Sleep & breathing = Schlaf & Atmung
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Previous studies addressing the question of whether continuous positive airway pressure (CPAP) could improve the insulin resistance and glucose control in patients with obstructive sleep apnea (OSA) have led to conflicting results. Therefore, we conducted the meta-analysis to evaluate the effects of CPAP on glycemic control and insulin resistance in OSA patients. ⋯ Our analysis showed that CPAP significantly improved insulin resistance in non-diabetic patients with moderate to severe OSA, while no significant change in body mass index was detected. Compared with fasting blood glucose at baseline, there was no change in glycemic control with CPAP. Further large-scale, randomized, and controlled studies are needed to evaluate the longer treatment and its possible effects on weight loss and glycemic homeostasis.
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This study aims to evaluate the incidence and prevalence of temporomandibular disorders (TMD) in patients receiving a mandibular advancement device (MAD) to treat obstructive sleep apnea using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). In addition, it also aims to assess the development of posterior open bite (POB). ⋯ The use of MADs may lead to the development of TMD in a small number of patients. Nevertheless, these signs are most likely transient. Patients with pre-existing signs and symptoms of TMD do not experience significant exacerbation of those signs and symptoms with MAD use. Furthermore, these may actually decrease over time. POB was found to develop in 17.9 % of patients; however, only 28.6 % of these patients were aware of any bite changes.
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There are little existing data on continuous positive airway pressure (CPAP) adherence in US Hispanic veterans with obstructive sleep apnea (OSA). Our aim was to describe determinants of 1-month adherence in a sleep clinic cohort of South Florida Hispanic veterans. ⋯ Our study suggests that South Florida Hispanic veterans with OSA evaluated in a sleep clinic show poor CPAP adherence. Insomnia and poor early use predicted poor adherence overall. Larger prospective studies with other race-ethnic groups are needed to determine the role of ethnicity and race in CPAP adherence among US veterans with OSA.
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Rapid eye movement (REM) sleep behavior disorder (RBD) is a type of REM parasomnia characterized by complex motor activity during REM sleep. In this study, cyclic alternating pattern (CAP) in patients with idiopathic RBD was analyzed to evaluate the expression of arousal instability of NREM sleep. ⋯ To our knowledge this is the first polysomnographic clinical study which evaluated CAP parameters in RBD. Increased CAP rate found may be considered as a sign showing that NREM sleep may also be affected in RBD patients. Therefore, CAP analysis may be important to enlighten the pathogenesis of parasomnias.