Sleep medicine
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Dysfunctional thinking about sleep is a central aspect in the perpetuation of primary insomnia and a target symptom of cognitive behavioral therapy for insomnia (CBT-I). Insomnia symptoms also occur in other sleep disorders, but it is not known to what extent it is related to dysfunctional thinking about sleep. ⋯ The observation of increased DBAS scores in other sleep disorders besides primary insomnia underscores the usefulness of a broadened diagnostic procedure and suggests that CBT-I modules may be a complementary treatment tool for these disorders.
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Adaptive servo-ventilation (ASV) is a well-established treatment of central sleep apnea (CSA) related to congestive heart failure (CHF). Few studies have evaluated the effectiveness and adherence in patients with CSA of other etiologies, and even less is known about treatment of CSA in patients of post ischemic stroke. ⋯ ASV was well tolerated and clinically effective in this group of patients with persistent CSA after ischemic stroke.
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Increased left atrial (LA) size is linked to elevated mortality in end-stage renal disease (ESRD). In addition, the degree of overnight rostral fluid shift from the legs is associated with severity of obstructive sleep apnea (OSA). As rostral fluid shift might distend the left atrium and increase fluid accumulation in the neck, we postulated that LA size would be related to the degree of overnight rostral fluid shift and OSA severity in ESRD patients. ⋯ In ESRD patients, there are relationships between ΔLFV and both LA size and OSA severity. These findings suggest that the relationship between LA size and mortality in ESRD may be related to ΔLFV and severity of OSA.
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To investigate whether different protocols of sleep deprivation modify sleep perception. ⋯ Selective REM sleep deprivation reduced the ability of healthy young volunteers to perceive their total sleep time when compared with time measured by PSG. The data reinforce the influence of sleep deprivation on sleep perception.