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Praxis (Bern 1994) 2019 Jan;108(2):131-138

2 Sleep and Health Zürich (SHZ), Universität Zürich.

Pharmacotherapy of Sleep-Wake Disorders Abstract. Sleep is a complex behavior, coordinated by many different brain regions and neurotransmitters. These neurochemical systems can be pharmacologically influenced to modulate wakefulness and sleep. Read More

Ann Neurol 2019 Jan 29. Epub 2019 Jan 29.

Reference National Center for Narcolepsy-Hypersomnia, Gui-de-Chauliac Hospital, CHU Montpellier, INSERM U1061, France.

Objective: Solriamfetol (JZP-110) is a selective dopamine and norepinephrine reuptake inhibitor with wake-promoting effects. This phase 3 study (NCT02348593) evaluated the safety and efficacy of solriamfetol in narcolepsy.

Methods: Patients with narcolepsy with mean sleep latency <25 minutes on the Maintenance of Wakefulness Test (MWT), Epworth Sleepiness Scale (ESS) score ≥10, and usual nightly sleep ≥6 hours were randomized to solriamfetol 75, 150, or 300 mg, or placebo for 12 weeks. Read More

J Alzheimers Dis 2019 ;67(3):911-921

University of California San Francisco, Memory and Aging Center, Weill Institute for the Neurosciences, San Francisco, CA, USA.

Background: Recent studies reveal an association between slow-wave sleep (SWS), amyloid-β aggregation, and cognition.

Objective: This retrospective study examines whether long-term use of trazodone, an SWS enhancer, is associated with delayed cognitive decline.

Methods: We identified 25 regular trazodone users (mean age 75. Read More

World Neurosurg 2019 Jan 22. Epub 2019 Jan 22.

Neurology and Neurosurgery Institute, Hospital Zambrano Hellion, TecSalud. Tecnologico de Monterrey. San Pedro Garza Garcia, Nuevo Leon, Mexico.

Intracranial germ cell tumors are a rare group of neoplasms constituting 1% to 2% of primary intracranial tumors in North America and Europe. Germinomas of the corpus callosum are exceedingly rare, accounting for only 0.7% of all intracranial germ cell tumors. Read More

Mo Med 2018 Nov-Dec;115(6):527-532

Madihah Hepburn, MD, Pradeep C. Bollu, MD, Pradeep Sahota, MD, MSMA member since 2003, and Brandi French, MD, are in the Department of Neurology, University of Missouri - Columbia.

Cerebrovascular disease encompassing both ischemic and hemorrhagic strokes are among the leading causes of disability and mortality globally. The current evidence strongly suggests that identifying and addressing sleep disorders should be a part of both primary and secondary stroke prevention. Stroke and sleep are 'bedfellows' since sleep disorders, including sleep-disordered breathing, parasomnias, sleep-related movement disorders, insomnia, and hypersomnia are intimately intertwined with co-morbid cardiovascular conditions and increase stroke risk. Read More

J Affect Disord 2019 03 18;246:659-666. Epub 2018 Dec 18.

Department of Psychiatry, Federal University of São Paulo, SP, Brazil; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.

Background: Hypersomnia is a common problem amongst individuals with Bipolar Disorder (BD). The objective of this meta-analysis is to estimate the frequency of hypersomnia in individuals with BD, and identify associated factors METHODS: Our search focused on articles documenting the frequency of hypersomnia among individuals with BD indexed in PubMed database and in the Cochrane Library, following the recommendations from the Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) Group. A meta-analysis of proportion was conducted; funnel plot and Egger's test were used for the assessment of publication bias. Read More

Chest 2018 Nov;154(5):e139-e142

Sleep Disorders Center, Neurologic Institute, Cleveland Clinic, Cleveland, OH.

