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Copyright of Conocimiento Enfermero is the property of Colegio Oficial de Enfermeria de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: el compromiso respiratorio en la enfermedad de Pompe es una de sus manifestaciones más frecuentes, tiene un impacto negativo en la calidad de vida y facilita la aparición de múltiples complicaciones. Se puede presentar como parte evolutiva de la enfermedad o incluso ser el síntoma inicial de la patología. Contenidos: la presentación clínica del compromiso respiratorio en la enfermedad de Pompe se caracteriza por disnea, ortopnea, cefalea y tos, y sus cambios paraclínicos incluyen hipercapnia, policitemia, elevación del índice de apnea/hipopnea, así como disminución de la capacidad vital y de las presiones inspiratoria y espiratorias máximas. El compromiso respiratorio es causado principalmente por disfunción muscular (especialmente el diafragma) y alteración de la regulación del sistema nervioso central. Conclusiones: es fundamental la valoración acuciosa inicial de los patrones respiratorios y por supuesto su seguimiento, el cual dependerá del tipo de progresión de la disfunción respiratoria (rápida o lenta) o del requerimiento específico para cada paciente (ventilación no invasiva o invasiva).

Background: Obstructive sleep apnea is a highly prevalent disorder, characterized by recurrent events of upper airway obstruction during sleep and associated with recurrent cycles of desaturation and re-oxygenation, sympathetic hyperactivity, and intra-thoracic pressure fluctuations, resulting in fragmentation of sleep and subsequent daytime fatigue with excessive sleepiness. Obstructive sleep apnea-induced bilateral tonic–clonic seizures are unheard of. We aimed to report 3 patients with previously undiagnosed obstructive sleep apnea who presented to the emergency department with new onset bilateral tonic–clonic seizure without any evidential neurological or metabolic cause. Methods: Patient data were obtained from medical records from the Department of Internal Medicine, IPGMER and SSKM Hospital, Kolkata, and Belle Vue Clinic, Kolkata, India. Results: Three male patients (67, 58, and 44 years old) presented with bilateral tonic–clonic seizure disorder without any underlying cause of seizures after rigorous investigations except for moderate to severe obstructive sleep apnea on polysomnography. All 2 patients were seizure-free after being treated with levetiracetam, chronic continuous positive airway pressure therapy in 2, and only continuous positive airway pressure in the other. The patients remained seizure-free on continuous positive airway pressure, even when levetiracetam was withdrawn, suggesting obstructive sleep apnea's causality in their new-onset acute seizures. Conclusion: Although further investigation is required to clarify this association, underlying obstructive sleep apnea should be ruled out in patients with a first-ever bilateral tonic–clonic seizure. Whether or not continuous positive airway pressure alone could effectively treat hypoxia and deranged cortical excitability, which may lead to seizures in cases with long-standing obstructive sleep apnea, is yet to be explored. Resumen: Introducción: La apnea obstructiva del sueño es una enfermedad con una alta prevalencia que se caracteriza por episodios recurrentes de obstrucción de las vías respiratorias altas durante el sueño, lo que conlleva ciclos repetidos de hipoxia y reoxigenación, hiperactividad simpática y fluctuaciones en la presión intratorácica. Todos estos procesos dan lugar a una fragmentación del sueño, lo que provoca fatiga diurna y somnolencia excesiva. Las crisis tónico-clónicas bilaterales inducidas por apnea obstructiva del sueño son poco conocidas. Presentamos los casos de tres pacientes con apnea obstructiva del sueño sin diagnosticar previamente que acudieron a urgencias por crisis tónico-clónicas de nueva aparición sin causa neurológica o metabólica aparente Métodos: Los datos de nuestros pacientes se recogieron de los historiales médicos del servicio de Medicina Interna del Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital y de la Belle Vue Clinic, ambos en Kolkata (India). Resultados: Tres pacientes varones de 67, 58 y 44 años de edad presentaron convulsiones tónico-clónicas bilaterales sin causa identificada tras examen riguroso, exceptuando una apnea obstructiva del sueño de gravedad moderada a grave observada en la polisomnografía. Los tres pacientes recibieron tratamiento con levetiracetam durante el ingreso; al alta, se pautó tratamiento crónico con presión positiva continua de las vías respiratorias más levetiracetam en dos pacientes, y en el tercero solo presión positiva continua de las vías respiratorias. Ninguno presentó nuevas crisis tras la retirada de levetiracetam, lo que sugiere que la causa de las convulsiones era la apnea obstructiva del sueño. Conclusión: Aunque es necesario realizar más estudios para aclarar esta asociación, debemos descartar la apnea obstructiva del sueño en pacientes con crisis tónico-clónicas bilaterales de nueva aparición. Queda aún por determinar si la presión positiva continua podría tratar de forma efectiva la hipoxia y las alteraciones en la excitabilidad cortical, que podrían provocar crisis en casos de apnea obstructiva del sueño de larga evolución.

