Sleep medicine
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized, double-blind, 6-week, dose-ranging study of pregabalin in patients with restless legs syndrome.
This study evaluated the dose-related efficacy and safety of pregabalin in patients with idiopathic restless legs syndrome (RLS). ⋯ In this 6-week phase 2b study, pregabalin reduced RLS symptoms in patients with moderate-to-severe idiopathic RLS. The symptom reduction at week 6 was dose-dependent with 123.9 mg/day providing 90% efficacy. Pregabalin was safe and well tolerated across the entire dosing range.
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Randomized Controlled Trial
The effect of sildenafil on sleep respiratory parameters and heart rate variability in obstructive sleep apnea.
To evaluate the magnitude of effects of sildenafil on respiratory parameters and heart rate variability (HRV) in slow wave sleep (SWS) and REM sleep of patients with severe obstructive sleep apnea (OSA). ⋯ In severe OSA, the use of sildenafil 50mg at bedtime plays a detrimental role on respiratory parameters in both non-REM and REM sleep, fragmentation in REM sleep, and a prolonged increase in LH/HF component of HRV after resumption of ventilation.
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Although extensive studies have indicated a relationship between obstructive sleep apnea (OSA) and depressive symptoms, the effect of continuous positive airway pressure (CPAP) treatment on residual depressive symptoms in patients with both major depressive disorder (MDD) and coexisting OSA has not been examined. ⋯ The results suggest that MDD patients with residual depressive symptoms despite pharmacotherapy who also have symptoms of suspected OSA, such as loud snoring, obesity, and daytime sleepiness, should be evaluated for sleep apnea by polysomnography and treated with an appropriate treatment such as CPAP. CPAP treatment may result in a significant improvement of residual depressive symptoms due to the improvement of daytime sleepiness in these patients.
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While the Berlin Sleep Questionnaire (BSQ) was developed to identify patients at high risk of having sleep apnea, assessment can be difficult in patients suffering from impaired cognitive functions (i.e., stroke patients). We therefore created a modified version of the questionnaire to be used in patients' bed partners to test whether it could give identical results to the original form of BSQ. ⋯ The bed-partner Berlin questionnaire predicts an RDI>15 with a better sensitivity and specificity than the original questionnaire. It could, therefore, be used in bed partners of patients suspected of obstructive sleep apnea syndrome who cannot fill in the self-reported Berlin questionnaire.
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Randomized Controlled Trial Comparative Study
A double-blind, crossover study of Doxazosin and Enalapril on peripheral vascular tone and nocturnal blood pressure in sleep apnea patients.
Pulse wave attenuation, which occurs in association with obstructive sleep apnea (OSA), is sympathetically mediated. We compared the effect of Doxazosin (DO, a peripheral alpha-receptor inhibitor) and Enalapril (EN, an ACE inhibitor) on digital vasoconstriction and nocturnal blood pressure (BP) in hypertensive OSA patients. ⋯ Digital vasoconstrictions associated with apneic events are alpha-receptor mediated. DO compared to EN has a proportionally poor effect on nocturnal BP control in OSA patients, which may be due to the enhanced sympathetic nervous system activity characteristic of this condition.