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Full-Text Articles in Sleep Medicine

Guideline To Sleep Disorder Consultation, Don O. Williams Sr Feb 2019

Guideline To Sleep Disorder Consultation, Don O. Williams Sr

Lynchburg Journal of Medical Science

Is it because of a sleep disorder? Due to the increasing complaints of sleep-related issues and the severe consequences untreated sleep disorders may cause, it is imperative to know how to identify sleep disorders and when to consult a sleep specialist. On average there are 50-70 million adults in the United States that have sleep-related disorders.1 There are several sleep disorders, but the most common are Insomnia and Sleep Disordered Breathing, (Apnea / Hypopnea). The prevalence of common sleep disorders are, Insomnia 10-30%; Sleep Apnea 5%; Restless Leg Syndrome (RLS) 10% and Narcolepsy 0.05%. Most commonly diagnosed disorders of ...


Doppler Radar-Based Non-Contact Health Monitoring For Obstructive Sleep Apnea Diagnosis: A Comprehensive Review, Vinh Phuc Tran, Adel Ali Al-Jumaily, Syed Mohammed Shamsul Islam Jan 2019

Doppler Radar-Based Non-Contact Health Monitoring For Obstructive Sleep Apnea Diagnosis: A Comprehensive Review, Vinh Phuc Tran, Adel Ali Al-Jumaily, Syed Mohammed Shamsul Islam

ECU Publications Post 2013

Today’s rapid growth of elderly populations and aging problems coupled with the prevalence of obstructive sleep apnea (OSA) and other health related issues have affected many aspects of society. This has led to high demands for a more robust healthcare monitoring, diagnosing and treatments facilities. In particular to Sleep Medicine, sleep has a key role to play in both physical and mental health. The quality and duration of sleep have a direct and significant impact on people’s learning, memory, metabolism, weight, safety, mood, cardio-vascular health, diseases, and immune system function. The gold-standard for OSA diagnosis is the overnight ...


Investigating The Relationships Between Hypothalamic Volume And Measures Of Circadian Rhythm And Habitual Sleep In Premanifest Huntington's Disease, Danielle M. Bartlett, Juan F. Domínguez D, Alvaro Reyes, Pauline Zaenker, Kirk W. Feindel, Robert U. Newton, Anthony J. Hannan, James A. Slater, Peter R. Eastwood, Alpar S. Lazar, Mel Ziman, Travis Cruickshank Jan 2019

Investigating The Relationships Between Hypothalamic Volume And Measures Of Circadian Rhythm And Habitual Sleep In Premanifest Huntington's Disease, Danielle M. Bartlett, Juan F. Domínguez D, Alvaro Reyes, Pauline Zaenker, Kirk W. Feindel, Robert U. Newton, Anthony J. Hannan, James A. Slater, Peter R. Eastwood, Alpar S. Lazar, Mel Ziman, Travis Cruickshank

ECU Publications Post 2013

Objective

Pathological changes within the hypothalamus have been proposed to mediate circadian rhythm and habitual sleep disturbances in individuals with Huntington’s disease (HD). However, investigations examining the relationships between hypothalamic volume and circadian rhythm and habitual sleep in individuals with HD are sparse. This study aimed to comprehensively evaluate the relationships between hypothalamic pathology and circadian rhythm and habitual sleep disturbances in individuals with premanifest HD.

Methods

Thirty-two individuals with premanifest HD and twenty-nine healthy age- and gender-matched controls participated in this dual-site, cross-sectional study. Magnetic resonance imaging scans were performed to evaluate hypothalamic volume. Circadian rhythm and habitual ...


The Use Of Online Cbt-I At Jefferson Sleep Disorder Clinic: A Quality Improvement Study, Kathy Tran, Do, Ritu Grewal, Md Jun 2018

The Use Of Online Cbt-I At Jefferson Sleep Disorder Clinic: A Quality Improvement Study, Kathy Tran, Do, Ritu Grewal, Md

Department of Sleep Medicine Posters

Objectives

We propose to introduce online CBT-I into our patient practice by distributing flyers to patients who complain of insomnia. We have made flyers available in all the exam rooms and educated physicians, nurse practitioners and staff. We will then review charts after the intervention period to evaluate for an increase in recommendation for CBT-I as a treatment option and education for patients.


