ITEMS IN AFP WITH KEYWORD:
Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.
Oct 01, 2021 Issue
Interventions to Improve Use of CPAP Machines in Adults with Obstructive Sleep Apnea [Cochrane for Clinicians]
Behavioral interventions increase CPAP use compared with usual care. These interventions also increase CPAP adherence, measured by participants using their machine four or more hours per night, from 371 to 501 per 1,000 patients.
Melatonin preparations reduce sleep-onset latency, increase total sleep time, and slightly improve sleep efficiency. Prolonged-release melatonin reduces sleep-onset latency in older adults and has rates of adverse effects similar to those of placebo.
Because an increasing percentage of patients are surviving to intensive care unit (ICU) discharge and require follow-up in the outpatient setting, family physicians should be prepared to provide ongoing care and screening for common post-ICU complications. Patients should be screened for physical and psychological complications, such as weakness, cognitive impairment, depression, anxiety, and posttraumatic stress disorder, and treated when indicated.
Positional therapies for obstructive sleep apnea produce moderate improvements (16% to 40%) in clinical apnea measures compared with no treatment.
The U.S. Department of Veterans Affairs and Department of Defense (VA/DoD) approved a clinical practice guideline for the management of obstructive sleep apnea and chronic insomnia disorder.
Lemborexant (Davigo) is labeled for adults with insomnia to improve with sleep onset and maintenance.
Night sweats are a nonspecific symptom that patients commonly experience but rarely discuss with their physicians without prompting. Conditions commonly associated with night sweats include menopause, mood disorders, gastroesophageal reflux disease, hyperthyroidism, and obesity. Serious causes should be considered when the history and physical examination do not reveal a specific cause.
Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy and, therefor...
What are the effectiveness, comparative effectiveness, and adverse effects of interventions for insomnia disorder in adults?