Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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To determine whether there are racial/ethnic differences in the prevalence of pediatric snoring and sleep disordered breathing (SDB). ⋯ Black race and prematurity are independent predictors of snoring. The degree of parental knowledge regarding SDB was not associated with seeking medical treatment.
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Central sleep apnea can be refractory to traditional positive airway pressure (PAP) therapy (CPAP or bilevel PAP), whether appearing first as a feature of baseline polysomnography or only later once PAP is applied in what is termed "complex sleep apnea" (CompSA). This retrospective study examined the efficacy of adaptive servoventilation (ASV) in 25 consecutive patients with PAP-refractory central sleep apnea, most exhibiting predominantly obstructive apnea during baseline polysomnography. ⋯ ASV proved superior to traditional PAP in reducing the AHI, CAI, and respiratory arousals in a heterogeneous patient group with sleep disordered breathing in whom central apneas emerged or persisted on PAP.
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To develop a polysomnographic video-based scale for rating the severity of REM sleep behavior disorder (RBD), to classify the severity of RBD and to determine the intraindividual variability of RBD in patients with Parkinson disease (PD). ⋯ The RBD severity scale (RBDSS) is a reliable, easy-to-use tool for assessing motor events during REM sleep with PSG. Severity and phenomenology of RBD shows a significant variability in the individual PD patient.
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Disturbed sleep is a common complaint in patients with rheumatoid arthritis (RA). The majority of the research investigating relationships between sleep and patient-reported outcomes in RA has focused on pain and depression. Poor sleep may also affect disability, though this association has not been explored in RA. The present study represents a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA. Depression, pain severity, and fatigue were examined as separate mediators of the relationship between sleep quality and disability. ⋯ Sleep quality has an indirect effect on functional disability through its relationship with pain severity and fatigue. Future research should investigate whether improvements in sleep can reduce disability in patients with RA.
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Case Reports
Biot's breathing in a woman with fatal familial insomnia: is there a role for noninvasive ventilation?
We present the case of a 48-year-old woman suffering from fatal familial insomnia (FFI)--a rare prion disease--who developed Biot's breathing and secondary respiratory failure during the early stages of the illness. Once hypercapnia was detected a trial of nocturnal noninvasive ventilation (NIV) was offered with important improvement of arterial blood gases (ABG), and subjective good quality of sleep. To our knowledge, this is the first report in the medical literature of the use of NIV in the management approach of this devastating disease. Its impact on the prognosis and survival of these patients, however, is yet to be elucidated.