These recommendations based on asymptomatic individuals highlight an important gap in sleep health awareness among both health care professionals and patients. Because the early symptoms of OSA tend to occur in sleep, when the person with the condition is less aware, there is a definite potential for underreporting. Hence, if the person with OSA is not fully aware of these symptoms it makes communicating them to their health care provider even harder. Gasping for air during t

Congenital central hypoventilation syndrome is a rare disorder due to a mutation in the PHOX2B gene, characterized by a failure in autonomic control of breathing with diminished or absent response to hypoxia and hypercapnia, which is most pronounced during sleep. Most patients present from birth with central apneas and hypoventilation, or later in the setting of a physiologic stress. Recent literature in mice with a Phox2b27Ala/+ mutation suggests a predisposition to obstru

Many children with possible obstructive sleep apnea remain unidentified due to low referral rates and low PSG completion rates. However, few data have been published about reasons for this gap and ways to improve referral rates and study completion. One study 1 showed that only 5.9% of snoring children were referred by their primary care providers for PSG despite having received prompting of a positive screen through a computer decision support system. Of those referred, onl

In the sphere of sleep medicine in general, and more particularly in the context of OSA, we are unfortunately dragging behind with regard to the progress realized in the below -mentioned directions of developing a multidimensional, validated, and pragmatically valuable score when compared with several other major respiratory diseases. We should be conscious that such diseases are all less prevalent than OSA, and yet even though they impose adverse morbidity and mortality cons

Our novel finding is that veterans with a high %REM (defined as more than 25%) were more than twice as likely to report having a vivid dream than those with a lower %REM. We did not see a similar association between nonvivid dreams and high %REM. We did not find similar results in the literature. Therefore, we discuss our findings further using what is known about dreams, vivid dreams, and REM sleep. Dreams are linked to REM sleep in both health and disease. 31 The interrela

Sleep disturbances are associated with short-term, midterm, and long-term BPV. RLS, shift work, insomnia, short sleep, long sleep, OSA, and sleep deprivation were all positively associated with SBP or DBP fluctuations. The most suggested mechanism behind the relation between sleep disorders and BPV is the increase in sympathetic nervous system activity. Given the prognostic implications of BPV and of sleep disorders on cardiovascular mortality, recognizing and treating these

This meta-analysis found that CPAP therapy is feasible in patients with early- and late-onset stroke complicated by SA, and CPAP may improve neurological outcomes. This study supported further research in this area. This meta-analysis included 14 RCTs that evaluated the effect of CPAP compared with that of usual treatment in patients with stroke or TIA with SA. Compared with the previous studies, our study added functional status as a primary outcome measure, and the results

To the best of our knowledge, this is the first prospective, observational study comparing risk for MACCEs in a revascularised CAD cohort with sleepy OSA receiving CPAP treatment with risk in patients without OSA. The results showed that the risk for MACCEs in revascularised CAD patients with sleepy OSA on CPAP was similar to that in CAD patients without OSA. In a multivariate analysis, age and former revascularisation were associated with an increased risk for MACCEs, while

The present study shows that serum levels of the inflammatory markers IL-6, hs-CRP, and G-CSF are increased in patients with COPD and OVS compared with healthy controls. Furthermore, levels of IL-6, hs-CRP, and G-CSF were higher in participants with COPD and OVS compared with OSA alone. Second, we showed that participants with OVS have higher systemic inflammation levels as measured by leukocytes and neutrophils levels than COPD and OSA alone. Third, we observed no major impa

In this large prospective cohort study, we found that ISSD, defined based on objective but not subjective sleep duration, is associated with increased risk of incident hypertension at a median follow-up duration of 5.1 years. In contrast, INSD, either defined based on objective or subjective sleep duration, is not associated with increased hypertension risk. These data further support that ISSD is a phenotype of insomnia disorder associated with new onset hypertension in adul

Observations that Organisms adapt their physiology and behavior to the time of the day in a circadian fashion have been documented for a long time and are commonly agreed to have begun with the observation of leaf and flower movements in plants. For example, the leaves of mimosa plants close at night and open during the day. In 1729, the French astronomer Jean Jacques d’Ortous de Mairan placed a mimosa plant in the dark and observed that the leaves still opened and closed rhy

These recent reports regarding the very high general prevalence of SDB and factors that influence the relationship with hypertension prompt a reassessment of the clinical relevance regarding the association between OSA and hypertension, especially nocturnal hypertension, and the underlying mechanisms that may contribute to the development of a non-dipping nocturnal blood pressure profile in OSA patients. This topic is important in the context of the recent SAVE (Sleep Apnea C

This randomized controlled clinical trial demonstrates that in the hands of sleep medicine specialists an integrated home-based portable monitoring strategy for both diagnosis and treatment of patients with moderate to severe OSA is not inferior to a laboratory-based strategy. The home-based strategy appears equivalent in terms of outcomes important to patients: acceptance of therapy, time to treatment, reduced hypersomnolence, improved functional outcomes (both generic and d

Our findings suggest that CBT-I may improve cognition among people with chronic HF and insomnia. Notably, the odds of improved self-reported cognition and less than 3 PVT-measured lapses in the CBT-I group were about twice the odds of improvement in the attention control condition, although there was only a significant group-time effect for the proportion with improvements in self-reported cognition. Although these findings must be interpreted cautiously and the study was not

Clinical studies have shown that levels of MPs of various cellular origins, including platelets, endothelial cells and leukocytes, are increased in OSA patients. Figure 1 illustrates the main antigenic epitopes harboured by MPs investigated in OSA patients. Levels of MPs harbouring markers of cellular activation or apoptosis that are known to predict poor cardiovascular outcomes were found to be correlated with OSA severity as well as markers of vascular impairment, and were

his study obtained sleep parameters and self-reported sleep status during both dPSG and tPSG. CPAP adherence in patients with OSA could be predicted by examining the changes in various indices with CPAP use. PSG evaluations demonstrated that CPAP adherence can be expected in patients who demonstrated improvements in AHI, sleep architecture, such as stage N1% and N3%, TST, sleep efficiency, and sleep latency with CPAP. These findings were correlated with self-reported sleep im

The hemodynamic benefits of MV are often-overlooked in patients with decompensated congestive heart failure and cardiogenic shock in particular. Favorable effects of MV in acute decompensated HF include reducing ventricular preload and afterload, decreasing extra-vascular lung water, and decreasing the work of breathing and its associated cardiac output requirements. The appropriate use of MV should be seen as an important adjunctive therapy in the initial stabilization and m

We have evaluated the RWD responses to PAP based on AHI reductions in 195 children with OSA. These analyses allowed us to define individual determinants of pediatric PAP responsiveness in a real-world setting. Our results showed that children have an adequate response to PAP therapy, with a median AHI reduction of 85% compared to baseline PSG results. We have also identified substantial heterogeneity of the PAP responses, with around 30% showing < 75% AHI reductions. Interest

Sleep disordered breathing and dysglycaemia are intimately linked, but the existence of an independent relationship between them, beyond their shared association with obesity, has been difficult to definitively identify. In the largest reported study on this topic to date, we found OSA severity to be an independent predictor of glycaemic health, adding to a growing body of evidence that OSA has an independent association with insulin resistance and impaired glucose tolerance.

The Portable Monitoring Task Force of the American Academy of Sleep Medicine reviewed available evidence and met to develop consensus recommendations on the use of PM in the diagnosis and management of patients with OSA. The AASM Board of Directors approved this clinical guideline. Previous reviews have concluded that PM should be used only on a limited basis. The Task Force identified additional appropriate indications and usage of PM within parameters guided by the followin