Evaluation and Management of Sleep Disorders in the Hand Surgery Patient.

Despite posing a significant public health threat, sleep disorders remain poorly understood and often underdiagnosed and mismanaged. Although sleep disorders are seemingly unrelated, hand surgeons should be mindful of these because numerous conditions of the upper extremity have known associations with sleep disturbances that can adversely affect patient function and satisfaction. In addition, patients with sleep disorders are at significantly higher risk for severe, even life-threatening medical comorbidities, further amplifying the role of hand surgeons in the recognition of this condition

Sleep Disorders and Genes

Versão preprintThe sleep-wake cycle is a neurobiological phenomenon that shows intervals of activity alternating with restfulness that appears with a periodicity approximating the 24h day-night cycle. The sleep-wake cycle is under the control of diverse neuroanatomical and neurochemical systems, including monoaminergic, cholinergic, adenosinergic among many other systems. In addition, neuroanatomical centers linked to sleep promotion, such as hypothalamus, project to the cerebral cortex, subcortical relays and brainstem. In addition, the sleep-wake cycle has been associated to aberrant features known as sleep disorders. Here, we will discuss the role of specific gene expression on sleep disturbances. Given the expansion of the knowledge in the sleep-wake cycle area, it is indeed ambitious to describe all the genetics involved in the sleep modulation. However, in this chapter we reviewed the current understanding of the sleep disorders and gene expression.info:eu-repo/semantics/publishedVersio

Best Practice for Insomnia Patients at a Sleep Center

Sleep disorders affect millions of people worldwide. The purpose of this project was to determine if individuals with sleep disorders can achieve better outcomes with treatment that includes education classes and cognitive therapy than with current treatments which utilize medication and equipment. Seven articles, obtained from a search of CINAHL, JBI, Medline, and Psych Info, were reviewed and critiqued. Studies contained samples of men and women with sleep disorders, reviews of previous studies, and reviews of effective alternative treatments. Designs included systematic reviews, meta-analysis, randomized control, longitudinal two group pre-test posttest, and a narrative review. Findings showed that when traditional pharmacological treatments are combined with alternative therapies, patients have much better outcomes. A decision to include cognitive behavioral therapy (CBT) and music therapy was made. A new education program will include a briefing about therapies for individuals with sleep disorders and a discussion about how to help patients incorporate CBT and music therapy into their current plan for treatment. In the future, patients will be educated about the importance of keeping a sleep journal to evaluate their progress. Patient success will be measured using data from patient journals and a sleep center survey

PREVALENSI GANGGUAN TIDUR PADA REMAJA USIA 12-15 TAHUN

Background: Sleep disorders caused adolescents growth and development problems. Disorders in the amount, quality and timing of sleep assessed sleep disorders. Sleep Disturbance Scale for Children (SDSC) questionnaires used to screening method sleep disorders. Data on the prevalence of sleep disorders has not been found in Indonesia. Aim: To determine the prevalence of sleep disorders in adolescents aged 12-15 years public junior high school 5 Semarang. Methods: Descriptive study with 122 subjects students public junior high school 5 Semarang during the months from April to June 2015. Data collection using SDSC questionnaires filled out by parents and their children. Results: The prevalence of sleep disorders in adolescents aged 12-15 years public junior high school 5 Semarang 81,1 %. Sleep-wake transition disorders 43,4 %, initiating and mainntaining sleep disorder 35,2 %, arousal disorders 24,6 %, excessive somnolence disorders 23 %, hyperhidrosis 4,1 %, sleep breathing disorders 3,3 %. Conclusion: Adolescents aged 12-15 years at public junior high school 5 Semarang have many sleep disorders. Sleep-wake transition disorders are the largest type of sleep disorder. Keywords: Sleep disorders, sleep disturbance scale for children (SDSC

Sleep Disorders in Parkinson’s Disease

Sleep disorders in Parkinson’s disease (PD) are common. They can develop due to many factors. PD symptoms like rigidity or tremor, some PD medications, restless legs syndrome, depression, nocturia, and degenerative changes in the brainstem can cause sleep disorders in PD. Sleep disorders in PD may occur during the day or at night. Sleep disorders can occur before or during the disease. Sleep disorders can impair patients’ quality of life and worsen their symptoms. For this reason, it is very important to recognize these disorders and treat them appropriately. This chapter discusses the clinical features, diagnosis, comorbidities, management, and pathogenesis of sleep disorders in PD under the literature light. At the same time, it describes the most appropriate treatment considerations

