Obstructive sleep apnea (OSA) in children and adolescents is much more prevalent than most practitioners realize: it is found in 1% to 4% of children… Read More
During my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily... More »
On Monday, August 24, 2009, in response to a Freedom of Information Act lawsuit, the Central Intelligence Agency (CIA) released a “Top Secret,” highly... More »
Surveys show that approximately 60% of the general population has gambled within the past 12 months.1 The majority of people who gamble do so socially... More »
0. Archives of. Search. Editor's Correspondence| May 14, 2012. To Sleep or Not To Sleep: Do We Forget Our Patient's Sleep? ... Given the typical compensatory increase of SWS in response to acute sleepdeprivation, another interesting question is whether
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Sleepiness and cognitive dysfunction are recognized as prominent consequences of sleepdeprivation. Experimentally induced short-term sleep fragmentation, even in the absence of any reductions in total sleep duration, will lead to the emergence of excessive daytime sleepiness and cognitive impairments in humans. Tumor necrosis factor (TNF)-alpha has important regulatory effects on sleep, and seems to play a role in the occurrence of excessive daytime sleepiness in children who have disrupted sleep as a re
Gastroesophageal reflux disease (GERD) is a very common disorder worldwide, comprised of reflux esophagitis (RE) and non-erosive reflux disease (NERD). As more than half of GERD patients are classified into the NERD group, precise evaluation of bothersome epigastric symptoms is essential. Nevertheless, compared with many reports targeting endoscopic reflux esophagitis, large-scale studies focusing on GERD symptoms have been very scarce.|Gastroesophageal reflux disease (GERD) is a very common disorder world
Sleepdeprivation was found to exert complex effects on affective dimensions and modalities of pain perception both in healthy volunteers and patients with major depression. Considering multifaceted links between mood and pain regulation in patients with chronic somatoform pain, it is intriguing to study sleepdeprivation effects for the first time in this group of patients. Twenty patients with a somatoform pain disorder according to ICD-10 diagnostic criteria were sleep-deprived for one night, followed by one recovery night. Clinical pain complaints (visual analog scale), detection- and pain thresholds (temperature and pressure) as well as mood states (Profile of Mood States) were assessed on the day prior to the experiment, on the day after sleepdeprivation and on the day after recovery sleep. We found a discrepancy between significantly increased clinical pain complaints and unaltered experimental pain perception after sleepdeprivation. Only the clinical pain complaints, but not
Sleep dramatically influences cardiovascular regulation. Changes in sleep duration or quality as seen in sleep disorders may prevent blood pressure to fall during sleep as expected in human physiology. This supports the increased prevalence of hypertension and drug-resistant hypertension in those with sleep loss. Other cardiovascular outcomes i.e. coronary lesions seem to be associated with sleep duration. Systemic inflammation, oxidative stress and endothelial dysfunction seem to be associated with both sleep loss and sleep disorders. The most critical example is Obstructive Sleep Apnea (OSA). Sympathetic activation, oxidative stress and systemic inflammation are the main intermediary mechanisms associated with sleep apnea and intermittent hypoxia. There are now convincing data regarding the associations between hypertension, arrhythmias, stroke, coronary heart disease, increased cardiovascular mortality and OSA. There are also data in OSA and in animal models supporting the link
Sleepdeprivation (SD) can alter extrinsic, task-related fMRI signal involved in attention, memory and executive function. However, its effects on intrinsic low-frequency connectivity within the Default Mode Network (DMN) and its related anti-correlated network (ACN) have not been well characterized. We investigated the effect of SD on functional connectivity within the DMN, and on DMN-ACN anti-correlation, both during the resting state and during performance of a visual attention task (VAT). 26 healthy participants underwent fMRI twice: once after a normal night of sleep in rested wakefulness (RW) and once following approximately 24h of total SD. A seed-based approach was used to examine pairwise correlations of low-frequency fMRI signal across different nodes in each state. SD was associated with significant selective reductions in DMN functional connectivity and DMN-ACN anti-correlation. This was congruent across resting state and VAT analyses, suggesting that SD induces a robust
22171212 2011 12 15 2012 04 30 1550-9397 7 6 Dec 15 J Clin Sleep Med 683 Gimino Vincent J VJ eng Comment Letter United States J Clin Sleep Med ... 101231977 1550-9389 IM J Clin Sleep Med.
There have been conflicting reports of the effects of modest sleepdeprivation on surgical skills. The aim of this study was to assess the effects of a 24-hour call shift on technical and cognitive function, as well as the ability to learning a new skill.|Thirty-one students trained to expert proficiency on a virtual reality part-task trainer. They then were randomized to either a control or sleep-deprived group. On the second testing day they were given a novel task. Fatigue was assessed using the Epworth Sleepiness Scale. The National Aeronautics and Space Administration-Task Load Index was used to assess cognitive capabilities.|There was no difference between the control and sleep-deprived groups for performance or learning of surgical tasks. Subjectively, the Epworth Sleepiness Scale showed an increase in sleepiness. The National Aeronautics and Space Administration-Task Load Index showed an increase in total subjective mental workload for the sleep-deprived group.|Sleep-deprived
(1) Diagnosis and management of epilepsy in adults. A national clinical guideline. (2) Diagnosis and management of epilepsy in adults. Update to printed guideline.
American Thoracic Society Documents An Official ATS/AASM/ACCP/ERS Workshop Report: Research Priorities in Ambulatory Management of Adults with Obstructive Sleep Apnea Samuel T. ... THE AMERICAN ACADEMY OF SLEEP MEDICINE ( AASM), THE AMERICAN COLLEGE OF
Making Public Health Policy and Economics a Priority Bryan R. Fine, MD, MPH, May 21, 2012 Public health as an important part of an allopathic, clinical program may be intuitive to some, but implementing it is still a challenge.
Using Pinterest to Market Your Medical Practice Jenny Conviser, PsyD, May 18, 2012 Pinterest is quickly becoming the next big social media outlet, so here's an easy guide on how your practice can get online and connect with patients.
How to Close Your Medical Practice the Right Way Sue Jacques, May 16, 2012 Whether you've decided to retire, relocate, or retreat from practice, you can reduce the pain for your patients and staff by following these five guidelines.