The diagnosis of various types of sleep disorders requires the experts to perform sleep stage scoring. However, it is an arduous and repetitive task and, therefore, an important candidate for automation. This work seeks to evaluate several scoring algorithms based on Machine Learning from the scientific literature. The comparison is performed with the same experimental design, using EEG, EOG and EMG signals from the polysomnographic records of the ISRUC-Sleep dataset. It is compared the precision, memory and speed of methods based on Linear Discriminant Analysis, Support Vector Machines, Random Forests and Neural Networks. As a result, several of the analyzed algorithms reach high levels of accuracy, exceeding 75%. Also, it is demonstrated that the accuracy can be raised to 85% by skipping the classification of doubtful epochs and still classify 65% of them. [ABSTRACT FROM AUTHOR]

Copyright of Revista CienciaUAT is the property of Universidad Autonoma de Tamaulipas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Los Movimientos Periódicos de las Piernas durante el Sueño (PLMS), diagnosticados por polisomnografía, se caracterizan por movimientos estereotipados de las piernas que aparecen de forma repetitiva durante la noche. Cada PLMS se asocia a un microdespertar e incrementos de la frecuencia cardiaca, presión arterial y actividad simpática. Objetivos: Analizar asociación entre el índice patológico de PLMS y la PA de 24 horas, en pacientes normotensos. Evaluar la asociación entre índice patológico de PLMS, con alteraciones en la velocidad de onda de pulso y frecuencia cardíaca. Métodos Estudio observacional de casos y controles. Se estudiaron 19 sujetos normotensos mediante Polisomnografía Nocturna y Monitoreo Ambulatorio de la Presión Arterial. Se determinaron las variables: Edad, sexo, peso, índice de masa corporal. La presión arterial y frecuencia cardíaca de 24 hs, diurna y nocturna se evaluaron con monitoreo ambulatorio de presión arterial de 24 h. Se excluyeron pacientes con índice de apneas/hipopneas ≥ 5 e/h. Se describieron las variables y compararon sujetos con y sin PLMS, considerando significativo una p

Background: Post-traumatic stress disorder (PTSD) is the clinical manifestation of traumatic events and is associated with sleep disturbances. Sleep disturbances, if left untreated, may perpetuate or even worsen symptoms of PTSD. Previous studies of other PTSD populations show a higher incidence of sleep impairments and sleep disorders compared to healthy controls (HCs); however, this has never been investigated in trauma-affected refugees diagnosed with PTSD. Objectives: To examine subjective sleep quality, measure sleep architecture, and identify latent sleep disorders in refugees diagnosed with PTSD compared to HCs. Method: This comparative study included 20 trauma-affected refugees diagnosed with PTSD and 20 HC matched on age, sex, and body mass index. All participants completed self-report questionnaires assessing sleep quality, insomnia severity, and disturbing nocturnal behaviour, and all took part in a one-night polysomnography (PSG) assessment. Results: Patients reported significantly poorer subjective sleep quality, sleep latency, sleep duration, and sleep efficiency compared to HCs. Subjective reports on hours spent in bed were not significantly different between patients and HCs. Patients reported significantly higher nightmare frequency and severity compared to HCs. PSG measures showed that patients had significantly reduced sleep efficiency, more awakenings, and longer REM sleep latency, and spent more time awake, whereas there was no significant differences regarding total time in bed, total sleep time, or sleep latency. The prevalence of sleep disorders was equal between groups. Conclusions: The study identified significant impairments in several sleep domains, with a preponderance of disturbed regulation of sleep resulting in awakenings. These results indicate a need for more focus on hyperarousal and nightmares as key elements of disturbed sleep in PTSD. Furthermore, the study identified a discrepancy between subjective and objective measures concerning total sleep time, raising questions regarding the causes of 'sleep state misperception'. Trial registration: ClinicalTrials.gov identifier: NCT03535636.. Trial registration: Sleep Impairments in Refugees Diagnosed with PTSD (PSG-PTSD). URL: . ClinicalTrials.gov NCT03535636. Date of registration: 24/05/2018. This is the first study assessing sleep impairments and sleep disorders in refugees diagnosed with post-traumatic stress disorder (PTSD) compared to healthy controls. The main finding is that both subjectively and objectively measured sleep is disrupted in refugees diagnosed with PTSD compared to healthy controls. The results suggest that these disturbances of sleep are significant targets in treatment of PTSD and stress the importance of focusing on treatment of sleep disturbances in PTSD. [ABSTRACT FROM AUTHOR]