PALLIATIVE CARE ELDERLY PATIENTS WITH SLEEPING DISORDERS ARE POORLY TREATED

Background: Sleep disorders are frequent in patients with advanced cancer receiving palliative-care, especially in elderly patients (1). Sleep disorders during palliative-care may be related with anxiety, opioids related central-sleep apnoea or corticoids therapy between others (2). Our aim was to quantify the effectiveness of hypnotic medication in the sleep quality in advanced cancer receiving palliative-care elderly patients. Material and methods: A descriptive cross-sectional study was conducted in elderly patients with advanced cancer receiving palliative-care exploring their sleep quantity and quality (approved by Local Ethical Committee). Patients who were in our palliative care program and didn´t have any exclusion criteria: Age below 60 years, with ability to communicate effectively, and without cognitive failure and/or delirium, and/or psychotic illness. The Pittsburgh Sleep Quality Index (PSQI) questionnaire and EVA scales were used to measured sleep quality and pain and anxiety levels. Patient under corticoids treatment were compared with other non-sleep disorders risky treatment. Results are expressed as mean ± sem. and were compared by Student t test and ANOVA test followed by Bonferroni post-test. Results: Patients, N=138, 63.8% male, aged 70.9±1.1 years old with diagnostic of 28.3% gastro-intestinal, 15.9% mama/gynaecological , 13% pulmonary, 12.3% urinary, 6.5% liver, 4.3% central nervous system, 1.4% pancreatic, and 18.1% others types of terminal cancer were enrolled. Patients were treated with no oncologic treatment (78.3%), chemotherapy (12.3%), radiotherapy (5.1%), hormone therapy (3.6%), or immunotherapy (0.7%). 54.3% were treated with corticoids vs. 20.3% under other sleep disorders risky treatment and 25.4% with no treatment. The sleep disturbances prevalence were 81.2% in the total population and 90.4% in patients treated with corticoids (p<0.05). However a 54.3% of the patients received benzodiazepines, zolpidem or chlormethiazole. 65.2% of the patients need more than three times rescue hypnotic medication during the last week. Bad sleeper showed significantly higher intensity of pain, asthenia, sadness, anxiety, nausea, dyspnea and discomfort. Discussion: Sleep disorders may be primary or, more commonly, a secondary symptom of the advancing disease process. Multiple pharmacologic and non-pharmacologic interventions may be used for the management of sleep disturbances in palliative medicine. However, many patients do not seek medical attention for sleep disturbances, and health care providers tend to under-diagnose this condition and under-treat it when diagnosed, thus missing an opportunity to improve the quality of life of patients already suffering from the burden of terminal disease. The diversity of patients under palliative care makes management of sleep disorders particularly challenging and highly needed to be individualized. Conclusion. Elderly patients with advanced cancer subjected to palliative care received insufficient hypnotic medication especially under corticoids co-treatment. References: (1) Sateia MJ and Lang BJ. 2008. Curr Oncol Rep 10(4):309-18. (2) Yennurajalingam S et al. 2011. J Pain Symptom Manage 41(1):49-56.University of Malaga. Campus of International Excellence Andalucia Tech

Protocol of the SOMNIA project : an observational study to create a neurophysiological database for advanced clinical sleep monitoring

Introduction Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods. Methods and analysis We aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm

The sleep cycle: a mathematical analysis from a global workspace perspective

Dretske's technique of invoking necessary conditions from information theory to describe mental process can be used to derive a version of Hobson's AIM treatment of the sleep/wake cycle from a mathematical formulation of Baars' Global Workspace model of consciousness. One implication of the analysis is that some sleep disorders may be recognizably similar to many other chronic, developmental dysfunctions, including autoimmune and coronary heart disease, obesity, hypertension, and anxiety disorder, in that these afflictions often have roots in utero or adverse early childhood experiences or exposures to systematic patterns of structured stress. Identification and alteration of such factors might have considerable impact on population-level patterns of sleep disorders, suggesting the possibility of a public health approach rather than current exorbitantly expensive case-by-case medical intervention

Prevalence and pattern of sleep disorder among children with neurological diseases in University of Benin Teaching Hospital, Benin City, Nigeria

Background: Sleep disorders significantly affect the quality of live and may impair cognitive development. Sleep disorders are reported to be common in children with neurological diseases. However no report has evaluated the prevalence of sleep disorders among children chronic neurological diseases in Nigeria. This study therefore sort to determine the prevalence and types of sleep disorders among children with neurological diseases seen Child neurology clinic of University of Benin Teaching Hospital (UBTH), Benin City. Subjects and methods: This was a questionnaire based cross sectional study. Parents/caregivers of children attending the Child Neurology Clinic of UBTH were recruited and a structured questionnaire was administered to evaluate the presence of sleep disorders in the children they have brought to the clinic. Response scale ranged from never, rarely, occasional, frequent and very frequent. Children were judged to have sleep disorder if the symptom were present frequently or very frequently. Variables were aggregated as simple proportions and differences determine using chi-square test. Results: One hundred and fifty children aged 17years and below consisting of 98 (65.3%) males and 52 (34.7%) were evaluated. The most common sleep disorders found include restlessness during sleep 68.7%, frequent awakening 66.0%, snoring 57.3%, excessive day time sleepiness 53.3% and sleep walking among others. Sleep disorders were more common in boys than in girls and those aged 5 years and below than older children. Conclusion: Sleep disorders are very common among children with neurological diseases. These problems have great potential of further impairing cognitive development and quality of life in these children. Key words: sleep disorder, children, neurological diseases, Benin City