Effect Of Manual Over Scoring On Automated Analysis Of Level 3 Home Sleep Testing (Hst) Results, Theodora Fynn, Ritu Grewal, Karl Doghramji, Prakash Vasudevan, Tingting Zhan Jun 2018

Effect Of Manual Over Scoring On Automated Analysis Of Level 3 Home Sleep Testing (Hst) Results, Theodora Fynn, Ritu Grewal, Karl Doghramji, Prakash Vasudevan, Tingting Zhan

Department of Sleep Medicine Posters

No abstract provided.


Treatment Of Obstructive Sleep Apnea With Maxillo-Mandibular Advancement Surgery: Evaluation And Predictors Of Success, Daniel Taub, Dmd, Md, Michael Courtney, Dmd, Md, Karl Doghramji, Md Jun 2018

Treatment Of Obstructive Sleep Apnea With Maxillo-Mandibular Advancement Surgery: Evaluation And Predictors Of Success, Daniel Taub, Dmd, Md, Michael Courtney, Dmd, Md, Karl Doghramji, Md

Department of Oral and Maxillofacial Surgery Posters

Obstructive sleep apnea (OSA) is a well-recognized disease entity affecting approximately 2% to 4% of the population. Maxillomandibular advancement (MMA) surgery is a highly successful surgical alternative to poorly tolerated CPAP therapy and achieves a success rate of 89% in the current literature. Our present study evaluates the effectiveness of MMA surgery in the treatment of patients with moderate to severe OSA based on Shers criteria of 50% reduction in AHI and AHI < 20. Radiographic and clinical treatment variables were evaluated in determining predictors of success for MMA in individuals with OSA.


Does Transition From Cpap To Bipap Improve Symptoms Of Aerophagia?, Kathy Tran, Do, Karl Doghramji, Md Jun 2018

Does Transition From Cpap To Bipap Improve Symptoms Of Aerophagia?, Kathy Tran, Do, Karl Doghramji, Md

Department of Sleep Medicine Posters

Introduction

Adherence to continuous positive airway pressure (CPAP) therapy has been an ongoing dilemma in obstructive sleep apnea patients and up to 83% of patients are noncompliant. It is believed that mask discomfort or pressure intolerance are the major causes. Aerophagia, or “air swallowing” may be an under-recognized and insidious cause for CPAP nonadherence. Patients generally complain of belching, bloating, abdominal pain and distention. Some studies have reported worsening gastrointestinal reflux symptoms from PAP-induced aerophagia. Although bi-level positive airway pressure (BIPAP) is often utilized in such circumstances, this practice had not been examined. We hypothesized that transitioning patients from CPAP ...


Mindfulness Meditation Targets Transdiagnostic Symptoms Implicated In Stress-Related Disorders: Understanding Relationships Between Changes In Mindfulness, Sleep Quality, And Physical Symptoms., Jeffrey M. Greeson, Haley Zarrin, Moria J. Smoski, Jeffrey G. Brantley, Thomas R. Lynch, Daniel M. Webber, Martica H. Hall, Edward C. Suarez, Ruth Q. Wolever May 2018

Mindfulness Meditation Targets Transdiagnostic Symptoms Implicated In Stress-Related Disorders: Understanding Relationships Between Changes In Mindfulness, Sleep Quality, And Physical Symptoms., Jeffrey M. Greeson, Haley Zarrin, Moria J. Smoski, Jeffrey G. Brantley, Thomas R. Lynch, Daniel M. Webber, Martica H. Hall, Edward C. Suarez, Ruth Q. Wolever

Student Papers & Posters

Mindfulness-Based Stress Reduction (MBSR) is an 8-week meditation program known to improve anxiety, depression, and psychological well-being. Other health-related effects, such as sleep quality, are less well established, as are the psychological processes associated with therapeutic change. This prospective, observational study (