Obstructive Sleep Apnea (OSA) is a widespread disease, but usually is an underdiagnosed and undertreated public health problem. Nowadays its study is expensive. Collaboration and involvement of all specialties are necessary, also the implementation of simplified diagnostic methods to try to improve detection, increase the diagnosis and treatment ratio. In the Osona region (Barcelona), it has been developed a protocol that defines a new care process that shortens and reduces the cost of the OSA's diagnosis process. This new care process also favors better knowledge of the pathology of OSA by all the specialists involved, resulting in an increase in community health, in addition to generating knowledge. This new care process could be implemented in other health areas around all the country and it would improve the management of this pathology and improve national community health., Competing Interests: Conflicto de intereses Los autores del estudio no tienen conflicto de intereses., (Copyright © 2024 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Sleep apnoea-hypopnoea syndrome (SAHS) and childhood obesity are two high prevalence conditions that represent a public health challenge. Objective: To analyse the association between both and comparing child groups that had or did not have both conditions. Patients and methods: A prospective study in children (3–14 years), referred to the “Multidisciplinary Sleep Unit” due to suspected SAHS, between 1 November 2015 and 1 August 2017. The following parameters were evaluated: anthropometry, symptoms, blood pressure, ear, nose, and throat examination, polysomnography (nocturnal PSG) and laboratory tests. Results: A total of 67 children were evaluated (64% non-obese (NOb) and 36% obese (Ob). It was observed that the Ob were older (P

Introducción: Los trastornos respiratorios durante el sueño (TRDS), sobre todo el síndrome de apneas hipopneas obstructivas (SAHOS) en pacientes con accidente cerebrovascular o ACV, son frecuentes y pueden complicar su evolución. El objetivo fue analizar diversos TRDS en pacientes con ACV. Métodos: Estudio descriptivo, de corte transversal y retrospectivo de 19 meses, en pacientes con ACV, mediante polisomnografía nocturna con oximetría (PSG). Resultados: Se incluyó a 53 pacientes, con edad media de 67 ± 12 años, y 62% pertenecían al sexo masculino. Se evaluó los TRDS mediante polisomnografía nocturna con oximetría dentro de los 10 días de instalado el ACV. Se detectó un índice de apneas hipopneas durante el sueño (IAH) de grado leve en 21%, grado moderado en 31% y severo en 34%. La media de tiempo de saturación de oxígeno < a 90% fue de 38 ±51 minutos. La saturación mínima de oxígeno fue marcada en lesiones infratentoriales. Conclusión: Nosotros hemos encontrado en nuestro estudio, un alto porcentaje de SAHOS, que se asoció a pacientes de mayor edad y mayor índice de masa corporal. Se constató descenso marcado de la saturación mínima y mayor tendencia a presentar apneas centrales en lesiones infratentoriales. El diagnóstico y tratamiento precoz podría minimizar el daño neuronal y mejorar el pronóstico.

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Esta es una revisión de algunos ensayos clínicos realizados acerca de las repercusiones en la estructura, arquitectura y percepción del sueño en los consumidores de cannabis. Para la búsqueda bibliográfica se consultó bases de datos, con especial énfasis en revisiones sistemáticas, metaanálisis, estudios de cohortes, ensayos controlados aleatorios y estudios de casos y controles. Las palabras claves incluyeron términos que describen el uso del cannabis combinado con otros que se refieren al sueño o anormalidades del sueño (por ejemplo: sueño, insomnio, polisomnografía, tiempo total de sueño, latencia del sueño, sueño de onda lenta, sueño de movimiento ocular rápido y su latencia). Se extrajeron datos relevantes de cada uno de los artículos consultados. Se resumió la literatura disponible sobre mediciones subjetivas y objetivas, correlaciones clínicas y paraclínicas, diferencias entre el consumo agudo, crónico y la abstinencia, y otros puntos de discusión. Se realizaron varias correlaciones moleculares y anatómicas que explican los cambios en el sueño desde el punto de vista del sistema nervioso central. Finalmente, los resultados demuestran una disminución de la latencia del sueño con el uso agudo a dosis bajas, además menor tiempo de vigilia luego del inicio del sueño, aumento del sueño de ondas lentas y disminución del sueño de movimientos oculares rápidos; estos efectos no permanecen con el uso crónico, ya que posteriormente se presenta una peor calidad del sueño; el escenario también varía con la abstinencia, puede presentarse insomnio, disminución del tiempo total del sueño de onda lenta y del sueño total.

