Ambulatory Sleep Medicine, An Issue of Sleep Medicine Clinics

Name: Ambulatory Sleep Medicine, An Issue of Sleep Medicine Clinics
Brand: Elsevier
Price: 45.99 EUR
Availability: OnlineOnly

Nicholas A. Antic Jr Teofilo Lee-Chiong(Autor*in)

Elsevier (Verlag)

1. Auflage

Erschienen am 24. August 2016

100 Seiten

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Front Cover
Ambulatory Sleep Medicine
Copyright
CME Accreditation Page
PROGRAM OBJECTIVE
TARGET AUDIENCE
LEARNING OBJECTIVES
ACCREDITATION
DISCLOSURE OF CONFLICTS OF INTEREST
UNAPPROVED/OFF-LABEL USE DISCLOSURE
TO ENROLL
METHOD OF PARTICIPATION
CME INQUIRIES/SPECIAL NEEDS
SLEEP MEDICINE CLINICS
FORTHCOMING ISSUES
December 2016
March 2017
June 2017
RECENT ISSUES
June 2016
March 2016
December 2015
Contributors
CONSULTING EDITOR
EDITORS
AUTHORS
Contents
Ambulatory Diagnosis and Management of Obstructive Sleep Apnea: Screening Questionnaires, Diagnostic Tests, and the Care Team
Consequences of Obstructive Sleep Apnea: Cardiovascular Risk of Obstructive Sleep Apnea and Whether Continuous Positive Airway Pressure Reduces that Risk
Impact of Obstructive Sleep Apnea on Neurocognitive Function and Impact of Continuous Positive Air Pressure
Personalized Medicine for Obstructive Sleep Apnea Therapies: Are We There Yet?
Managing Comorbid Illness in Obstructive Sleep Apnea: What Can We Learn from Other Diseases?
Continuous Positive Airway Pressure Therapy for Obstructive Sleep Apnea: Maximizing Adherence Including Using Novel Information Technology-based Systems
Surgical Approaches to Obstructive Sleep Apnea
Mandibular Advancement Splints
Residual Daytime Sleepiness in Obstructive Sleep Apnea After Continuous Positive Airway Pressure Optimization: Causes and Management
Disorders of Excessive Daytime Sleepiness Including Narcolepsy and Idiopathic Hypersomnia
Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea
Diagnosis, Cause, and Treatment Approaches for Delayed Sleep-Wake Phase Disorder
Ambulatory Diagnosis and Management of Obstructive Sleep Apnea
Key points
THE IMPORTANCE OF PATIENT HISTORY, EXAMINATION, AND CLINICAL JUDGEMENT
OBSTRUCTIVE SLEEP APNEA SCREENING QUESTIONNAIRES AND CLINICAL PREDICTION TOOLS
HOME SLEEP TESTS VERSUS IN-LABORATORY POLYSOMNOGRAPHY
HOME AUTO-ADJUSTING POSITIVE AIRWAY PRESSURE TREATMENT VERSUS IN-LABORATORY CONTINUOUS POSITIVE AIRWAY PRESSURE TITRATION
PRINCIPLES OF OBSTRUCTIVE SLEEP APNEA CARE
THE OBSTRUCTIVE SLEEP APNEA CARE TEAM
An Expanded Role for Specialist Sleep Nurses?
REFERENCES
Consequences of Obstructive Sleep Apnea
Key points
INTRODUCTION
OVERVIEW OF SLEEP-DISORDERED BREATHING
MECHANISM OF CARDIOVASCULAR DISEASE IN OBSTRUCTIVE SLEEP APNEA
Intermittent Hypoxia
Sympathetic Activation, a Critical Mediator for Cardiovascular Disease in Obstructive Sleep Apnea
Oxidative Stress
Metabolic Dysregulation in Obstructive Sleep Apnea
CLINICAL LINK BETWEEN OBSTRUCTIVE SLEEP APNEA/SLEEP-DISORDERED BREATHING AND SPECIFIC CARDIOVASCULAR DISEASES
Systemic Hypertension and Obstructive Sleep Apnea: A Critical Causative Relationship
Coronary Artery Disease and Obstructive Sleep Apnea
Cardiac Arrhythmia (with a Focus on Atrial Fibrillation) and Obstructive Sleep Apnea
Cerebrovascular Accidents and Obstructive Sleep Apnea
Pulmonary Hypertension and Obstructive Sleep Apnea
Cardiomyopathy, Heart Failure, and Sleep-disordered Breathing
Treatment of Sleep-disordered Breathing as a Therapeutic Intervention to Modify Cardiovascular Disease Risk
SUMMARY
REFERENCES
Impact of Obstructive Sleep Apnea on Neurocognitive Function and Impact of Continuous Positive Air Pressure
