Home Portable Monitoring For Obstructive Sleep Apnea An Issue Of Sleep Medicine Clinics
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Home Portable Monitoring For Obstructive Sleep Apnea An Issue Of Sleep Medicine Clinics
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Author : Michael R. Littner
language : en
Publisher: Saunders
Release Date : 2011
Home Portable Monitoring For Obstructive Sleep Apnea An Issue Of Sleep Medicine Clinics written by Michael R. Littner and has been published by Saunders this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with Medical categories.
Portable Sleep monitoring is a very important method of diagnosis and follow-up for sleep-disordered breathing. This state-of-the-art issue reviews the most recent information on classification, technical specifications and types of portable monitors, use and limitations of portable monitoring with integration into positive airway pressure treatment. use of portable monitors in children and in patients with oral appliances. Use of portable monitoring for SDB treatment with upper airway surgery is also discussed. Current published standards incliding CMS requirements for portable monitoring are reviewed. Outcome measures, illustrative cases, and a comparison with polysomnogram are included. Finally, future directions are discussed.
Effectiveness Of Portable Monitoring Devices For Diagnosing Obstructive Sleep Apnea
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Author : Linda J. Lux
language : en
Publisher:
Release Date : 2004
Effectiveness Of Portable Monitoring Devices For Diagnosing Obstructive Sleep Apnea written by Linda J. Lux and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2004 with categories.
CONTEXT: Obstructive sleep apnea (OSA) is a serious public health problem. Approximately 2 percent to 4 percent of middle-aged women and men, respectively, have this condition; the majority are undiagnosed. Undiagnosed and thus untreated, OSA is associated with significant morbidity and mortality. Effective treatment modalities should not be applied without an accurate diagnosis of OSA, but medical history and physical examination are insufficient to establish the diagnosis or its severity. Using the accepted reference standard test - attended, in-laboratory polysomnography (PSG) - can be expensive and involve long waiting times for studies, so various groups have developed portable technologies to classify patients in terms of the presence or absence of OSA and, for the former, level of severity. Such devices are intended for use in sleep laboratories or in the home. OBJECTIVES: We updated a 2002-2003 systematic review of OSA diagnostic testing to address the key questions of how portable sleep testing devices compared to PSG in diagnosing OSA and, assuming equivalent effectiveness, what sleep and physiologic factors and what patient and technician conditions were important to measure or have in place. The Centers for Medicare and Medicaid Services commissioned the Agency for Healthcare Research and Quality to provide a technology assessment that addressed the following: 1. How does the diagnostic test performance of unattended portable multi-channel home sleep testing compare to facility-based polysomnography in the diagnosis of obstructive sleep apnea?1.1. If unattended portable multi-channel home sleep testing is as effective as polysomnography in the diagnosis of obstructive sleep apnea, which parameters of sleep and cardiorespiratory function (i.e., sleep staging, body position, limb movements, respiratory effort, airflow, oxygen saturation, electrocardiogram) are required?1.2. If unattended portable multi-channel home sleep testing is as effective as polysomnography in the diagnosis of obstructive sleep apnea, what conditions (i.e., patient education, technician support) are required so that it is done correctly in the home? DATA SOURCES: We searched for studies published since the original review (i.e., from 2002 on) in MEDLINE, The Cochrane Library, the National Guidelines Clearinghouse, and the International Network of Agencies for Health Technologies Assessment (INAHTA) database; we also handsearched bibliographies of included articles. In MEDLINE, we used the following main terms in various combinations: polysomnography, oximetry, physiologic monitoring, and sleep apnea (with limits of human, adults, and English language); we refined searches using the terms airway resistance, upper airway resistance syndrome, respiratory disturbance index, autoset, snoring, and respiratory events related arousals as well as reproducibility of results, predictive value of tests, and sensitivity and specificity. STUDY SELECTION: We included studies of humans, both sexes, ages 18 and over, with any diagnosis of OSA; studies of any type of portable device used for diagnosis that also included a reference standard test (PSG or another acceptable test for diagnosing OSA); studies in which each analysis group, after the end of the study, included at least 10 subjects; and studies published in English. Specifically excluded were studies in which results from portable devices were not compared with results from PSG. Also excluded were reviews, meta-analyses, case reports, abstracts, letters, and editorials. DATA EXTRACTION: One investigator recorded abstracted data onto data abstraction forms used for the original review and created detailed evidence tables. A second investigator checked entries against the original articles. One