The Effect Of Napping On Sleep Quality And Quantity In Healthy And Concussed Collegiate Athletes, Katie Stephenson-Brown May 2018

The Effect Of Napping On Sleep Quality And Quantity In Healthy And Concussed Collegiate Athletes, Katie Stephenson-Brown

Theses and Dissertations

Clinicians are increasingly prescribing a regulated sleep schedule to athletes post injury; however, baseline sleep habits of collegiate athletes are unknown. Moreover, the connection between napping and sleep quality and quantity has not been studied in collegiate athletes. Therefore, the purpose of this study is to investigate napping behaviors and their effects on sleep quantity and quality in concussed and non-concussed collegiate athletes. In a sample of 233 non-concussed collegiate athletes, 74% (172/233) of participants reported napping. Napping was not significantly associated with sleep quantity (χ 2 (2) = .23, p = .64) or quality (χ 2 (1) = .42, p =.52 ...


The Relationship Between Iron Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md Jan 2018

The Relationship Between Iron Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Iron status is an important aspect of the evaluation of children with excessive limb movements during sleep. •While there is clear data in adults to support this relationship, the data in children is less well established. •We evaluated the association between iron status and limb movements during sleep in a large pediatric sample. Methods •This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and ferritin test within 24 hours of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr ...


The Relationship Between Vitamin D Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md Jan 2018

The Relationship Between Vitamin D Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Vitamin D deficiency has recently been posited as an important factor in the pathogenesis of restless leg syndrome.

•We evaluated the association between vitamin D deficiency and limb movements and sleep architecture in a pediatric sample.

Methods

•This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and 25-OH vitamin D within 60 days of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr or Obstructive Apnea Hypopnea Index >2/ hr) were excluded. Results •There were a total of 83 ...


Examining Eye-Level Light Exposure Patterns And Human Sleep Behavior, Larissa Hunt Jan 2018

Examining Eye-Level Light Exposure Patterns And Human Sleep Behavior, Larissa Hunt

Undergraduate Honors Theses

While laboratory studies have demonstrated that not only light exposure intensity, but also its duration, timing, and spectral composition are relevant for circadian physiology, most field studies examining links between light, circadian rhythms, sleep, and behavior rely on simple quantification of light intensity. Unpublished findings from the Circadian and Sleep Epidemiology Laboratory indicate that continuous light exposure levels of free-living individuals measured at the wrist are best captured by eight independent dimensions, represented by metrics including light intensity, timing, spectral composition, and the variability in timing of light exposure. However, wrist-level recordings of light have been shown to have error ...


Does Chronotype Moderate The Relationship Between Time Of Day And Performance In Human Anatomy Laboratory (Iphy3415)?, Amy Bazzoni Jan 2018

Does Chronotype Moderate The Relationship Between Time Of Day And Performance In Human Anatomy Laboratory (Iphy3415)?, Amy Bazzoni

Undergraduate Honors Theses

Chronotype, an individual’s propensity and preference for sleep and wakefulness behavior, has been shown in numerous studies to be importantly related to high school and college student success. Students who are “larks” generally have peak alertness in the morning and perform better in morning classes. Students who are “owls” struggle to maintain alertness in morning classes and perform better in afternoon classes. This project extends this chronotype research by investigating the relationship between chronotype and performance in the Integrative Physiology Department’s Human Anatomy Laboratory course which has sections offered at different times throughout the day. The study design ...


Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv Jan 2018

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity ...


Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem Dec 2017

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air ...


