Sleep medicine
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Insomnia and Obstructive Sleep Apnoea Hypopnea Syndrome (OSAHS) are the two most common sleep disorders, and both have significant associated health costs. Despite this, relatively little is known about the prevalence or impact of insomnia in those with OSAHS, although a recent study suggested there may be substantial comorbidity between these disorders [Chest 120 (2001) 1923-9]. The primary aim of this study was to further explore the prevalence of insomnia in OSAHS. A secondary aim was to assess the effect of factors that may impact on both conditions, including mood and sleep-beliefs. ⋯ Overall these findings suggest that comorbidity of insomnia in OSAHS patients may lead to increased OSAHS severity and that patients with both conditions may experience more symptoms relating to depression, anxiety and stress. These findings underscore the need for insomnia assessment and management services, even in clinics that primarily service patients with OSAHS.
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To assess prevalence, severity, and predictive factors of excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) in an Asian population. ⋯ OSA causes EDS in the majority of patients. Severe snoring, higher sleep efficiency and increased total arousals in polysomnography seem to predict EDS.
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To determine useful cutoffs on the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) in an epilepsy population. ⋯ The SA-SDQ is a useful screening instrument for OSA in an epilepsy population. Our results indicate that the previously suggested cutoffs for OSA (36 for men and 32 for women) may be too high for this specific population. We suggest screening cutoffs of 29 for men and 26 for women.
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Obstructive sleep apnea (OSA) is far more common in males than females. The discrepancy between the lower prevalence of OSA, the greater frequency of obesity and the smaller airway size in women compared to men suggests that a gender difference underlies this condition. We hypothesized that due to differences in tissue linkage women have more stable and less mobile upper airway structures than men, providing protection against severe forms of OSA. ⋯ Men tend to have a larger but more collapsible airway during mandibular movement than women and this, in part, may play a role in the positional dependency and severity of OSA in men.
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Randomized Controlled Trial Clinical Trial
A prospective 8 week trial of nasal interfaces vs. a novel oral interface (Oracle) for treatment of obstructive sleep apnea hypopnea syndrome.
To compare efficacy, compliance rates, and side effects of a new strapless oral interface, the Oracle, with available nasal masks over 8 weeks of use for the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). ⋯ Oral delivery of CPAP with the Oracle is an effective and suitable alternative for patients with OSAHS.