Latest in Sleep Medicine News

Insomnia in the Elderly: A Review

Insomnia remains one of the most common complaints among elderly patients. However, treatment options are not easily understood among primary care physicians. There are risks of overuse of sedatives without proper analysis of underlying risk factors for insomnia. Cognitive behavioral therapy remains a viable treatment option in addition to pharmacological therapy. This review article outlines evidence-based treatment options for insomnia.

Source:Patel D, Steinberg J, Patel P. Insomnia in the elderly: a review. J Clin Sleep Med. 2018;14(6):1017–1024.

Nonadherence to CPAP Associated With Increased 30-Day Hospital Readmissions

Effective CPAP therapy is associated with improved cardiovascular and pulmonary-related morbidity and mortality. Nonadherence to CPAP leads to worsened health outcomes, but it is unclear whether this translates into increased 30-day hospital readmissions. A recent study published in the Journal of Clinical Sleep Medicine (JCSM) showed that Nonadherence to CPAP is associated with increased 30-day all-cause and cardiovascular-cause readmission in patients with OSA. Thirty-day all-cause and cardiovascular-cause readmission rate was significantly higher in the nonadherent group, with an adjusted odds ratio (OR) of 3.52 and 2.31 respectively. This study suggests that ensuring CPAP adherence is crucial in addressing general and cardiovascular-related healthcare utilization and morbidity in patients with OSA.

Source: Truong KK, De Jardin R, Massoudi N, Hashemzadeh M, Jafari B. Nonadherence to CPAP associated with increased 30-day hospital readmissions. J Clin Sleep Med. 2018;14(2):183–189.

Sleep-disordered breathing (SDB) and Atrial Fibrillation: A Case of Bidirectional Relationship and Continuous PAP Compliance Monitoring

Sleep-disordered breathing (SDB) is a contributor to atrial fibrillation (AF) and the treatment of obstructive sleep apnea can reduce the recurrence of AF following catheter ablation. On the other hand, the impact of AF therapy and conversion to sinus rhythm is not fully understood. This is a case of a middle-aged man with SDB and persistent AF who exhibited improvement in SDB events, following sinus rhythm conversion. This supports the hypothesis that a bidirectional relationship between SDB and AF exist and highlights the importance of continuous monitoring of CPAP compliance, beyond improvement of daytime sleepiness.

Improvement in Sleep-Disordered Breathing Indices Downloaded From a Positive Airway Pressure Machine Following Conversion of Atrial Fibrillation to Sinus Rhythm.

J Clin Sleep Med. 2018 Nov 15;14(11):1953-1957

Authors: Monahan K, Upender R, Sherman K, Sheller J, Montgomery J, Abraham RL

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Latest in Sleep Medicine Research

Insomnia

Kim, N, Kang, SG, Lee, YJ, Kim, SJ, Kim, S, Choi, JW et al.. Decreased regional brain activity in response to sleep-related sounds after cognitive behavioral therapy for psychophysiological insomnia. Psychiatry Clin. Neurosci. 2019; :. doi: 10.1111/pcn.12822. PubMed PMID:30663182 .
Irwin, MR, Vitiello, MV. Implications of sleep disturbance and inflammation for Alzheimer's disease dementia. Lancet Neurol. 2019; :. doi: 10.1016/S1474-4422(18)30450-2. PubMed PMID:30661858 .
Blumenthal, H, Taylor, DJ, Cloutier, RM, Baxley, C, Lasslett, H. The Links Between Social Anxiety Disorder, Insomnia Symptoms, and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States. Behav Ther. 2019;50 (1):50-59. doi: 10.1016/j.beth.2018.03.010. PubMed PMID:30661566 .
Bahrami, A, Khorasanchi, Z, Tayefi, M, Avan, A, Seifi, N, Tavakoly Sany, SB et al.. Anemia is associated with cognitive impairment in adolescent girls: A cross-sectional survey. Appl Neuropsychol Child. 2019; :1-7. doi: 10.1080/21622965.2018.1550405. PubMed PMID:30661397 .
Boerekamps, A, De Weggheleire, A, van den Berk, GE, Lauw, FN, Claassen, MAA, Posthouwer, D et al.. Treatment of acute hepatitis C genotypes 1 and 4 with 8 weeks of grazoprevir plus elbasvir (DAHHS2): an open-label, multicentre, single-arm, phase 3b trial. Lancet Gastroenterol Hepatol. 2019; :. doi: 10.1016/S2468-1253(18)30414-X. PubMed PMID:30660617 .