Sleep
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Randomized Controlled Trial Clinical Trial
Sleeping position, orientation, and proximity in bedsharing infants and mothers.
The impact of mother-infant bedsharing on infant sleeping position, orientation, and proximity to the mother was assessed in 12 breast-feeding Latino mother-infant pairs. Six routinely bedsharing and six routinely solitary-sleeping pairs slept 3 nights in the sleep laboratory. The first night matched the routine home condition, followed by 1 bedsharing night and 1 solitary-sleeping night in random order. ⋯ We conclude that bedsharing minimizes the use of the prone infant sleeping position, probably in part to facilitate breast feeding. By promoting nonprone positions, bedsharing may protect some infants from sudden infant death syndrome (SIDS), since prone sleeping is a known risk factor for SIDS. The large percentage of the night that mothers spent oriented toward their infants suggests that a higher degree of maternal vigilance may also result from bedsharing.
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Randomized Controlled Trial Clinical Trial
Treatment of obstructive sleep apnea with a self-titrating continuous positive airway pressure (CPAP) system.
Conventional manually adjusted continuous positive airway pressure (CPAP) is an effective therapy for sleep-disordered breathing. We prospectively investigated the efficacy of a self-titrating nasal CPAP system in the acute treatment of obstructive sleep apnea (OSA) syndrome. Twenty patients with moderately severe OSA [apnea hypopnea index (AHI) > 15/hour] were enrolled in a randomized, controlled, prospective clinical trial. ⋯ An unsupervised study would have resulted in undertreatment of OSA. Based on a single-night laboratory study, self-titrating CPAP was well tolerated and improved OSA and sleep architecture comparable to manually adjusted CPAP. The future modifications of this prototype will require further research to assess its efficacy and safety in the laboratory and home environments before its recommendation for general long-term use.
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Randomized Controlled Trial Clinical Trial
Successful treatment of the idiopathic restless legs syndrome in a randomized double-blind trial of oxycodone versus placebo.
In a double-blind randomized crossover trial, oxycodone or placebo was given in divided night-time doses to 11 patients with idiopathic restless legs syndrome (RLS) for 2 weeks prior to appropriate polysomnographic studies. Under double-blinded conditions, patients were asked to do daily ratings of their leg sensations, motor restlessness and daytime alertness on a 1-4 scale for the 2 weeks prior to the polysomnographic studies and for the nights of the polysomnographic studies as well. Leg sensations (p < 0.009), motor restlessness (p < 0.006) and daytime alertness (p < 0.03) were significantly improved on oxycodone as compared to baseline or placebo. ⋯ On an average dose of 15.9 mg oxycodone (equivalent to approximately three 5-mg tablets of commercial preparation), there was a statistically significant reduction in the number of periodic limb movements in sleep [(PLMS)/hour sleep (p < 0.004)] and in the number of arousals/hour sleep (p < 0.009) on drugs as compared to baseline or placebo. A statistically significant improvement was also noted in sleep efficiency (p < 0.006) and 10 of the 11 patients preferred oxycodone over placebo. We conclude that oxycodone is an effective treatment for RLS and PLMS.