ITEMS IN AFP WITH KEYWORD:
Feb 1, 2012 Issue
Respiratory Indications for Polysomnography in Children [Practice Guidelines]
Although assessment of sleep disorders in children relies on the history and physical examination, polysomnography (PSG) is sometimes used to aid in the diagnosis. The American Academy of Sleep Medicine has provided recommendations regarding the use of the test in children. This guideline focuses on...
Nov 1, 2011 Issue
Antidepressants for the Treatment of Insomnia in Patients with Depression [FPIN's Clinical Inquiries]
There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep physiology, but does not seem to improve subjective ratings of sleep quality.
In older patients with primary insomnia, Silenor can increase duration of sleep without next-day effects. However, it does not significantly decrease the time to sleep onset, and it is less effective in younger adults.
Clinical indicators (e.g., sex, snoring severity, history of apnea, age, menopausal status, waist-to-hip ratio, body habitus) can predict OSA as diagnosed using overnight polysomnography or sleep study.
What are the effects of treatment for severe and nonsevere OSAHS?
Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, and it affects an estimated 20 percent of the population. Persons with excessive daytime sleepiness are at risk of motor vehicle and work-related incidents, and have poorer health than comparable adults. The most ...
Chronic insomnia is highly prevalent in our society, with an incidence of 10 to 30 percent. It is a major cost to society in terms of health care expenditure and reduced productivity. Nonpharmacologic interventions have been studied and shown to produce reliable and sustained improvements in sleep p...
The frequency of sleep disruption and the degree to which insomnia significantly affects daytime function determine the need for evaluation and treatment. Physicians may initiate treatment of insomnia at an initial visit; for patients with a clear acute stressor such as grief, no further evaluation ...
Ramelteon is safe and effective for decreasing the time to persistent sleep in patients with chronic insomnia. It does not have the potential for abuse or dependence that sedative hypnotics have and is not a controlled substance.
Although oral appliances provide improved subjective sleepiness and sleep-disordered breathing, continuous positive airway pressure (CPAP) is more effective. Oral appliances should not be used as a first-line treatment but rather should be reserved for patients who cannot tolerate CPAP or who refuse to use it.