Annals of internal medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. a randomized, controlled trial.
The sleep apnea-hypopnea syndrome is defined by a pathologic number of respiratory events during sleep (the apnea-hypopnea index, defined as the number of apnea and hypopnea episodes per hour) and daytime symptoms (mostly, excessive sleepiness). In patients with the sleep apnea syndrome, treatment with continuous positive airway pressure (CPAP) normalizes both the apnea-hypopnea index and diurnal symptoms. However, the effect of CPAP in persons with a pathologic apnea-hypopnea index without daytime sleepiness is unclear. ⋯ In patients with an apnea-hypopnea index of 30 or greater and no subjective daytime sleepiness, CPAP does not modify quality of life, objective sleepiness, vigilance, attention, memory, information processing, visuomotor coordination, or arterial blood pressure. Treatment with CPAP is therefore not indicated in nonsleepy patients with a pathologic apnea-hypopnea index.
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Randomized Controlled Trial Clinical Trial
Home monitoring service improves mean arterial pressure in patients with essential hypertension. A randomized, controlled trial.
Technological advances in the distribution of information have opened new avenues for patient care. Few trials, however, have used telemedicine to improve blood pressure in patients with essential hypertension. ⋯ This telecommunication service was efficacious in reducing the mean arterial pressure of patients with established essential hypertension.