Key points
INTRODUCTION
OBSTRUCTIVE SLEEP APNEA EFFECTS ON ATTENTION AND VIGILANCE
OBSTRUCTIVE SLEEP APNEA EFFECTS ON VERBAL MEMORY
OBSTRUCTIVE SLEEP APNEA EFFECTS ON VISUAL AND VISUOSPATIAL MEMORY
OBSTRUCTIVE SLEEP APNEA EFFECTS ON PSYCHOMOTOR FUNCTION AND PROCEDURAL MEMORY
OBSTRUCTIVE SLEEP APNEA EFFECTS ON EXECUTIVE FUNCTION
OBSTRUCTIVE SLEEP APNEA EFFECTS ON OVERALL IQ
NEUROCOGNITIVE EFFECTS OF OBSTRUCTIVE SLEEP APNEA FOR CHILDREN
IMAGING: MAGNETIC RESONANCE SPECTROSCOPY, DIFFUSION TENSOR IMAGING, FUNCTIONAL MRI STUDIES
MECHANISMS OF OBSTRUCTIVE SLEEP APNEA EFFECTS ON COGNITION
IMPACT OF CONTINUOUS POSITIVE AIR PRESSURE
CONTINUOUS POSITIVE AIR PRESSURE WITHDRAWAL
SUMMARY
REFERENCES
Personalized Medicine for Obstructive Sleep Apnea Therapies
Key points
CURRENT TREATMENT OPTIONS FOR OBSTRUCTIVE SLEEP APNEA PATIENTS
Continuous Positive Airway Pressure
Mandibular Advancement Splints
Upper Airway Surgery
Weight Loss
Summary
OBSTRUCTIVE SLEEP APNEA IS A MULTIFACTORIAL DISORDER
Alternative Therapies Targeting the Nonanatomic Traits
High loop gain
Low arousal threshold
Poor upper airway muscle responsiveness
Combinations of Therapies
PERSONALIZED MEDICINE FOR OBSTRUCTIVE SLEEP APNEA
Currently Applied/Available Methods to Personalize or Predict Therapeutic Response
Supine predominant obstructive sleep apnea and supine avoidance therapy
Mandibular advancement titration and prediction algorithms
Drug-induced sleep endoscopy
Summary
Personalized Treatment for Obstructive Sleep Apnea: A Physiologically Driven Treatment Model
A predictive model for assessing the effectiveness of targeted therapeutic interventions
Clinically implementable methods for measuring the physiology responsible for obstructive sleep apnea
Necessary clinical trials
SUMMARY
REFERENCES
Managing Comorbid Illness in Obstructive Sleep Apnea
Key points
INTRODUCTION
CARDIOVASCUAR DISORDERS
Overview
Hypertension
Atrial fibrillation
Congestive heart failure
Management Goals
Treatment Considerations
Monitoring Therapy
PULMONARY DISORDERS
Overview
Obstructive lung disease
Interstitial lung disease
Chronic hypoventilation
Management Goals
Treatment Considerations
Monitoring Therapy
PSYCHIATRIC
Overview
Management Goals
Treatment Considerations
Monitoring Therapy
NEUROLOGIC DISORDERS
Overview
Management Goals
Treatment Considerations
Monitoring Therapy
ENDOCRINE DISORDERS
Overview
Management Goals
Treatment Considerations
Monitoring Therapy
SLEEP DISORDERS
Overview
Restless legs syndrome
Insomnia
Management Goals
Treatment Considerations
Monitoring Therapy
SUMMARY
REFERENCES
Continuous Positive Airway Pressure Therapy for Obstructive Sleep Apnea
Key points
REFERENCES
Surgical Approaches to Obstructive Sleep Apnea
Key points
INTRODUCTION
DEFINITION OF OBSTRUCTIVE SLEEP APNEA SURGERY
PHILOSOPHY OF SURGERY
CLINICAL ASSESSMENT IN OBSTRUCTIVE SLEEP APNEA SURGERY, INCLUDING DYNAMIC AIRWAY ASSESSMENT
PREPHASE NASAL SURGERY
CONTEMPORARY SURGICAL INTERVENTION PARADIGMS AND SELECTION
COMPLICATIONS OF SURGERY
EFFECTIVENESS OF OBSTRUCTIVE SLEEP APNEA SURGERY: CURRENT STATUS OF LITERATURE: NONRANDOMIZED TRIALS
EFFECTIVENESS OF OBSTRUCTIVE SLEEP APNEA SURGERY: CURRENT STATUS OF LITERATURE AND CHALLENGES OF RANDOMIZED CONTROLLED TRIALS
How to Define Obstructive Sleep Apnea Surgery
Patient Selection
Recruitment/Enrollment
Economics
Comparator Group
Outcome Measures
RECENT/CURRENT INNOVATIONS
FUTURE DIRECTIONS AND INNOVATIONS
ACKNOWLEDGMENTS
REFERENCES
Mandibular Advancement Splints
Key points
INTRODUCTION
