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Latest Physician News2019-02-15T12:10:02+00:00

Latest in Sleep Medicine News

The Food and Drug Administration has approved pitolisant (Wakix) for excessive daytime sleepiness among patients with narcolepsy, according to a release from the drug’s developer.

The Food and Drug Administration has approved pitolisant (Wakix) for excessive daytime sleepiness among patients with narcolepsy, according to a release from the drug’s developer. Approval of this once-daily, selective histamine 3–receptor antagonist/inverse agonist was based on a pair of multicenter, randomized, double-blind, placebo-controlled studies that included a total of 261 patients. Patients in both studies experienced statistically significant improvements in excessive daytime sleepiness according to Epworth Sleepiness Scale scores.

Rates of adverse advents at or greater than 5% and more than double that of placebo included insomnia (6%), nausea (6%), and anxiety (5%). Patients with severe liver disease should not use pitolisant. Pitolisant has not been evaluated in patients under 18 years of age, and patients who are pregnant or planning to become pregnant are encouraged to enroll in a pregnancy exposure registry.

Source: https://www.mdedge.com/chestphysician/article/206754/sleep-medicine/fda-approves-wakix-excessive-daytime-sleepiness

Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries



To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events.

Methods and results

We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.8 years, we recorded 4381 deaths and 4365 major cardiovascular events. It showed both shorter (≤6 h/day) and longer (>8 h/day) estimated total sleep durations were associated with an increased risk of the composite outcome when adjusted for age and sex. After adjustment for demographic characteristics, lifestyle behaviours and health status, a J-shaped association was observed. Compared with sleeping 6–8 h/day, those who slept ≤6 h/day had a non-significant trend for increased risk of the composite outcome [hazard ratio (HR), 1.09; 95% confidence interval, 0.99–1.20]. As estimated sleep duration increased, we also noticed a significant trend for a greater risk of the composite outcome [HR of 1.05 (0.99–1.12), 1.17 (1.09–1.25), and 1.41 (1.30–1.53) for 8–9 h/day, 9–10 h/day, and >10 h/day, Ptrend < 0.0001, respectively]. The results were similar for each of all-cause mortality and major cardiovascular events. Daytime nap duration was associated with an increased risk of the composite events in those with over 6 h of nocturnal sleep duration, but not in shorter nocturnal sleepers (≤6 h).


Estimated total sleep duration of 6–8 h per day is associated with the lowest risk of deaths and major cardiovascular events. Daytime napping is associated with increased risks of major cardiovascular events and deaths in those with >6 h of nighttime sleep but not in those sleeping ≤6 h/night.

Chuangshi Wang, Shrikant I Bangdiwala, Sumathy Rangarajan, Scott A Lear,Khalid F AlHabib, Viswanathan Mohan, Koon Teo, Paul Poirier, Lap Ah TSE, Zhiguang Liu, Annika Rosengren, Rajesh Kumar, Patricio Lopez-Jaramillo, Khalid Yusoff, Nahed Monsef,Vijayakumar Krishnapillai, Noorhassim Ismail, Pamela Seron, Antonio L Dans,Lanthé Kruger, Karen Yeates, Lloyd Leach, Rita Yusuf, Andres Orlandini, Maria Wolyniec,Ahmad Bahonar, Indu Mohan, Rasha Khatib, Ahmet Temizhan, Wei Li,

Source: https://academic.oup.com/eurheartj/article-abstract/40/20/1620/5229545

Water Pipe (Hookah) Smoking and Cardiovascular Disease Risk: A Scientific Statement From the American Heart Association