investigator assigned initial classifications for level of evidence and presence or absence of eight quality indicators and a second investigator reviewed these; disagreements were resolved by consensus discussion. A third investigator combined level of evidence and quality indicators into a summary quality grade; the other investigators reviewed these grades, with differences resolved by consensus. DATA SYNTHESIS: We identified 172 unique titles and abstracts from the literature searches, and excluded 157 articles as not meeting inclusion criteria; reasons included the fact that PSG studies were not performed on all patients, that the portable device was an electroencephalogram (EEG), and that the study assessed a telemedicine approach that did not compare a portable device to the PSG. We obtained 15 articles for full review and retained 12 for inclusion here. These 12 studies fell into four categories: Type 3 devices used in laboratory settings (four studies); Type 3 devices tested in homes whether or not they were also tested in facilities (two studies); Type 4 devices in laboratory settings (six studies); and Type 4 devices tested in homes (whether or not in facilities, three studies). Type 3 devices include a minimum of four channels and must monitor at least two channels of respiratory movement or respiratory movement and airflow, and heart rate or ECG and oxygen saturation to define an event; generally, no electroencephalogram (EEG) signals are monitored. Level 4 devices include only one or two channels of physiologic signals and generally use only one channel (either saturated oxygen or airflow) to define a sleep-disordered breathing event; no EEG signals are monitored. Most articles provided only comparisons of the results from portable monitoring done simultaneously with full PSG in the laboratory, i.e., "a side-by-side" study. The in-laboratory simultaneous studies, which used technologies identical or similar to those in the previous review, produced sensitivity and specificity results for diagnosing OSA similar to those reported earlier; that is, the newer studies produced no meaningful changes in the level or quality of evidence for the effectiveness for home monitoring devices in diagnosing OSA. Only four of these studies (two of Type 3 and two of Type 4 devices) were graded good or fair quality. Ultimately, we focused on the five studies with in-home testing, because the questions we were asked concerned the effectiveness of unattended monitoring in the home. Four in-home studies employed technologies similar or identical to those reviewed before; of these, two studies (one of good quality, one poor) used Type 3 devices and two (one of fair quality , one poor) used Type 4 devices. Reported sensitivity and specificity values were similar to those from older studies, so the newer studies yielded no major information that would change the previous basic conclusions about portable devices used in the home. The one in-home study using a new technology, of fair quality, produced likelihood ratios that indicated that the test had little effect in changing pretest probabilities of the presence or absence of OSA. Reported data loss in the home studies ranged from a low of 3 percent to a high of 33 percent, in a subgroup of patients who did their own hookup. Automated scoring appeared to agree less closely with the reference standard than manual scoring. Internal validity of the five in-home studies was mixed: one study of good quality, two of fair quality, and two of poor quality. In terms of external validity, the patient populations were mostly male, middle-aged, and with high pretest probabilities of OSA; comorbidities were generally not specified or taken into account in analyses. Finally, these studies typically did not evaluate the accuracy of clinical management decisions based on portable results compared to those based on the reference standard. CONCLUSIONS: This newer body of evidence does not materially change earlier findings regarding in-home devices for diagnosing OSA. Choices of cutoffs for determining OSA by AHI or RDI differed widely across these studies, making cross-study comparisons impossible. The better studies yielded sensitivity and specificity values (or LRs) that provided modes changes in the probability of OSA over the pretest probability. In studies that directly compared automated versus manual scoring from home monitoring devices, manual scoring correlated better with data from laboratory PSG than did automated scoring.
Obstructive Sleep Apnea An Issue Of Sleep Medicine Clinics
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Author : Jim Barker
language : en
Publisher: Elsevier Health Sciences
Release Date : 2013-11-30
Obstructive Sleep Apnea An Issue Of Sleep Medicine Clinics written by Jim Barker and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-11-30 with Medical categories.
This issue of Sleep Medicine Clinics will be Guest Edited by Jim Barker, MD CPE, FACP, FCCP, FAASM Shirley Fong Jones, MD, FCCP of Scott and White Memorial Hospital and will focus on Obstructive Sleep Apnea. Article topics include Weight loss, Pharmacologic therapy of obstructive sleep apnea, Alternative Therapies, Masks and Interfaces, Outcomes of treatment of hypersomnia for OSA, Effects of therapy on CV outcomes, Complex Sleep Apnea, Oral appliances, Cost of therapy, Medicolegal aspects of treatment, Residual sleepiness, Therapy and Metabolic Outcomes, and Therapies for Children with OSA.