Objective: To determine the differences in the prediction of the risk of developing obstructive sleep apnea-hypopnea syndrome (OSAHS) by comparing the results of the Berlin Questionnaire (BQ), the STOP-Bang (SB) Questionnaire and the Epworth Sleepiness Scale (ESS) in patients admitted to the Hospital Nacional Dos de Mayo from 2019 to 2020. Materials and methods: A quantitative, observational, descriptive, prospective and cross-sectional clinical study of diagnostic tests. A sample of 304 patients older than 18 years was included in the research. The results are presented with frequencies, measures of central tendency and dispersion. The variables were associated using the chi-square test. The sensitivity and specificity of the BQ and ESS were measured against the SB Questionnaire. A p value less than 0.05 was considered as statistically significant. Results: The average age of the study population was 52.89 ± 15.97 years and adults under 50 years of age (40.5 %) prevailed. Sixty point five percent (60.5 %) of the participants were males. The average BMI was 30.74 ± 6.02 kg/m², with the overweight category being the most numerous (43.40 %). Forty-two point eight percent (42.8 %) of the participants had hypertension. According to the SB Questionnaire, BQ and ESS, 77.0 %, 62.5 % and 60.5 % had a high risk of developing OSAHS, respectively. The questionnaires showed an association between age, sex, nutritional diagnosis and arterial hypertension, and a high risk of developing OSAHS (p < 0.05). There is a weak correlation between the SB Questionnaire and BQ (Kappa: 0.39), and between the SB Questionnaire and ESS (Kappa: 0.33). Conclusions: The abovementioned questionnaires are useful tools to predict the risk of developing OSAHS. They show a significant but weak correlation between them. However, they should be considered as rapid and reliable screening tests. [ABSTRACT FROM AUTHOR]

El lavado de manos frecuente, el uso obligatorio de mascarilla por parte de la población general en sitios públicos, el distanciamiento físico y social, y el confinamiento obligatorio de la mayoría de la población en sus casas son las medidas que hasta el momento han ayudado a frenar la propagación del nuevo coronavirus (SARS-CoV-2), causante de la actual pandemia por COVID-19. Sin embargo, la adopción de algunas de estas medidas ha generado retraso en el diagnóstico y tratamiento de diferentes enfermedades, incluyendo los trastornos del sueño, por lo que es urgente que los especialistas en medicina del sueño y los centros de sueño retomen sus actividades gradualmente, siempre que se implementen estrictos protocolos de bioseguridad que mitiguen el riesgo de contagio. En este contexto, y con el fin de ayudar a los somnólogos a reabrir los centros de sueño y reanudar los procedimientos allí realizados, la Asociación Colombiana de Medicina del Sueño propone en la presente reflexión una serie de recomendaciones para tener en cuenta durante el proceso de reactivación. Estas recomendaciones se basan en las estrategias de mitigación establecidas por las autoridades sanitarias del país, las directrices de la American Academy of Sleep Medicine, y la literatura disponible sobre el tema, la cual fue revisada luego de realizar una búsqueda en las bases de datos PubMed, SciELO y Google Scholar usando los términos “sleep” “sleep medicine” y “COVID19”.

Introduction: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Patients and methods: Retrospective descriptive study of sleep tests conducted on children up to 14 years old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. Results: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age was 5 years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, SatO2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Conclusions: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight. Resumen: Introducción: El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Pacientes y métodos: Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Resultados: Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. Conclusiones: La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso.