Case Presentation: A 48-year-old athletic man with history of dyslipidemia and second-degree atrioventricular block (Mobitz type I 2:1 atrioventricular block) endorses sleep-related difficulties at his annual physical examination. Mobitz type I block was diagnosed 11 years earlier when the patient presented to his primary care physician with left-sided chest pain for 2 months. He was evaluated by cardiology, with a normal stress echocardiogram. Read More

Cochrane Database Syst Rev 2018 10 30;10:CD009622. Epub 2018 Oct 30.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Changchun Street 45, Beijing, China, 100053.

Background: Gamma aminobutyric acid (GABA) receptor agonists have been shown to have a neuroprotectant effect in reducing infarct size and improving functional outcome in animal models of cerebrovascular disease. However, the sedative effects of GABA receptor agonists have limited their wider application in people with acute stroke, due to the potential risk of stupor. This is an update of a Cochrane Review first published in 2013, and previously updated in 2014 and 2016. Read More

Praxis (Bern 1994) 2018;107(21):1161-1167

1 Universitäres Schlaf-Wach-Epilepsie Zentrum des Inselspitals Bern.

Narcolepsy and Other 'Central Disorders of Hypersomnolence' Abstract. 'Excessive daytime sleepiness', 'hypersomnia' in the sense of prolonged sleep need, 'tiredness' or 'fatigue' are frequent complaints in primary care, requiring a careful separation in view of a correct diagnostic. After exclusion of various internistic and neurologic causes by clinical and laboratory investigations and after exclusion of sleep apnoea syndrome or other causes of disturbed sleep by polysomnography, the ambiguous group of 'Central Disorders of Hypersomnolence' remains, including narcolepsy with and without cataplexy, idiopathic hypersomnia, and non-organic hypersomnia. Read More

Cochrane Database Syst Rev 2018 09 21;9:CD012555. Epub 2018 Sep 21.

Katharine House Hospice, Mandeville Road, Aynho Road, Adderbury, Banbury, UK, OX17 3NL.

Background: Olanzapine as an antiemetic represents a new use of an antipsychotic drug. People with cancer may experience nausea and vomiting whilst receiving chemotherapy or radiotherapy, or whilst in the palliative phase of illness.

Objectives: To assess the efficacy and safety of olanzapine when used as an antiemetic in the prevention and treatment of nausea and vomiting related to cancer in adults. Read More

Lancet Child Adolesc Health 2018 Jul 21;2(7):483-494. Epub 2018 May 21.

Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA, USA.

Background: Narcolepsy is a lifelong neurological disorder with onset commonly in childhood or adolescence. No drugs are indicated for cataplexy and excessive daytime sleepiness in paediatric patients with narcolepsy. Sodium oxybate is approved for use in adult patients with excessive daytime sleepiness or cataplexy, or both, in narcolepsy. Read More

BMJ Case Rep 2018 Aug 27;2018. Epub 2018 Aug 27.

Department of Medicine (Oncology), Houston Methodist Hospital, Houston, Texas, USA.

A 37-year-old Hispanic man with a right atrial intracardiac mass diagnosed as diffuse large B-cell lymphoma (DLBCL) was successfully treated with surgery and chemotherapy. During 4 years, several total-body positron emission tomography and MRI scans showed no extracardiac lymphoma. On year 5 after the cardiac surgery, patient presented with sleepiness, hyperphagia, memory loss, confabulation, dementia and diabetes insipidus. Read More

J Head Trauma Rehabil 2018 Jul 24. Epub 2018 Jul 24.

School of Psychology (Drs Bogdanov and Lah) and Brain and Mind Centre and Charles Perkins Centre (Dr Naismith), University of Sydney, Camperdown, Australia; Rehab2Kids Rehabilitation Unit (Ms Brookes and Dr Epps) and Department of Sleep Medicine (Dr Teng), Sydney Children's Hospital, Randwick, Australia; School of Paediatrics and Women's Health, University of New South Wales, Kensington, Australia (Dr Teng); and ARC Centre of Excellence in Cognition and Its Disorders, Macquarie University, North Ryde, Australia (Dr Lah).