EFFICACY AND HEALTH OUTCOMES OF MANDIBULAR ADVANCEMENT SPLINTS
MANDIBULAR ADVANCEMENT SPLINTS COMPARED WITH OTHER OBSTRUCTIVE SLEEP APNEA TREATMENT MODALITIES
FACTORS INFLUENCING THE EFFICACY OF MANDIBULAR ADVANCEMENT SPLINTS
Design of Mandibular Advancement Splints
Preference and Adherence to Mandibular Advancement Splints
SIDE EFFECTS
PATIENT SELECTION
SUMMARY
REFERENCES
Residual Daytime Sleepiness in Obstructive Sleep Apnea After Continuous Positive Airway Pressure Optimization
Key points
PREVALENCE AND PREDICTORS OF RESIDUAL SLEEPINESS IN OBSTRUCTIVE SLEEP APNEA
Fatigue or Sleepiness?
A Distinct Phenotype? Permanent Brain Injury
MEASUREMENT OF EXCESSIVE DAYTIME SLEEPINESS
Subjective Measures
Objective Measures
DIAGNOSTIC APPROACH
Optimizing Continuous Positive Airway Pressure
Insufficient Sleep
Ruling Out Concomitant Sleep Disorders
Mood Disorders
Medications or Illicit Drug Use
Neurologic Disorders
Other Uncontrolled or Undiagnosed Medical Conditions
Unrealistic Expectations
Investigations
MANAGEMENT OF RESIDUAL DAYTIME SLEEPINESS IN OBSTRUCTIVE SLEEP APNEA
Treat Comorbidities
Treating Sleepiness with Pharmacotherapy
Modafinil and armodafinil
Mechanism of action
Evidence from clinical trials
Common side effects
Clinical application
Amphetamines and Other Sympathomimetics
Caffeine
Potential Future Drugs
Summary of Pharmacologic Strategies
SUMMARY
REFERENCES
Disorders of Excessive Daytime Sleepiness Including Narcolepsy and Idiopathic Hypersomnia
Key points
INTRODUCTION
PATIENT EVALUATION
Clinical History
Subjective questionnaires
Symptoms of Central Disorders of Hypersomnolence
Physical Examination
Laboratory Testing
General medical testing
Cerebrospinal fluid testing
Human leukocyte antibody testing
Diagnostic Evaluation
Sleep logs
Actigraphy
Polysomnography
Multiple sleep latency test
Evaluation of the results from the polysomnogram and multiple sleep latency test
Miscellaneous tests
TREATMENT OF CENTRAL DISORDERS OF HYPERSOMNOLENCE
Pharmacologic Treatment
Medication Side Effects
Alternative Therapies
SUMMARY AND FUTURE CONSIDERATIONS
REFERENCES
Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea
Key points
INTRODUCTION
CONSEQUENCES OF COMORBID INSOMNIA/OSA
MUTUAL INTERACTIONS BETWEEN OBSTRUCTIVE SLEEP APNEA AND INSOMNIA
SHOULD INSOMNIA COMORBID WITH OBSTRUCTIVE SLEEP APNEA BE TREATED?
DIAGNOSIS OF INSOMNIA COMORBID WITH OBSTRUCTIVE SLEEP APNEA
TREATMENT OF INSOMNIA COMORBID WITH OBSTRUCTIVE SLEEP APNEA
BEHAVIORAL THERAPIES
EFFECTIVENESS OF BEHAVIORAL THERAPIES
COGNITIVE ELEMENTS AND THERAPY
SUMMARY ABOUT THE TREATMENT OF INSOMNIA COMORBID WITH OBSTRUCTIVE SLEEP APNEA
TREATMENT OF INSOMNIA BEFORE OR DURING POSITIVE AIRWAY PRESSURE THERAPY?
RECOMMENDATIONS FOR SLEEP MEDICINE CLINICS
REFERENCES
Diagnosis, Cause, and Treatment Approaches for Delayed Sleep-Wake Phase Disorder
Key points
INTRODUCTION
CLASSIFICATION OF DELAYED SLEEP-WAKE PHASE DISORDER
PATIENT EVALUATION OVERVIEW
Diagnostic Issues
Current Assessment Tools
Sleep logs
Actigraphy
Morningness-eveningness questionnaires
Circadian phase markers
CAUSE
Physiologic
Delay in timing of circadian rhythm
Longer circadian period (tau)
Phase relationships between circadian phase and sleep timing
Hypersensitivity to light
Decreased buildup of homeostatic sleep drive
Behavioral Modulation of Light Exposure
Genetic
TREATMENT OPTIONS
Chronotherapeutic Treatment
Chronobiotic Treatment
Melatonin
Melatonin receptor agonists
Photic Treatment
Other Treatments
SUMMARY
DISCLOSURE STATEMENT
REFERENCES

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