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate the frequency of sleep disorders occurrence according to age, sex and period of evolution. Methods: A descriptive cross-sectional study was conducted through interview, clinical examination and polysomnography study of 77 patients diagnosed with Parkinson's disease, these subjects were referred to the International Center for Neurological Restoration, Havana, Cuba, from September 2014 to January 2018. Age, sex, and evolution time of Parkinson's disease were evaluated based on sleep disorders diagnosed by polysomnography. Descriptive statistics were used, as well as non-parametric analysis (Kruskal-Wallis). Results: The evaluation showed results within normal parameters in 6.49% of the patients, rapid eye movement sleep behavior disorder in 29.87%, insomnia in 29.87% (mainly, type of sleep maintenance insomnia), obstructive sleep apnea syndrome in 25.97% and restless legs syndrome associated with periodic movement of the legs during sleep in 7.79%. These disorders showed similar behavior in both sexes, as well as a tendency to worsen with age and time of evolution. Conclusions: High prevalence of sleep disorders was detected in patients with Parkinson's disease, which do not reflect variations according to sex; however, they were more frequent in older patients or patients with a longer evolution period. [ABSTRACT FROM AUTHOR]

Increasing evidence supports a close link between REM sleep and the consolidation of emotionally toned memories such as traumatic experiences. In order to investigate the role of sleep for the development of symptoms related to traumatic experiences, beyond experimental models in the laboratory, sleep of acutely traumatised individuals may be examined on the first night after trauma. This might allow us to identify EEG variables predicting the development of posttraumatic stress disorder (PTSD) symptoms, and guide the way to novel sleep interventions to prevent PTSD. Based on our experience, patients' acceptance of polysomnography in the first hours after treatment in an emergency room poses obstacles to such a strategy. Wearable, self-applicable sleep recorders might be an option for the investigation of sleep in the aftermath of trauma. They would considerably decrease the perceived burden for patients and thus increase the likelihood of successful patient recruitment. As one potential sleep intervention, sleep deprivation directly after trauma has been suggested to reduce the consolidation of traumatic memories and hence act as a secondary preventive measure. However, experimental data from sleep deprivation studies in healthy volunteers with the trauma film paradigm have been inconclusive regarding the beneficial or detrimental effects of sleep on traumatic memory processing. Depending on further insights into the role of sleep in traumatic memory consolidation through observational and experimental studies, several options for therapeutic sleep interventions are conceivable: besides behavioural sleep deprivation, selective REM sleep suppression or enhancement by a pharmacological intervention into the serotonergic, noradrenergic or cholinergic systems might provide novel therapeutic options. While REM-modulating drugs have been used with some success for the prevention of PTSD after trauma, they have never been tried before the first night of sleep. In conclusion, more experimental and observational research is needed before sleep interventions are performed in actual trauma victims. [ABSTRACT FROM AUTHOR]

El ronquido en los niños es el signo más frecuente de trastorno respiratorio del sueño (TROS). La importancia de estos trastornos reside en su alta prevalencia y las morbilidades asociadas, como trastornos neurocognitivos, rendimiento escolar deficiente, disfunción conductual, complicaciones cardiovasculares, consecuencias metabólicas y mala calidad de vida relacionada con la salud. La sospecha clínica se basa en una buena anamnesis y examen físico, aunque en muchos casos es insuficiente para afirmar o descartar la existencia de un TROS; por esta razón es importante contar con pruebas específicas, entre las cuales la polisomnografía es el estándar de oro, pero es necesario establecer criterios para indicar estos exámenes debido a su disponibilidad limitada y a su elevado costo. La adenotonsilectomía es el tratamiento más común de TROS en los niños, sin embargo, el grupo de pacientes con comorbilidad de mayor complejidad requiere un estudio más completo y un tratamiento multidisciplinario. En esta revisión se actualizan los conocimientos acerca de los TROS y su manejo. Se propone un diagrama de flujo para el estudio y manejo de un niño que ronca.