Pediatric Sleep Clinics An Issue Of Sleep Medicine Clinics E Book
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Author : Haviva Veler
language : en
Publisher: Elsevier Health Sciences
Release Date : 2023-05-02
Pediatric Sleep Clinics An Issue Of Sleep Medicine Clinics E Book written by Haviva Veler and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-05-02 with Medical categories.
In this issue of Sleep Medicine Clinics, guest editor Dr. Haviva Veler brings her considerable expertise to the topic of Pediatric Sleep Clinics. Sleep disorders in children span the gamut from behavioral issues to medical disorders. In this issue, top experts cover a wide variety of topics in the field, including measuring pediatric sleep health, circadian rhythm disorders, narcolepsy and idiopathy hypersomnia, and much more. Contains 17 practice-oriented topics including what’s new in pediatric OSA; sleep and inflammation; pediatric sleep pharmacology; sleep during the pandemic; sleep technology, sleep and mental health, the PHAT study update; and more. Provides in-depth clinical reviews on pediatric sleep, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
Telehealth In Sleep Medicine An Issue Of Sleep Medicine Clinics E Book
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Author : Jean-Louis Pépin
language : en
Publisher: Elsevier Health Sciences
Release Date : 2020-08-28
Telehealth In Sleep Medicine An Issue Of Sleep Medicine Clinics E Book written by Jean-Louis Pépin and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-08-28 with Medical categories.
This issue of Sleep Medicine Clinics has been compiled by esteemed Consulting Editor, Teofilo Lee-Chiong, and brings together recent sleep medicine articles that will be useful for Primary Care Providers. Topics include: Internet-Delivered Cognitive Behavioral Therapy for Insomnia Tailoring Cognitive Behavioral Therapy for Insomnia for Patients with Chronic Insomnia; Prescription Drugs Used in Insomnia; Hypnotic Discontinuation in Chronic Insomnia; Evaluation of the Sleepy Patient Differential Diagnosis; Subjective and Objective Assessment of Hypersomnolence; Pharmacologic Management of Excessive Daytime Sleepiness; Nonpharmacologic Management of Excessive Daytime Sleepiness; Treatment of Obstructive Sleep Apnea Choosing the Best Positive Airway Pressure Device; Treatment of Obstructive Sleep Apnea Choosing the Best Interface; Treatment of Obstructive Sleep Apnea Achieving Adherence to Positive Airway Pressure Treatment and Dealing with Complications; Oral Appliances in the Management of Obstructive Sleep Apnea; Avoiding and Managing Oral Appliance Therapy Side Effects; Positional Therapy for Positional Obstructive Sleep Apnea; Pharmacologic and Nonpharmacologic Treatment of Restless Legs Syndrome; Drugs Used in Parasomnia; Drugs Used in Circadian Sleep-Wake Rhythm Disturbances; Sleep in the Aging Population; and Sleep, Health, and Society.
Ambulatory Sleep Medicine An Issue Of Sleep Medicine Clinics E Book
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Author : Nicholas A. Antic
language : en
Publisher: Elsevier Health Sciences
Release Date : 2016-08-24
Ambulatory Sleep Medicine An Issue Of Sleep Medicine Clinics E Book written by Nicholas A. Antic and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-08-24 with Health & Fitness categories.
This issue of Sleep Medicine Clinics focuses on Ambulatory Sleep Medicine. Article topics include: Diagnosis of Obstructive Sleep Apnea; Personalised medicine for Obstructive Sleep Apnea therapies: Are we there yet?, Cardiovascular risk of Obstructive Sleep Apnea; Motor Vehicle Accident risk related to Obstructive Sleep Apnea; Impact of Obstructive Sleep Apnea Syndrome on Neurocognitive function and impact of CPAP; CPAP therapy for Obstructive Sleep Apnea; Maximizing adherence including using novel IT based systems; Mandibular advancement splints; Surgical approaches to Obstructive Sleep Apnea; Consequences of Obstructive Sleep Apnea; and more!