Tobacco smoking with a water pipe or hookah is increasing globally. There are millions of water pipe tobacco smokers worldwide, and in the United States, water pipe use is more common among youth and young adults than among adults. The spread of water pipe tobacco smoking has been abetted by the marketing of flavored tobacco, a social media environment that promotes water pipe smoking, and misperceptions about the addictive potential and potential adverse health effects of this form of tobacco use. There is growing evidence that water pipe tobacco smoking affects heart rate, blood pressure regulation, baroreflex sensitivity, tissue oxygenation, and vascular function over the short term. Long-term water pipe use is associated with increased risk of coronary artery disease. Several harmful or potentially harmful substances present in cigarette smoke are also present in water pipe smoke, often at levels exceeding those found in cigarette smoke. Water pipe tobacco smokers have a higher risk of initiation of cigarette smoking than never smokers. Future studies that focus on the long-term adverse health effects of intermittent water pipe tobacco use are critical to strengthen the evidence base and to inform the regulation of water pipe products and use. The objectives of this statement are to describe the design and operation of water pipes and their use patterns, to identify harmful and potentially harmful constituents in water pipe smoke, to document the cardiovascular risks of water pipe use, to review current approaches to water pipe smoking cessation, and to offer guidance to healthcare providers for the identification and treatment of individuals who smoke

Aruni Bhatnagar | Wasim Maziak | Thomas Eissenberg | Kenneth D. Ward | George Thurston | Brian A. King | Erin L. Sutfin | Caroline O. Cobb | Merlyn Griffiths | Larry B. Goldstein | Mary Rezk-Hanna

Source: https://www.mdedge.com/chestphysician/article/194683/sleep-medicine/sleep-strategies

Latest in Sleep Medicine Research

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  6. Hendricks, AJ, Manivannan, M, Shi, VY. Clinical Pearls on Sleep Management in Atopic Dermatitis. Dermatitis. ;30 (5):287-293. doi: 10.1097/DER.0000000000000523. PubMed PMID:31524756 .
  7. Bergl, PA, Taneja, A, El-Kareh, R, Singh, H, Nanchal, RS. Frequency, Risk Factors, Causes, and Consequences of Diagnostic Errors in Critically Ill Medical Patients: A Retrospective Cohort Study. Crit. Care Med. 2019; :. doi: 10.1097/CCM.0000000000003976. PubMed PMID:31524644 .
  8. Silveira, SL, Pilutti, LA, Motl, RW. No evidence of associations among body composition and symptoms in persons with multiple sclerosis. Rehabil Psychol. 2019; :. doi: 10.1037/rep0000292. PubMed PMID:31524430 .
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  12. Kondziella, D, Dreier, JP, Olsen, MH. Prevalence of near-death experiences in people with and without REM sleep intrusion. PeerJ. 2019;7 :e7585. doi: 10.7717/peerj.7585. PubMed PMID:31523519 PubMed Central PMC6716500.
  13. Camargos, EF, Goncalves, ID, Bretones, LA, Machado, MF, Morais-Junior, GS, Brito, AF et al.. Evidence for a contribution of the APOE (but not the ACE) gene to the sleep profile of non-demented elderly adults. Int J Mol Epidemiol Genet. 2019;10 (4):59-66. . PubMed PMID:31523375 .
  14. Lindsey, GL, Yesen, A, Christie, AD. The Impact of Physical Activity and Sleep on Physiology Following a mTBI. Int J Exerc Sci. 2019;12 (3):919-931. . PubMed PMID:31523349 .
  15. Clemente, FM, Mendes, B, Bredt, SDGT, Praça, GM, Silvério, A, Carriço, S et al.. Perceived Training Load, Muscle Soreness, Stress, Fatigue, and Sleep Quality in Professional Basketball: A Full Season Study. J Hum Kinet. 2019;67 :199-207. doi: 10.2478/hukin-2019-0002. PubMed PMID:31523318 PubMed Central PMC6714361.
  16. Ghavami, H, Shamsi, SA, Abdollahpoor, B, Radfar, M, Khalkhali, HR. Impact of hot stone massage therapy on sleep quality in patients on maintenance hemodialysis: A randomized controlled trial. J Res Med Sci. 2019;24 :71. doi: 10.4103/jrms.JRMS_734_18. PubMed PMID:31523257 PubMed Central PMC6734672.
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  21. Fujimura, Y, Sekine, M, Yamada, M. The Relationship Between Quality of Life and Pubertal Timing in Adolescence: The Toyama Birth Cohort Study, Japan. J Adolesc Health. 2019; :. doi: 10.1016/j.jadohealth.2019.07.004. PubMed PMID:31522905 .
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Search Terms: Insomnia, Narcolepsy, REM Sleep, Sleep Apnea, Sleep Quality