Copyright of Review of Medicine / Przeglad Lekarski is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Autistic spectrum disorder (ASD) is characterized by difficulties in communication and social interaction. The theory of mind (TM) links social deficiencies in ASD with a difficulty in representing the mental states of other people. The Mu rhythm (8-13Hz) has been studied as an expression of the possible neuronal basis of TM. In ASD, the physiological reactivity of the Mu rhythm to motor events is affected. During sleep, there are also phenomena related to sensorimotor processing. Objective. To characterize the Mu rhythm in the sleep of children with level 1 ASD, ages six to 10, and compare it with control children paired by age and sex. Method. Polysomnographic records for two consecutive nights. The record of the second night was analyzed visually (the first was considered habituation) to identify and select Mu rhythm segments throughout the night. The extracted segments were analyzed using the fast Fourier transform and subsequently with t tests on the data of C3 and C4. Results. A significant difference was found in the power spectrums of C3 and C4 t (1, 144) = 3.038, p = .003 and t (1, 144) = -2.301, p = .023, respectively. Discussion and conclusion. The results of this study are consistent with the morphological and topographic characteristics found in studies conducted during wakefulness. The results suggest that the Mu rhythm is caused intrinsically, without external sensory stimulation, and that there is a difference in this generation in the population with ASD. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El síndrome de apnea hipopnea obstructiva del sueño (SAHOS) consiste en episodios recurrentes de limitación del paso del aire durante el sueño secundarios a alteraciones de tipo anatómico y/o funcional. Compromete la calidad de vida de quienes lo padecen y acarrea importantes complicaciones que pueden afectar a múltiples sistemas e incluso causar la muerte. Objetivos: Establecer un protocolo que reúna recomendaciones para la atención, diagnóstico y tratamiento del SAHOS, basado en guías de práctica clínica (GPC) evaluadas mediante AGREE II. Metodología: Se revisaron guías de práctica clínica de SAHOS en adultos, en inglés y en español, publicadas entre 2000 y 2016, valoradas con el instrumento AGREE II. Resultados: Se encontraron 65 documentos; al escoger los que cumplían los requisitos establecidos, se obtuvieron 8 GPC evaluadas con el instrumento AGREE II; 7 mostraron tener rigor e independencia > 60%, que fue el criterio de elección para la obtención de las recomendaciones. Conclusiones: La principal herramienta diagnóstica del SAHOS es el polisomnograma. El tratamiento de elección es el CPAP, pues genera un impacto en la reducción de las apneas y en la mejoría clínica del paciente, con pocos efectos colaterales. La cirugía tiene indicaciones específicas y rara vez se propone como manejo aislado.

Introduction. Wake-sleep transition is a continuous, gradual process of change. Most studies evaluating electroencephalogram spectral power during this transition have used variance analysis (ANOVA). However, using this type of analysis does not allow one to detect specific changes in the statistical properties of a time series. Objective. To determine whether change point analysis (CPA) makes it possible to identify and characterize electroencephalographic, electromyographic, and cardiac changes during the wake-sleep transition through a cross-sectional study. Method. The study included 18 healthy volunteers (12 women and six men), from which polysomnography data were obtained during a two-minute transition. Heart rate, respiratory sinus arrhythmia, electroencephalogram spectral power, as well as electromyographic median and mean frequency and electromyographic root mean square were calculated in five-second segments. These segments were analyzed using repeated measures ANOVA, and CPA focused individually and for the group as a whole. Results. Repeated measures ANOVA and CPA by group found decreased levels of alpha and beta power and beta/delta index during wakefulness, and increased theta and delta power levels during sleep. CPA by individual found that only alpha power changed in all participants and failed to identify a specific moment when all the variables studied changed simultaneously. Discussion and conclusion. We consider that CPA provides additional information to statistical analyses such as ANOVA for the specific location of physiological changes during sleep-wake transition. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Type 1 human immunodeficiency virus (HIV-1) is a lymphotropic and neurotropic retrovirus. Thus, it causes immunological and neurological alterations particularly in children. In the neonatal period the maturational changes of the central nervous system occur rapidly, and their alteration can be reflected in processes such as the sleep-awake pattern. Objective: To evaluate sleep organization, EEG and respiratory pattern in newborns to HIV-1 positive mothers. Methods: 22 infants underwent polysomnography. Delta brushes number in REM and NREM sleep, duration of interburst interval and interhemispheric synchrony were used to calculate EEG maturation. Analysis of the sleep architecture was based on polysomnographic sleep percentage of REM, NREM and transitional sleep to total sleep time. Results: The difference between electroencephalographically calculated and clinically calculated conceptional age was less than two weeks. Percentages of REM and NREM sleep ranged from 39-64 and 30-58 with a median of 52.5 and 36.5 respectively. Concordance was lower in newborns who had high transitional sleep percentages, compared to that in newborns who did not have high such characteristic (p less 0.05). Discussion: Despite intrauterine exposure to HIV-1 and to antiretroviral drugs we did not observe a significant effect on EEG maturation. The decreased concordance in newborns with high transitional sleep percentages would suggest an alteration in the maturation process, but this aspect itself is not sufficient to consider that intrauterine exposure to HIV-1 and antiretrovirals affect the entire sleep architecture Future studies should clarify whether the decreased concordance between behavior and NREM sleep is replicable.