Patient-Predicted Sleep Position Vs. Hst Data: A Tendency To Underestimate Supine Sleep, Adam J. Sorscher, Anthony P. Anzivino, Todd Mackenzie Oct 2017

Patient-Predicted Sleep Position Vs. Hst Data: A Tendency To Underestimate Supine Sleep, Adam J. Sorscher, Anthony P. Anzivino, Todd Mackenzie

Open Dartmouth: Faculty Open Access Articles

Purpose The purpose of this study is to measure people’s accuracy when they estimate what proportion of their nightly sleep at home is supine vs. non-supine. Methods A series of patients referred for obstructive sleep apnea (OSA) evaluation were asked if they Bknew with confidence^ how they slept with regard to their body position. BYes^ responders were then asked to estimate what percentage of their sleep was supine vs. non-supine. This value was compared with the actual proportion of supine vs. non-supine sleep that they exhibited in a home sleep test (HST) that followed. Results We obtained data from ...


A Quality Improvement Project To Reduce The Wait Time For Initial Appointment In An Urban Outpatient Sleep Center, Anasua Chakraborty, Md, Ritu G. Grewal, Md Jun 2017

A Quality Improvement Project To Reduce The Wait Time For Initial Appointment In An Urban Outpatient Sleep Center, Anasua Chakraborty, Md, Ritu G. Grewal, Md

House Staff Quality Improvement and Patient Safety Posters

Project aim:

In this study we aimed to see if replacing one face to face follow up visit after sleep study with a phone call by a trained office staff will

  • decrease the total number of follow up office visits, thus decreasing health care cost
  • increase the number of new patients seen during the 6 month follow up period
  • Did not decrease patient compliance

Poster presented at annual Thomas Jefferson University Hospital House Staff Quality Improvement and Patient Safety conference.


The Acquisition And Analysis Of Electroencephalogram Data For The Classification Of Benign Partial Epilepsy Of Childhood With Centrotemporal Spikes, Jessica A. Scarborough May 2017

The Acquisition And Analysis Of Electroencephalogram Data For The Classification Of Benign Partial Epilepsy Of Childhood With Centrotemporal Spikes, Jessica A. Scarborough

Master's Theses

In this thesis, I will expand upon each step in the process of acquiring and analyzing electroencephalogram (EEG) for the classification of benign childhood epilepsy with centrotemporal spikes. Despite huge advancements in the field of health informatics—natural language processing, machine learning, predictive modeling—there are significant barriers to the access of clinical data. These barriers include information blocking, privacy policy concerns, and a lack of stakeholder support. We will see that these roadblocks are all responsible for stunting biomedical research in some way, including my own experiences in acquiring the data for the second chapter of this thesis.

This ...


Commentary: How To Make The Ghosts In My Bedroom Disappear? Focused-Attention Meditation Combined With Muscle Relaxation (Mr Therapy)-A Direct Treatment Intervention For Sleep Paralysis., Brian A. Sharpless, Karl Doghramji Apr 2017

Commentary: How To Make The Ghosts In My Bedroom Disappear? Focused-Attention Meditation Combined With Muscle Relaxation (Mr Therapy)-A Direct Treatment Intervention For Sleep Paralysis., Brian A. Sharpless, Karl Doghramji

Department of Sleep Medicine Faculty Papers

No abstract provided.


Consequences Of Untreated Obstructive Sleep Apnea, Binyamin S. Kanter Jan 2017

Consequences Of Untreated Obstructive Sleep Apnea, Binyamin S. Kanter

The Science Journal of the Lander College of Arts and Sciences

Over the past few years, awareness of the prevalence of obstructive sleep apnea has significantly increased. Indeed, sleep apnea may be more common now with the increasing incidence of obesity and the growing number of elderly individuals in our population. How serious is this condition, and what are the potential long-term effects and consequences of obstructive sleep apnea if left untreated? An overlap of many serious conditions with obstructive sleep apnea has been noticed. These conditions include hypertension, heart disease and failure, stroke, diabetes, neurological diseases, depression, and a number of other serious health concerns. The purpose of this paper ...


Effects Of Screen Light Filtering Software On Sleep And Morning Alertness, Hengyu Chi Jan 2017

Effects Of Screen Light Filtering Software On Sleep And Morning Alertness, Hengyu Chi

All Master's Theses

Research has shown that blue light can impact the circadian rhythm. Research has also suggested that use of electronic devices, such as computers and televisions that emit blue light before sleep, can negatively impact sleep quality. This research has led to the creation of computer software which lowers the levels of blue light in the evening to help with sleep. This study looked at the impact of wavelength filtering software on sleep onset, sleep duration and subjective alertness after morning waking of four college students. The college students were randomized into two groups and had the wavelength filtering software f ...