Objectives: To characterize the sleep disturbance in children with moderate or severe traumatic brain injury (TBI), and to identify associated factors.

Setting: An urban tertiary pediatric healthcare facility.

Participants: Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n = 38) comparable in age, gender, and socioeconomic status. Read More

Front Neurol 2018 7;9:424. Epub 2018 Jun 7.

Division of Sleep Medicine and Neuromuscular Disorders, Department of Neurology, University Hospital Muenster, Muenster, Germany.

The vast majority of living organisms have evolved a circadian rhythm of roughly 24 h in adaptation to ever-changing environmental conditions, such as the cycle of light and darkness. In some sleep disorders like idiopathic hypersomnia (IH) this adaptation is defective. As the etiology of this disease is largely unknown, we examined the circadian period length of patients suffering from IH. Read More

Am J Respir Crit Care Med 2018 Oct;198(7):941-950

1 CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.

Rationale: Patients with obstructive sleep apnea (OSA) unable to tolerate standard treatments have few alternatives. They may benefit from weight loss, but the major symptom of daytime performance impairment may remain during weight loss programs.

Objectives: We hypothesized that wakefulness-promoter armodafinil would improve driving task performance over placebo in patients undergoing weight loss. Read More

J Can Acad Child Adolesc Psychiatry 2018 Apr 1;27(2):148-151. Epub 2018 Apr 1.

Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario8.

Objective: To consider whether the concepts of tolerance and withdrawal to stimulant medications apply to a preadolescent female, affected by autism spectrum disorder (ASD) and treated for associated attention-deficit/hyperactivity disorder (ADHD).

Methods: We describe the case history and review scientific English language literature pertaining to acute withdrawal effects associated with methylphenidate and amphetamine derivatives in children.

Results: An 11-year-old female with ASD and ADHD referred to our clinic experienced vomiting, headaches, and light sensitivity following abrupt discontinuation of methylphenidate; she subsequently presented with migraines and marked malaise immediately after a dose reduction in lisdexamfetamine. Read More

J Sleep Res 2018 Oct 14;27(5):e12690. Epub 2018 Apr 14.

National Reference Centre for Narcolepsy, Hypersomnia and Kleine-Levin Syndrome, Pitie-Salpetriere University Hospital, AP-HP, Paris, France.

In Kleine-Levin syndrome (KLS), episodes of hypersomnia and cognitive, psychiatric and behavioural disturbances alternate with asymptomatic periods in adolescents. We evaluated whether psychiatric disorders would emerge during asymptomatic periods in a naturalistic, uncontrolled clinical cohort. Patients with primary KLS underwent psychiatric interviews at diagnosis and every year for 1-10 years, leading to diagnosis of former and present comorbid psychiatric disorders. Read More

Sleep Med 2018 Apr 3;44:53-60. Epub 2018 Jan 3.

Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy. Electronic address:

Background: Type 1 narcolepsy (NT1) is a central hypersomnia linked to the destruction of hypocretin-producing neurons. A great body of genetic and epidemiological data points to likely autoimmune disease aetiology. Recent reports have characterized peripheral blood T-cell subsets in NT1, whereas data regarding the cerebrospinal fluid (CSF) immune cell composition are lacking. Read More

J Thorac Dis 2018 Jan;10(Suppl 1):S177-S183

Sleep Disorders Centre, St Thomas' Hospital, London, UK.

Background: Excessive daytime sleepiness (EDS) is a complaint common to many aspects of medicine. There are primary and secondary causes for EDS, with secondary causes including a large number of common conditions. Primary causes, such as narcolepsy, are much rarer. Read More

Mov Disord 2018 Apr 8;33(4):618-627. Epub 2018 Feb 8.

CHU Montpellier, Institut de Recherche en Biothérapie, hôpital St Eloi, Laboratoire de Biochimie Protéomique Clinique et CCBHM, INSERM U1040, Montpellier, France.