Objetivos. Describir las diferencias clínicas y polisomnográficas en pacientes obesos y no obesos con diagnóstico del síndrome de apneas-hipopneas del sueño (SAHS). Materiales y métodos. A los pacientes incluidos se les realizó un examen físico, se aplicó la escala de somnolencia de Epworth (ESE) y además se les realizó una polisomnografía. Se consideró obeso si el índice de masa corporal (IMC) era mayor o igual a 30 kg/m2. Resultados. Se analizaron 408 pacientes con SAHS, de estos, 119 (47 %) fueron obesos. El SAHS fue leve en 101 (25 %), moderado en 91 (22 %) y severo en 216 (53 %). No hubo diferencias por sexo, edad y puntaje ESE al compararse obesos con no obesos. La diferencias del perímetro cervical y presencia de somnolencia según ESE fue significativamente mayor en obesos. Estos tuvieron mayor comorbilidad en términos de dislipidemia, hipertensión arterial y enfermedad coronaria. De las variables polisomnográficas, los índices de eventos respiratorios fueron mayores en obesos, asimismo fueron peores los valores de saturación de oxígeno. No hubo diferencias en el resto de variables. El análisis de regresión mostró asociación entre la obesidad y la severidad del SAHS. Conclusiones. El SAHS no es una enfermedad limitada a la población obesa, aunque esta última tienen mayor comorbilidad y formas más severas de enfermedad.Objectives. To describe the clinical and polysomnographyc differences between obese and non- obese patients with obstructive sleep apnea-hypopnea (OSAH) syndrome. Materials and methods. A physical examination, the Epworth Sleepiness Scale (ESS) and a polysomnography were performed to all included patients. Obesity was defined as a body mass index (BMI) of ≥ 30 kg/m2. Results. 408 patients with OSAH were analyzed, out of these, 119 (47 %) were obese. OSAH was mild in 101 (25 %), moderate in 91 (22 %) and severe in 216 (53 %). There were no age, sex and EES score differences between obese and non-obese patients. Cervical perimeter and sleepiness prevalence according to the ESS were significant higher in obese population. Obese patients had higher comorbidity related to dyslipidemia, high blood pressure and coronary disease. With respect to the polysomnographyc variables, the indexes of respiratory events and the levels of oxygen saturation were worse in obese patients. There were no differences in the other variables. The regression analysis showed association between obesity and OSAH severity. Conclusions. OSAH is a clinical condition not limited to obese population, although this group has a higher comorbidity and OSAH severity.

La información publicada indica que hasta un tercio de los accidentes de tránsito son producidos por la somnolencia del conductor. El síndrome de apnea-hipopnea del sueño (SAHS) es una enfermedad orgánica que causa somnolencia. Puede diagnosticarse por medio de un registro del sueño y controlarse con modalidades terapéuticas distintas y de diferente complejidad según su gravedad, lo que determina el costo final del manejo del SAHS. En los pacientes que emplean disciplinadamente la terapia, los resultados son muy buenos y logran controlar la somnolencia, mejoran la calidad de vida del afectado, protegen su salud y disminuyen ostensiblemente el riesgo de accidentes durante la conducción debido a somnolencia. Ponemos en consideración de las autoridades responsables la aplicación de estas pruebas en choferes con sospecha de SAHS que renuevan licencias de conducir de tipo A-II y A-III.The available information indicates that up to one third of the road traffic accidents are produced by the driver’s sleepiness. Sleep apnea-hypopnea syndrome (SAHS) is an organic disease that causes sleepiness. It can be diagnosed by a sleep register and can be controlled by different therapeutic means, varying their complexity according to its severity, which determines the final cost of the management of SAHS. In patients using the therapy thoroughly, the results are very good and achieve to control the sleepiness, improve the quality of life of the affected subject, protect his health and markedly decrease the risk of accidents due to sleepiness during driving. We put into consideration of the respective authorities the application of these tests in drivers suspected of having SAHS who renew their driving licenses type A-II and A-III.

