Sleep
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Randomized Controlled Trial Multicenter Study Comparative Study
Effect of gaboxadol on sleep in adult and elderly patients with primary insomnia: results from two randomized, placebo-controlled, 30-night polysomnography studies.
To evaluate the efficacy and tolerability of gaboxadol in the treatment of adult and elderly patients with primary insomnia. ⋯ The maximum studied doses of gaboxadol (GBX15 in adult patients and GBX10 in elderly patients) were effective at enhancing objective polysomnography measures of sleep maintenance and SWS, and also some subjective sleep measures, over 30 nights but had little or no effects on sleep onset. The clinical relevance of the enhancement of SWS by gaboxadol is unclear.
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Randomized Controlled Trial Comparative Study
Portable monitoring and autotitration versus polysomnography for the diagnosis and treatment of sleep apnea.
To compare a clinical pathway using portable monitoring (PM) for diagnosis and unattended autotitrating positive airway pressure (APAP) for selecting an effective continuous positive airway pressure (CPAP) with another pathway using polysomnography (PSG) for diagnosis and treatment of obstructive sleep apnea (OSA). ⋯ A clinical pathway utilizing PM and APAP titration resulted in CPAP adherence and clinical outcomes similar to one using PSG.
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Randomized Controlled Trial Multicenter Study Comparative Study
Adaptive servoventilation versus noninvasive positive pressure ventilation for central, mixed, and complex sleep apnea syndromes.
Although continuous positive airway pressure (CPAP) is most often effective in patients with obstructive sleep apnea, optimal treatment of patients with predominantly mixed apneas, central sleep apnea syndrome/Cheyne-Stokes respiration (CSA/CSR), or complex sleep apnea (CompSAS) is less straightforward, and may require alternative ventilatory assist modalities. ⋯ These data confirm that in patients with CSA/CSR, mixed apneas, and CompSAS, both NPPV and ASV are effective in normalizing breathing and sleep parameters, and that ASV does so more effectively than NPPV in these types of patients.
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Randomized Controlled Trial Comparative Study
Comparison of CPAP titration at home or the sleep laboratory in the sleep apnea hypopnea syndrome.
Continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) is conventionally started after in-laboratory overnight titration. This use of sleep laboratory space is both costly and limits access for diagnostic studies. This study aimed to evaluate whether automated CPAP titration in the home produced patient outcomes equal to those following laboratory-based automated CPAP titration. The main outcomes were Epworth Sleepiness Scale score, objective daytime sleepiness (Oxford SLEep Resistance test or OSLER test), and CPAP use; we also performed quality-of-life questionnaires: Functional Outcomes of Sleep Questionnaire and SF-36. ⋯ Home-based automated CPAP titration is as effective as automatic in-laboratory titrations in initiating treatment for OSAHS.
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Randomized Controlled Trial
A randomized trial evaluating the effectiveness of sodium oxybate therapy on quality of life in narcolepsy.
To evaluate the efficacy of sodium oxybate versus placebo to improve quality of life in patients with narcolepsy. ⋯ The nocturnal administration of sodium oxybate in patients with narcolepsy was associated with statistically significant and clinically relevant improvements in functional status, an important component of quality of life.