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Life Care Planning for the Burn Patient
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
Ruth B. Rimmer, Kevin N. Foster
Sleep Study: John Doe continues to have major problems with sleeping. Dr. X recommended a sleep study, but it has not be approved as of yet. Due to the long term sleep issues of many burn patients, it is recommended that John Doe have access to a sleep study every 5 years through life expectancy.
Introduction to polysomnography
Published in Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam, Clinical Atlas of Polysomnography, 2018
Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam
A sleep study is used to objectively assess changes in physiological parameters that occur during sleep. First, the objective monitoring of sleep became possible after the discovery of the EEG by the German Psychiatrist, Hans Berger, in 1924. He was the first person to record and demonstrate the cortical electrical activity via electrodes applied to the human scalp. He could depict alpha activity during wakefulness and slowing of waves during sleep. A group of researchers from Harvard Medical School and University of Chicago (USA) described the features of NREM sleep between the years 1935-1938. At the same time, researchers kept experimenting with the filters of the EEG to get clearer signals and using different channels to record other bioelectrical potentials, such as electrocardiography, body movements, and respiration along with EEG. However, it took another fifteen years to describe the REM sleep. Two researchers, Eugene Aserinsky and Nathanial Kleitman, developed the electrooculogram and published their findings regarding REM sleep in 1953. Atonia during REM sleep was described by Michael Jouvet in 1959 in cats and, hence, it was proposed that an electromyogram should be recorded during sleep study. Thus, it was recommended to include the EEG, EOG, and EMG channels during polysomnographic recording.
Fibromyalgia and the neurobiology of sleep
Published in S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer, Sleep and Psychosomatic Medicine, 2017
A total of 10%–30% of FM patients exhibit another pattern of sleep pathology that can be documented via a sleep study: restless legs syndrome, also known as sleep myoclonus or periodic limb movement syndrome.24,25 These patients experience an alpha-wave burst followed by limb movement, and may have excess sympathetic tone, more movement arousals, and less stage 3 and 4 sleep. They do not respond to usual sleep aids and report that their legs shoot out, lift, jerk, or go into spasm. Bed partners are often the first to alert one that this is present. Respiratory flow dynamics during sleep in FM are just beginning to be surveyed. While initial reports suggested that these may correlate with sleep apnea (especially in men), its true prevalence is only 5%. One group has associated upper-airway resistance syndrome, rather than sleep apnea or hypopnea, in the overwhelming majority of FM patients.26,27
Comorbidities of sarcoidosis
Published in Annals of Medicine, 2022
Claudio Tana, Marjolein Drent, Hilario Nunes, Vasilis Kouranos, Francesco Cinetto, Naomi T. Jessurun, Paolo Spagnolo
In the study by Mari et al., which has systematically investigated 68 unselected sarcoidosis patients, OSA affected 88.2% of them. OSA was mild (5 ≥ apnoea/hypopnea index (AHI) > 15) in 36.8%, and moderate-to-severe (AHI ≥ 15) in 51.5% of cases [62]. This surprisingly high prevalence may suffer from a selection bias since patients were recruited in a referral centre for ILD. Furthermore the overnight sleep study was performed using a portable device instead of supervised in-laboratory polysomnography. Male gender, body mass index, Scadding stage, total lung capacity and FAS-score were predictors of AHI severity while sleepiness and GCsuse for more than 3 months at baseline were not [62]. Amongst the 20 patients treated with CPAP and evaluated at 3 months, FAS and Epworth Sleepiness Scale (ESS) scores improved significantly. Compliance to treatment was good in 65.0% of cases [62].
The urocortin peptides: biological relevance and laboratory aspects of UCN3 and its receptor
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
Norah J. Alghamdi, Christopher T. Burns, Roland Valdes
The diagnosis of OSA is based on measuring the frequency and duration of disrupted respiratory events during sleep. Overnight polysomnography (PSG) performed in a sleep laboratory is considered the standard of care and first-line diagnostic method for OSA. Overnight sleep studies have limitations, including being time-consuming, labor-intensive, complex, and inconvenient to patients, particularly children [57]. Alternative sleep study tests, such as those performed at home, are generally considered to be less accurate than in-laboratory testing [58]. Thus, the development of an accurate and non-invasive method is needed. Recent studies have focused on developing new technologies and assays to provide greater insight related to the early-stage diagnosis of OSA. Few clinical studies have reported the levels of urinary metabolites in patients with OSA [59–61]. In 2016, Xu et al. performed a metabolomics profiling study using mass spectrometry techniques to analyze the urinary metabolites in OSA subjects. Interestingly, the group identified multiple metabolite signatures in patients with OSA compared to normal individuals. These types of studies identify multiple potential biomarkers to diagnose and/or monitor OSA as alternatives to PSG [62].
Associations Between Child Sleep Problems and Maternal Mental Health in Children with ADHD
Published in Behavioral Sleep Medicine, 2021
Christina A. Martin, Nicole Papadopoulos, Nicole Rinehart, Emma Sciberras
This study used data sourced from the Attention to Sleep study (Lycett et al., 2014b). Participants were 379 children aged 5–13 years with ADHD (M = 10.18 years, SD = 1.87) and their female caregivers (M = 40.24 years, SD = 6.35). Families were recruited from public and private pediatric clinics in Victoria Australia (n = 21). All children had an ADHD diagnosis from their pediatrician and had attended an appointment with their pediatrician in the last 12 months. Caregivers were contacted by the research team to reconfirm that their child met the ADHD criteria in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) (DSM-IV-TR; American Psychiatric Association, 2000) and were therefore eligible to participate in the study. The family was excluded if the child had a serious medical condition; an intellectual disability (IQ < 70); obstructive sleep apnea, as assessed by the Children’s Sleep Habits Questionnaire (CSHQ; Owens, Spirito, & McGuinn, 2000); was receiving sleep problem assistance from someone other than their pediatrician; or the family was non-English speaking.