Objetivo: Evaluar la relación entre el Síndrome de Apneas-Hipopneas del Sueño (SAHS) e hipertensión arterial (HTA). Material y métodos: Estudio en población clínica de 367 pacientes con sospecha de trastornos respiratorios del sueño. Se realizó historia clínica completa y polisomnografía (PSG) o poligrafía respiratoria (PR). Fueron excluidos 85 pacientes. Se implementaron medidas de resumen, análisis de diferencia de medias, relación entre variables y análisis de regresión logística univariada y multivariada. Resultados: Edad 49,6 ± 12,7 [18-90) años, 247 pacientes (84%) varones, Índice de Masa Corporal (IMC) 29,6 ± 4,7 (20,1-47,6) kg/m2. La tasa de HTA en esta población fue 67%. Se realizaron 229 PSGs (78%) y 65 PRs (22%). Los resultados fueron: índice apnea-hipopnea (IAH) 34,8 ± 27,4 (0-125), desaturación máxima (DesatMax) 81,5 ± 9,5 (38-95) % y porcentaje del tiempo total del estudio con SatO2 < 90% (T90) 8,8 ± 15,2 (0-72) %. Diagnósticos principales: 253 (86%) SAHS, 34 (12%) ronquido primario y 7 (2%) sin trastorno respiratorio del sueño. De los pacientes con SAHS, 45 (18%) fueron de grado leve (IAH de 5 a

Introduction. Decreased need for sleep has been proposed as a core symptom of mania and it has been associated with the pathogenesis of Bipolar Disorder. The emergence of Disruptive Mood Dysregulation Disorder (DMDD) as a new diagnostic has been controversial and much has been speculated about its relationship with the bipolar spectrum. REM sleep fragmentation could be a biomarker of affective disorders and it would help us to differentiate them from other disorders. Method. Polysomnographic cross-sectional study of children with DMDD, bipolar disorder and Attention Deficit Hyperactivity Disorder (ADHD). All participants underwent a psychiatric semi-structured interview to obtain the diagnosis, comorbidities and primary sleep disorders. DMDD's sample was performed following DSM5 criteria. Goals. Perform polysomnography in a sample of bipolar, DMDD and ADHD children and compare their profiles to provide more evidence about the differences or similarities between bipolar disorder and DMDD. Results. Bipolar group had the highest REM density values while ADHD had the lowest. REM density was not statiscally different between bipolar phenotypes. REM density was associated with antidepressant treatment, episodes of REM and their interaction. REM latency was associated with antipsychotic treatment and school performance. Bipolar patients had higher scores on the depression scale than DMDD and ADHD groups. ++++++++++++++++Conclusions. No significant differences between the two compared affective disorders were found. However there were differences in REM density between bipolar and ADHD groups. REM sleep study could provide a new theoretical framework to better understand the pathogenesis of pediatric bipolar disorder. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: El estudio tuvo la finalidad de determinar las frecuencias de síntomas relacionados al SAHS e insomnio en 99 médicos. Material y métodos: Se empleó una encuesta anónima y autoadministrada. Respondieron 42 encuestados con edad promedio 48±5.3 (35-78) años, 39 fueron hombres. Cuatro aceptaron realizarse una polisomnografía. Resultados: Las frecuencias de los síntomas registrados por medio de la encuesta fueron: ronquido 22 (51 %), hipersomnia 9 (22 %) y pausas respiratorias durante el sueño 5 (11 %). Ronquido + pausas 5 (11 %), ronquido + pausas + IMC>27 2 (5 %) y ronquido + pausas + hipersomnia 1 (3 %). Diecinueve (45 %) presentaron insomnio. Las cuatro polisomnografías documentaron SAHS. Conclusión: El estudio permite concluir que los síntomas de SAHS e insomnio en la población evaluada fueron frecuentes y que el SAHS fue documentado en al menos 4 de 39 médicos hombres encuestados. ( Rev Med Hered 2003; 14: 53-58).

El Síndrome Apneas Hipopneas del Sueño (SAHS) es factor de riesgo de accidentes durante la conducción. En este informe, presentamos dos series de casos de conductores (Grupo A de 39 y Grupo B de 14) que laboran en centros mineros de nuestra serranía. Todos fueron estudiados con polisomnografía convencional (PSG-C) a nivel del mar. Se estableció diagnóstico de SAHS en 17 (43%) y 1 (7%) del Grupo A y B respectivamente. La prevalencia de los trastornos respiratorios del sueño en esta población es desconocida. Considerando los altos costos de la PSG-C, es imperativo implementar el cribado de trastornos respiratorios del sueño con poligrafías respiratorias de monitoreo simplificado de bajo costo y aplicarlas en los recintos mineros.