Objective Snoring Time And Carotid Intima-Media Thickness In Non-Apneic Female Snorers, Jinyoung Kim, Allan I. Pack, Barbara Riegel, Julio A. Chirinos, Alexandra Hanlon, Seung Ku Lee, Chol Shin Dec 2016

Objective Snoring Time And Carotid Intima-Media Thickness In Non-Apneic Female Snorers, Jinyoung Kim, Allan I. Pack, Barbara Riegel, Julio A. Chirinos, Alexandra Hanlon, Seung Ku Lee, Chol Shin

School of Nursing Departmental Papers

Controversy persists about whether snoring can affect atherosclerotic changes in adjacent vessels, independently of obstructive sleep apnea and other cardiovascular risk factors. This study examined the independent association between snoring and carotid artery intima-media thickness (IMT) in non-apneic snorers and non-snorers. We studied 180 non-apneic snorers and non-snorers participating in a full-night home-based sleep study. Snoring sound was measured objectively by a microphone. Based on snoring time across the night, participants were classified as non-snorers (snoring time: 0%), mild snorers (1-25%) and moderate to heavy snorers (≥25%). We measured IMT on both common carotid arteries. The three groups were matched ...


Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles Dec 2016

Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles

Doctor of Nursing Practice

The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical ...


Is Suvorexant (Belsomra) Effective In Reducing Wakefulness After Sleep Onset In Healthy Patients Diagnosed With Insomnia?, Danielle Hart Dec 2016

Is Suvorexant (Belsomra) Effective In Reducing Wakefulness After Sleep Onset In Healthy Patients Diagnosed With Insomnia?, Danielle Hart

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine if Suvorexant (Belsomra) is effective in reducing wakefulness after sleep onset in healthy patients diagnosed with insomnia that are 18 years old or older.

STUDY DESIGN: Systematic review of three published, randomized controlled trials (doubleblind, placebo-controlled) between 2012-2014, all English.

DATA SOURCES: Three randomized controlled trials published between 2012-2014 were found using PubMed.

OUTCOMES MEASURED: Polysymnography, psychomotor performance test, PSG measurements of sleep, visual scoring, efficacy assessed with an electronic diary, Sheehan Disability Scale, vitals, EKGs, PE, MVAV questionnaire, QIDS-SR to assess mood, Tyler Withdrawal Symptom Questionnaire

RESULTS: The ...


Age-Related Effect Of Viral-Induced Wheezing In Severe Prematurity, Geovanny F. Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E. Rodriguez-Martinez, Mary C. Rose, Dinesh Pillai, Gustavo Nino Oct 2016

Age-Related Effect Of Viral-Induced Wheezing In Severe Prematurity, Geovanny F. Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E. Rodriguez-Martinez, Mary C. Rose, Dinesh Pillai, Gustavo Nino

Pediatrics Faculty Publications

Abstract: Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (> 37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (< 32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to ...


Associations Of Subjective Sleep Quality And Daytime Sleepiness With Cognitive Impairment In Adults And Elders With Heart Failure, Eeeseung Byun, Jinyoung Kim, Barbara Riegel Apr 2016

Associations Of Subjective Sleep Quality And Daytime Sleepiness With Cognitive Impairment In Adults And Elders With Heart Failure, Eeeseung Byun, Jinyoung Kim, Barbara Riegel

School of Nursing Departmental Papers

This study examined the association of subjective nighttime sleep quality and daytime sleepiness with cognitive impairment in 105 adults (< 60 years old) and 167 elders (≥ 60 years old) with heart failure. Nighttime sleep quality and daytime sleepiness were measured by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Cognitive impairment was assessed using a neuropsychological battery measuring attention, memory, and processing speed. Multivariate logistic regression was used. In adults, daytime sleepiness was associated with cognitive impairment, whereas poor nighttime sleep quality was associated with cognitive impairment in elders. Age may play an important role in how sleep impacts cognition in persons with heart failure. Improving nighttime sleep quality and daytime sleepiness in this population may improve cognition.


