Impaired sustained attention and lapses are present in patients with mild obstructive sleep apnea

Sleep and Breathing - Severe obstructive sleep apnea (OSA) directly affects the quality of life, mood, and sustained attention of individuals, but it has not yet been established in the literature,...     

Psychotherapy Improved the Sleep Quality in a Patient Who Was a Victim of Child Sexual Abuse: A Case Report

IntroductionVictims of child sexual abuse (CSA) often experience symptoms such as recurrent nightmares, which affect their adult life.AimThis study aimed to evaluate the effect of psychotherapy on the quality of life and sleep in a female patient with a previous history of CSA.MethodsThe patient was climacteric (menopausal transition) and treated in an outpatient clinic. She underwent 40 sessions of psychotherapy and was evaluated before and after the sessions using questionnaires and polysomnography (PSG).Main Outcome MeasuresMeasurements were taken using the following: Kupperman Index (KI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Prospective and Retrospective Memory Questionnaire, and PSG. Reports of dream content were also evaluated during the study.ResultsAfter psychotherapeutic intervention, the frequency of nightmares and their attendant suffering decreased. Additionally, the context of the nightmares changed, and a decrease was noted in the KI, BAI, and BDI parameters. The PSG indicated an increase in rapid eye movement sleep.ConclusionPsychotherapeutic intervention combined with zolpidem and fluoxetine treatment contributed to a resignification of the dreams of a patient with a history of CSA. The treatment also improved the quality of her dreams and her quality of life. Coelho GA, Rodrigues E, Andersen ML, Tufik S, and Hachul H. Psychotherapy improved the sleep quality in a patient who was a victim of child sexual abuse: A case report. J Sex Med 2013;10:3145–3149.     

The effects of continuous positive airway pressure and mandibular advancement therapy on metabolic outcomes of patients with mild obstructive sleep apnea: a randomized controlled study

Background

Moderate and severe obstructive sleep apnea (OSA) have been independently associated with dyslipidemia. The results of metabolic improvement with continuous positive airway pressure (CPAP) have been controversial. Less evidence exists regarding this issue in mild OSA. A current treatment for mild OSA is mandibular advancement device (MAD) therapy, but its effectiveness on the metabolic profile needs to be compared with CPAP. The purpose of this study was to compare MAD vs CPAP vs no treatment on the metabolic profile during 6 and 12 months of follow-up in patients with mild OSA.

Methods

The inclusion criteria were patients with mild OSA, both genders, ages 18 to 65 years, and body mass index (BMI) of < 35 Kg/m². Patients were randomized in 3 groups (CPAP, MAD, and control). The evaluations included physical examination, metabolic profile, and full polysomnography at baseline, 6 months, and 12 months of follow-up.

Results

Seventy-nine patients with mild OSA were randomized in three treatment groups, with mean age (± SD) of 47?±?9 years, 54% men, and AHI 9.5?±?2.9 events/h. MAD and CPAP reduced AHI at 6 and 12 months compared to the control group. MAD adherence was higher than CPAP at 6 and 12 months. Despite lower adherence compared to MAD, CPAP was more effective in reducing total cholesterol over 12 months (baseline 189.3?±?60.2 mg/dl to 173.4?±?74.3 mg/dl) and low-density lipoprotein cholesterol (LDL-c, baseline 112.8?±?54.9 mg/dl to 94.5?±?67.4 mg/dl).

Conclusions

After 1 year of treatment, CPAP was superior to MAD in reducing total cholesterol and LDL-c in patients with mild OSA.