Development and validation of a Chinese version of the Sleep Apnea Quality of Life Index

Sleep and Breathing - A Chinese version of the Sleep Apnea Quality of Life Index (SAQLI) for patients with obstructive sleep apnea (OSA) undergoing treatment with continuous positive airway...     

Impact of the sleep apnea management group clinic on positive airway pressure adherence

Sleep and Breathing - Positive airway pressure (PAP) adherence is critical for managing obstructive sleep apnea (OSA). We postulate that group-based Sleep Apnea Management (SAM) clinic,...     

A French update on the Self-Efficacy Measure for Sleep Apnea (SEMSA) to assess continuous positive airway pressure (CPAP) use

Sleep and Breathing - The Self-Efficacy Measure for Sleep Apnea (SEMSA) is a 26-item self-questionnaire composed of three factors: risk perception of obstructive sleep apnea syndrome (OSAS),...     

Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial

Sleep and Breathing - The Sleep Position Trainer (SPT) is a new option for treating patients with positional obstructive sleep apnea (POSA). This study investigated long-term efficacy, adherence,...     

Predictive ability of the International Classification of Sleep Disorders-3 in identifying risk of obstructive sleep apnea among recently unemployed adults

Sleep and Breathing - The International Classification of Sleep Disorders (ICSD)-3 was developed to aid in the identification of these disorders. The core criterion A (ICSD-3A) to identify...     

Developing an Action Plan for Integrating Sleep Topics into the Medical School Curriculum

Sleep disorders are prevalent although they go unrecognized by clinicians, partially because of limited exposure to sleep medicine topics during medical school. Sleep topics can be integrated during both the preclinical and clinical years of the medical school curriculum by developing an integration strategy and action plan. Components of the action plan include examining the current medical school curriculum and the teaching infrastructure. Understanding curricular governance issues and how curriculum time is allocated will allow development of an effective integrative strategy. Sleep topics can be integrated into neuroscience, neuroanatomy, physiology, and behavioral science courses during the preclinical years. The sleep history and physical can be integrated into the physical diagnosis course. Sleep disorders can be introduced in clinical correlation courses. Integration strategies during the clinical years may include computer-based simulations. Careful assessment of the existing curriculum, curricular governance processes, and available educational resources will optimize the probability of successfully integrating sleep topics into the medical school curriculum.     

Education and training in the field of sleep medicine

Sleep disorders are highly prevalent but are under-recognized and under-diagnosed by the majority of health care providers. This article reviews recent studies of sleep medicine education in the United States and abroad and the reasons offered by most instructors for the lack of adequate education at their institutions. Quantity and quality of sleep medicine education have been lacking. Knowledge assessment is an important aspect of educational research, and several instruments for the assessment of sleep knowledge have been developed. A noteworthy development is the Sleep Academic Award program of the National Center on Sleep Disorders Research. This twenty-site, NIH-funded program has developed model interventions and sleep training curricula that are being widely disseminated. Sleep medicine fellowship training programs have also been established in the past decade and serve as the major vehicle for advanced specialty training. Finally, a number of strategies for introducing sleep medicine topics and issues into the medical curriculum have been proposed. Considering the paucity of publications in this area, our review was not restricted to studies in the past year.     

Correction to: Durability of treatment effects of the sleep position trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial

Sleep and Breathing - The article “Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled...     

Relationships between sleep apnea,cardiovascular disease risk factors,and aortic pulse wave velocity over 18 years: the Wisconsin Sleep Cohort

Sleep and Breathing - The purpose of this study is to determine if apnea-hypopnea index (AHI) severity predicts future aortic pulse wave velocity (PWV) in the Wisconsin Sleep Cohort. Applanation...     

Sleep and sleep disorders in the hospital

Sleep abnormalities are common and underrecognized in hospitalized patients. Sleep restriction is common and can have undesirable behavioral and physiologic effects. The general pattern of polysomnographic abnormalities observed in hospitalized patients is reduction in total sleep time, stages R (rapid eye movement), and N3 (slow wave) and increase in stage N1 percentage. Sleep is also fragmented with more arousals and awakenings. Multiple factors are responsible for sleep disruption in hospitalized patients and include environmental noise. Abnormalities in melatonin secretion leading to circadian rhythm abnormalities have also been noted. Hospitalized patients may also present with symptoms of obstructive sleep apnea. Protocols for sleep enhancement and management of obstructive sleep apnea are being implemented at various hospitals. Outcome data are awaited from these measures.     

Hidden secrets of the upper airway on the track to individualized sleep medicine: highlights from the 2018 ATS Conference in San Diego

Sleep and Breathing -     

On the importance of polysomnography after stroke

Sleep and Breathing -     

Genetic Tools in the Study of Drug Self-administration

Recent studies have shown that large genetic differences exist in the extent to which orally delivered ethanol will come to serve as a positive reinforcer under operantly defined conditions. In addition, these studies suggest that a significant correlation exists between results from two-bottle choice studies of ethanol drinking and operant self-administration studies of ethanol functioning as a reinforcer. The present paper reports further genetic influences on ethanol self-administration which were found using Long Sleep and Short Sleep mice, bred selectively for high and low duration of loss of the righting reflex in responses to ethanol, respectively. It was possible to establish ethanol as a reinforcer in Long Sleep mice but not in Short Sleep mice. These results indicate that neurosensitivity to ethanol may determine the absolute amount of ethanol consumption but is not highly related to the ability of ethanol to serve as a positive reinforcer. In addition, this paper presents genetic correlations which indicate that (a) ethanol preference and self-administration are highly correlated across genotype; (b) sensitivity to ethanol and self-administration of this drug are not highly genetically correlated; (c) ethanol is not self-administered in operant studies solely for its caloric value; and (d) there exist important genetic determinants of drug reinforced behavior.     

Pharmaceuticals are back in the Game for OSA Treatment

Sleep and Breathing -     

Sleep, the hypothalamic-pituitary-adrenal axis, and cytokines: multiple interactions and disturbances in sleep disorders.

Sleep is an important component of mammalian homeostasis, vital for survival. Sleep disorders are common in the general population and are associated with significant medical, psychologic, and social disturbances. Sleep, in particular deep sleep, has an inhibitory influence on the HPA axis, whereas activation of the HPA axis or administration of glucocorticoids can lead to arousal and sleeplessness. Insomnia, the most common sleep disorder, is associated with a 24-hour increase of ACTH and cortisol secretion, consistent with a disorder of central nervous system hyperarousal. Sleepiness and fatigue are very prevalent in the general population, and recent studies have demonstrated that the proinflammatory cytokines IL-6 and/or TNF-alpha are elevated in disorders associated with excessive daytime sleepiness, such as sleep apnea, narcolepsy, and idiopathic hypersomnia. Sleep deprivation leads to sleepiness and daytime hypersecretion of IL-6. Combined, these findings suggest that the HPA axis stimulates arousal, while IL-6 and TNF-alpha are possible mediators of excessive daytime sleepiness in humans.     

Evidence-Based Recommendations for the Assessment and Management of Sleep Disorders in Older Persons

Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert-based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder.     

Obstructive sleep apnea syndrome and public health: the Italian way

Sleep and Breathing -     

Obstructive sleep apnoea and non-restorative sleep induced by the interface

Sleep and Breathing -     

Benefits of selenium in the treatment of depression and sleep disorders

Sleep and Breathing -     

CPAP adherence and cardiovascular disease: beware of the healthy adherer effect

Sleep and Breathing -