Healthy Living An In-Depth Look, Nina Radcliff, Md, Kristin Detterline Apr 2016

Healthy Living An In-Depth Look, Nina Radcliff, Md, Kristin Detterline

Jefferson Sleep Disorders Center in the News

Features Dr. Ritu Grewal, pulmonologist and attending physician at Jefferson Sleep Disorder Center Women's Program.


Pharmacotherapy For Chronic Insomnia: A Brief Survey Of Pcp Attitudes And Preferences, Adam J. Sorscher, Ali A. Siddiqui, Ardis Olson, Deborah J. Johnson Mar 2016

Pharmacotherapy For Chronic Insomnia: A Brief Survey Of Pcp Attitudes And Preferences, Adam J. Sorscher, Ali A. Siddiqui, Ardis Olson, Deborah J. Johnson

Open Dartmouth: Faculty Open Access Articles

Purpose: To examine primary care professionals (PCP) attitudes and prescribing preferences toward hypnotic medications to treat chronic insomnia. Methods: An online survey was sent to members of the Dartmouth CO-OP, a practice-based primary care research network in Maine, Vermont, and New Hampshire. The survey begins with a case vignette of a 64-year old woman suffering from chronic insomnia. Clinicians were then presented with eight questions about management of the patient and their attitudes toward prescribing medications, focusing on benzodiazepines/benzodiazepine receptor agonists (BDZ/BZRAs). Results: 103 of 198 clinicians (52%) responded. Regarding choice of medication for the case vignette, 80 ...


Does A Short, Thick Neck Predict Obstructive Sleep Apnea?: The Role Of Physical Examination In Osa Screening, Ramya Punati, Md, Shivan Saxena, Md, Constantine Daskalakis, Sc.D., Salvatore Mangione, Md, Ritu G. Grewal, Md Jan 2016

Does A Short, Thick Neck Predict Obstructive Sleep Apnea?: The Role Of Physical Examination In Osa Screening, Ramya Punati, Md, Shivan Saxena, Md, Constantine Daskalakis, Sc.D., Salvatore Mangione, Md, Ritu G. Grewal, Md

Department of Sleep Medicine Faculty Papers

Purpose:

The purpose of this study was to determine whether a short neck, alone or together with a thick neck, can predict obstructive sleep apnea (OSA).

Methods:

The laryngeal heights of 169 new adult patients presenting to a sleep medicine physician were measured over a period of 5 months. Neck circumference, Mallampati score, and body-mass index (BMI) were also determined, together with medical history, smoking status, and serum bicarbonate. Lastly, patients’ polysomnograms were obtained in order to ascertain the presence or absence of OSA as indicated by the apnea-hypopnea index, as well as other sleep study parameters.

Results:

No association ...


Severe Obesity Hypoventilation Syndrome Treated With Auto-Cpap, Zhanna Fast, Md, Ritu G. Grewal, Md Jan 2016

Severe Obesity Hypoventilation Syndrome Treated With Auto-Cpap, Zhanna Fast, Md, Ritu G. Grewal, Md

Department of Sleep Medicine Faculty Papers

Summary

Obesity hypoventilation syndrome (OHS) is a serious medical condition that remains undiagnosed in seriously ill hospitalized patients. Significant improvement of daytime hypercapnia can be achieved with positive airway pressure (PAP) therapy. Bi-level PAP is generally employed with the goal of improving ventilation. A 50-year-old woman with OHS and severe hypercapnia was successfully treated with an auto titrating continuous PAP (Auto-CPAP) device. The major role in the pathogenesis of daytime hypercapnia in patients with OHS, is the progressive accumulation of carbon dioxide (CO2) caused by repetitive obstructive events at night, which can be eliminated with the low cost approach of ...