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  1. Article ; Online: An Integrated Interdisciplinary Sleep Care Model-The Ultimate Dream Team.

    Benjamin, Sara E / Exar, Elliott N / Gamaldo, Charlene E

    JAMA neurology

    2023  Volume 80, Issue 6, Page(s) 541–542

    MeSH term(s) Humans ; Sleep ; Patient Care Team
    Language English
    Publishing date 2023-04-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2023.0549
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The association of upper airway resistance with periodic limb movements.

    Exar, E N / Collop, N A

    Sleep

    2001  Volume 24, Issue 2, Page(s) 188–192

    Abstract: Study objectives: We hypothesized that the upper airway resistance syndrome (UARS), the component event being a respiratory effort related arousal (RERA), and periodic limb movements in sleep (PLMS), the component event being repetitive, stereotyped ... ...

    Abstract Study objectives: We hypothesized that the upper airway resistance syndrome (UARS), the component event being a respiratory effort related arousal (RERA), and periodic limb movements in sleep (PLMS), the component event being repetitive, stereotyped extremity movements occurring in a periodic fashion, were associated in certain patients.
    Design: Invasive polysomnography using Pes and full facemask pneumotachography was used to identify RERA's in patients. Periodic limb movements (PLM) were scored according to standard criteria and as associated with RERA if the movement occurred between the Pes nadir and the onset of the arousal.
    Setting: A university hospital Sleep Disorders Laboratory.
    Participants: Patients consecutively diagnosed with PLMS in our sleep disorders laboratory over a 1 year period.
    Interventions: None.
    Measurements and results: Fourteen of twenty patients demonstrated UARS in addition to PLMS (70%). In those 14, 63% of RERAs were associated with a PLM (mean = 51.7 + 36.2 PLM/RERAs per study vs 5.6 + 6.3 PLM/RERAs per study if the association were random). Patients with UARS had more arousals with their PLMs (P = 0.0006).
    Conclusions: An association exists between PLMS and UARS on both a group level and an event level. A high percentage of PLM with arousals correlated with breathing events due to increased effort in UARS; this may be of clinical utility in the management of PLMS patients.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Arousal/physiology ; Female ; Humans ; Male ; Middle Aged ; Nasal Obstruction/complications ; Nocturnal Myoclonus Syndrome/complications ; Polysomnography ; Sleep/physiology
    Language English
    Publishing date 2001-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 424441-2
    ISSN 1550-9109 ; 0161-8105
    ISSN (online) 1550-9109
    ISSN 0161-8105
    DOI 10.1093/sleep/24.2.188
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The upper airway resistance syndrome.

    Exar, E N / Collop, N A

    Chest

    1999  Volume 115, Issue 4, Page(s) 1127–1139

    Abstract: The upper airway resistance syndrome (UARS) is a recently described form of sleep-disordered breathing in which repetitive increases in resistance to airflow within the upper airway lead to brief arousals and daytime somnolence. This review will first ... ...

    Abstract The upper airway resistance syndrome (UARS) is a recently described form of sleep-disordered breathing in which repetitive increases in resistance to airflow within the upper airway lead to brief arousals and daytime somnolence. This review will first describe the chronological progression of our understanding of UARS within the broader context of sleep-disordered breathing. The primary symptom, daytime somnolence, appears to result directly from repetitive EEG arousals. The level of negative intrathoracic pressure is the most likely stimulus for arousal, possibly mediated by mechanoreceptors in the upper airway. A general consensus regarding the exact clinical definitions and the physiologic measurement techniques leading to a diagnosis does not exist, although esophageal manometry and pneumotachographic airflow measurements taken during polysomnography are the "gold standard." Less invasive diagnostic modalities have been proposed, but none of them have been well-validated. Aside from daytime somnolence, hypertension is an important sequela of this disorder, likely resulting from autonomic and cardiovascular changes induced by increased negative intrathoracic pressure. Nasal continuous positive airway pressure is the most efficacious form of therapy, although low patient compliance may limit its practical application. The safety and efficacy of surgical treatments are poorly documented in the literature. Palatal tissue reduction by radiofrequency ablation and the use of oral appliances hold promise as safe and effective modalities, but these treatments require further study.
    MeSH term(s) Airway Resistance ; Humans ; Sleep Apnea Syndromes/complications ; Sleep Apnea Syndromes/diagnosis ; Sleep Apnea Syndromes/physiopathology ; Sleep Apnea Syndromes/therapy
    Language English
    Publishing date 1999-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.115.4.1127
    Database MEDical Literature Analysis and Retrieval System OnLINE

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