Prevention Screening And Treatments For Obstructive Sleep Apnea Beyond Pap An Issue Of Sleep Medicine Clinics
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Author : Song Tar Toh
language : en
Publisher: Elsevier Health Sciences
Release Date : 2019-02-01
Prevention Screening And Treatments For Obstructive Sleep Apnea Beyond Pap An Issue Of Sleep Medicine Clinics written by Song Tar Toh and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-02-01 with Medical categories.
This issue of Sleep Medicine Clinics, edited by Song Tar Toh in collaboration with Consulting Editor, Teofilo Lee-Chiong, is devoted to the Preventing, Screening, and Treatments for Obstructive Sleep Apnea, beyond Positive Airway Pressure (PAP). Topics covered in this issue include: Prevention and Screening of Obstructive Sleep Apnea (OSA); Anatomical and Physiologic Considerations in Surgical Treatment for OSA; Medical and Surgical Options for Weight Management in OSA; Positional Therapy for OSA; Oral Appliances in Adults and Pediatrics; Myofunctional Therapy for OSA; Drug-induced Sleep Endoscopy in Treatment Options Selection; Establishing a Patent Nasal Passage in OSA; Palatal Surgery: From Ablation to Reconstruction; Volumetric Tongue Reduction Surgery in Clinical Practice; Transoral Robotic Surgery for OSA; Genioglossus Advancement and Hyoid Surgery; Maxillomandibular Rotational Advancement: Airway, Aesthetics, and Angle Considerations;
Parasomnias An Issue Of Sleep Medicine Clinics E Book
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Author : Mark Pressman
language : en
Publisher: Elsevier Health Sciences
Release Date : 2011-11-29
Parasomnias An Issue Of Sleep Medicine Clinics E Book written by Mark Pressman and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-11-29 with Medical categories.
Parasomnias can be roughly divided in Non-REM disorders and REM disorders, and this issue covers much of what is known today on the diagnosis and treatment of various types of parasomnias. Articles examine disorders such as sleepwalking, sleep sex, sleep violence, sleep eating, and diagnostic methods of these. The issue also delves into Forensic concerns, especially with regard to sleep violence. Other types of parasomnias discussed include sleep talking and sleep enuresis.
Unraveling The Puzzle Of Adherence In Sleep Medicine An Issue Of Sleep Medicine Clinics
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Author : Jessie P. Bakker
language : en
Publisher: Elsevier Health Sciences
Release Date : 2021-01-25
Unraveling The Puzzle Of Adherence In Sleep Medicine An Issue Of Sleep Medicine Clinics written by Jessie P. Bakker and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021-01-25 with Medical categories.
This issue of Sleep Medicine Clinics, guest-edited by Dr. Jessie Bakker, focuses on Unraveling the Puzzle of Adherence in Sleep Medicine. This issue is one of four selected each year by series Consulting Editors, Dr. Teofilo Lee-Chiong and Dr. Ana C Krieger. Articles include: What can we consider to be a clinically meaningful target for PAP adherence?, Adherence to sleep therapies in children and adolescents, Socioeconomic Disparities in Positive Airway Pressure Adherence: An Integrative Review, What do we know about adherence to oral appliances?, Alternative care pathways for OSA and the impact on PAP adherence, Summary and Update on Behavioural Interventions for Improving Adherence with Positive Airway Pressure Treatment in Adults and more.
Sleep In Older Adults An Issue Of Sleep Medicine Clinics
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Author : Cathy Alessi
language : en
Publisher: Elsevier Health Sciences
Release Date : 2018-02-09
Sleep In Older Adults An Issue Of Sleep Medicine Clinics written by Cathy Alessi and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-02-09 with Health & Fitness categories.
This issue of Sleep Medicine Clinics focuses on Sleep in Older Adults, with topics including: Sleep in Normal Aging; Insomnia in the Older Adult; Sleep Apnea in the Older Adult; Circadian Rhythm Sleep-Wake Disorders in the Older Adult; Restless Legs Syndrome; Periodic Limb Movement Disorder and Other Sleep Related Movement Disorders in the Older Adult; REM Sleep Behavior Disorder and Other Parasomnias in the Older Adult; Neurodegenerative Disorders and Sleep; Medical Conditions and Sleep in the Older Adult; Psychiatric Illness and Sleep in the Older Adult; Sleep and Cognition in the Older Adult; Sleep and Nocturia in the Older Adult; Sleep and Long Term Care; and Sleep in the Hospitalized Older Adult.