, Todd Swick, Mortimer Mamelak, Ruzica Kovacevic-Ristanovic, Kathleen F Villa, Fannie Mori, Jacques Montplaisir
INTRODUCTION: Narcolepsy patients report lower health-related quality of life (HRQoL) than the general population, as measured by the Short Form-36 Health Survey (SF-36). This analysis evaluated whether changes in SF-36 correlated with physician-rated Clinical Global Impression of Change (CGI-C). METHODS: Data were from 209 of 228 narcolepsy patients participating in an 8-week clinical trial of sodium oxybate. Changes from baseline for SF-36 subscales (Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health) and the summary scores were evaluated for correlation with CGI-C overall and by treatment group...
July 13, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/28691719/narcolepsy-type-1-and-hypersomnia-associated-with-a-psychiatric-disorder-show-different-slow-wave-activity-dynamics
#17
Ewa Walacik-Ufnal, Anna Justyna Piotrowska, Dorota Wołyńczyk-Gmaj, Piotr Januszko, Bartłomiej Gmaj, Marcin Ufnal, Marek Kabat, Marcin Wojnar
The aim of the study was to compare electrophysiological parameters of night sleep in narcolepsy type 1 and hypersomnia associated with a psychiatric disorder. Fortyfour patients: 15 with narcolepsy type 1, 14 with hypersomnia associated with a psychiatric disorder and 15 age- and sex-matched controls participated in the study. The study subjects filled in the Athens Insomnia Scale (AIS) and the Beck Depression Inventory (BDI). The severity of daytime sleepiness was quantified subjectively using the Epworth Sleepiness Scale (ESS) and the Stanford Sleepiness Scale (SSS), and objectively using the Multiple Sleep Latency Test (MSLT)...
2017: Acta Neurobiologiae Experimentalis
https://www.readbyqxmd.com/read/28684017/postnatal-treatment-of-women-with-narcolepsy-who-choose-to-breastfeed-time-for-a-reappraisal
#18
EDITORIAL
Todd J Swick
No abstract text is available yet for this article.
May 29, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28680929/orexins-and-the-cardiovascular-events-of-awakening
#19
REVIEW
Alessandro Silvani
This brief review aims to provide an updated account of the cardiovascular events of awakening, proposing a testable conceptual framework that links these events with the neural control of sleep and the autonomic nervous system, with focus on the hypothalamic orexin (hypocretin) neurons. Awakening from non-rapid-eye-movement sleep entails coordinated changes in brain and cardiovascular activity: the neural "flip-flop" switch that governs state transitions becomes biased toward the ascending arousal systems, arterial blood pressure and heart rate rise toward waking values, and distal skin temperature falls...
2017: Temperature: Multidisciplinary Biomedical Journal
https://www.readbyqxmd.com/read/28677318/the-cost-utility-of-sodium-oxybate-as-narcolepsy-treatment
#20
K Bolin, P Berling, P Wasling, H Meinild, J Kjellberg, P Jennum
AIMS AND OBJECTIVES: Based on class-I studies, sodium oxybate is regarded as a first-line treatment for both EDS and cataplexy. The cost-effectiveness of sodium oxybate is largely unknown, though. In this study, we estimate the cost-effectiveness of sodium oxybate as treatment for patients with narcolepsy as compared to standard treatment, by calculating incremental cost-effectiveness ratios (cost per quality-adjusted life year, QALY) for patients in a Swedish setting. MATERIALS AND METHODS: Calculations were performed using a Markov model with a 10-year time horizon...
July 5, 2017: Acta Neurologica Scandinavica
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