Background: To better understand the role of iron homeostasis dysregulation in restless legs syndrome, we compared serum hepcidin and ferritin levels in drug-free patients with primary restless legs syndrome and healthy controls and studied the relationship between hepcidin level and restless legs syndrome severity.

Methods: One hundred and eight drug-free patients with primary restless legs syndrome (65 women; median age, 61.5 years) and 45 controls (28 women; median age, 53. Read More

Sleep Med Clin 2018 Mar 10;13(1):63-70. Epub 2017 Nov 10.

Department of Neurology, Saint Louis University School of Medicine, Monteleone Hall, 1438 South Grand Boulevard, St Louis, MO 63104, USA. Electronic address:

Sleep disorders are commonly found in cerebral degenerative disorders. The sleep disorders may be caused by the primary symptoms of the neurologic disease or may result from damage to sleep-controlling centers in the brain. Common sleep disorders found in this population include insomnia, hypersomnia, sleep apnea, restless legs syndrome, circadian rhythm disorders, and rapid eye movement sleep behavior disorder. Read More

J Neuroimmunol 2018 Feb 18;315:28-32. Epub 2017 Dec 18.

Center for Sleep Sciences and Medicine, Stanford University, 3165 Porter Drive, Palo Alto, CA 94304, USA. Electronic address:

Anti-Yo paraneoplastic cerebellar degeneration (PCD) is a devastating autoimmune complication of gynecological cancers. We hypothesized that as for other autoimmune diseases, specific HLA haplotypes are associated. We conducted high resolution HLA typing of Class I/Class II in 40 cases versus ethnically matched controls. Read More

BMC Pulm Med 2017 Dec 12;17(1):192. Epub 2017 Dec 12.

Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.

Background: Excessive daytime sleepiness may be determined by a number of factors including personal characteristics, co-morbidities and socio-economic conditions. In this study we identified factors associated with excessive daytime sleepiness in 2 First Nation communities in rural Saskatchewan.

Methods: Data for this study were from a 2012-13 baseline assessment of the First Nations Lung Health Project, in collaboration between two Cree First Nation reserve communities in Saskatchewan and researchers at the University of Saskatchewan. Read More

Clin Med (Lond) 2017 Dec;17(6):499-503

Basildon and Thurrock University Hospital, Basildon, UK.

Obstructive sleep apnoea (OSA), which is often overlooked in patients presenting to primary and secondary care, is an increasingly common comorbidity. The prevalence of OSA has not been studied in the unselected acute medical take. The aim of this study was to screen for the prevalence of undiagnosed OSA using the STOPBANG Questionnaire and the Epworth sleepiness scale (ESS) score in an unselected acute medical take. Read More

Eur J Paediatr Neurol 2018 Jan 21;22(1):194-198. Epub 2017 Nov 21.

Children's Sleep Medicine Department, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, King's Health Partners Academic Health Science Centre, UK. Electronic address:

Type 1 narcolepsy (NT1) is a chronic primary disorder of hypersomnolence characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. NT1 is linked to hypothalamic hypocretin deficiency, strongly associated with Human Leukocyte Antigen (HLA) marker DQB1*06:02 and of probable autoimmune origin. NT1 is usually associated with increased rates of overweight and obesity, and sometimes with increases in overnight blood pressure and increased rates of hypoventilation with raised CO levels overnight. Read More

Sleep Breath 2018 05 9;22(2):305-309. Epub 2017 Oct 9.

Respiratory Medicine, Alfred Hospital, 55 Commercial Road, Melbourne, 3004, Australia.

Purpose: Excessive daytime sleepiness (EDS) is a debilitating symptom which occurs commonly in both primary sleep and mood disorders. The prevalence of mood disorders in patients with EDS, evaluated objectively with a mean sleep latency test (MSLT), has not been reported. We hypothesize that mood disorders are highly prevalent in patients being investigated for EDS. Read More

Mov Disord 2017 Dec 4;32(12):1748-1755. Epub 2017 Oct 4.

Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Background: Patients with Parkinson's disease experience debilitating motor symptoms as well as nonmotor symptoms, such as cognitive dysfunction and sleep disorders. This constellation of symptoms has the potential to negatively influence pedestrian safety. The objective of this study was to investigate the association of motor symptoms, daytime sleepiness, impaired vigilance, and cognitive dysfunction with pedestrian behavior in patients with Parkinson's disease and healthy older adults. Read More

J Affect Disord 2018 01 25;226:132-141. Epub 2017 Sep 25.

Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.

Objectives: To examine (i) the frequency of different sleep complaints (early wake-up, trouble falling asleep, hypersomnia) and their co-occurrence and (ii) the sociodemographic characteristics and psychiatric comorbidity associated with each type of sleep profiles.

Methods: Data were drawn from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of the US adult population (wave 1, 2001-2002; wave 2, 2004-2005). The primary analyses were limited to 3573 participants who had a DSM-IV-TR diagnosis of major depressive episode (MDE) between the two waves. Read More

Med Lav 2017 08 28;108(4):297-303. Epub 2017 Aug 28.

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Intermittent hypoxia and sleep fragmentation cause excessive daytime sleepiness (EDS) and cognitive impairment in obstructive sleep apnoea (OSA); neuroimaging and neurophysiological studies in patients with OSA have delineated a putative regional "fingerprint" of OSA-induced brain injury: a disconnection of the fronto-parietal regions and a disruption of the thalamocortical oscillator, with involvement of the hippocampal formation with impaired attention, awareness, working memory, time reaction, visuoconstructive and executive functions. For these reasons OSA is the main medical cause of EDS and is also associated with an increased risk of motor vehicle accidents (MVAs). About 7% of MVAs for a population of male drivers involved in MVAs are attributable to OSA. Read More

Med Lav 2017 08 28;108(4):260-266. Epub 2017 Aug 28.

IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences and Università Vita-Salute San Raffaele, Milan, Italy.

Excessive Daytime Sleepiness (EDS) is a common condition with a significant impact on quality of life and general health. A mild form of sleepiness can be associated with reduced reactivity and modest distractibility symptoms, but more severe symptomatic forms are characterized by an overwhelming and uncontrollable need to sleep, causing sudden sleep attacks, amnesia and automatic behaviors. The prevalence in the general population is between 10 and 25%. Read More

Internist (Berl) 2017 Oct;58(10):1029-1036

Abteilung Innere Medizin I und Klinische Chemie, Sektion Osteologie, Medizinische Universitätsklinik Heidelberg, INF 410, 69120, Heidelberg, Deutschland.

A serum calcium level >3.5 mmol/l together with clinical symptoms such as muscle weakness, fatigue, nausea, vomiting, pancreatitis or even coma are characteristic for a hypercalcemic crisis (HC). Primary hyperparathyroidism (1HPT) and malignancy-associated hypercalcemia are the most frequent causal diseases for a HC. Read More

Asian J Psychiatr 2017 Aug 3;28:186-187. Epub 2017 Jun 3.

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore560029, India. Electronic address:

Hypersomnia presents as excessive daytime sleepiness with a prevalence of 7.1% in general population. Hypersomnia has serious negative effects on persons functioning. Read More

Psychiatry Res 2017 11 31;257:238-241. Epub 2017 Jul 31.

Centre de Référence Narcolepsie, Unité des Troubles du Sommeil Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France; Inserm U1061, Montpellier, France; Université de Montpellier, Montpellier F-34000 France.

Recent population-based longitudinal studies concluded that most adults with attention deficit/hyperactivity disorder (ADHD) symptoms would not have a childhood history of ADHD, leading to the concept of adult-onset ADHD. In a large, well-characterized clinical population of 446 adults with a primary complaint of ADHD, we reported a low frequency of adult-onset ADHD (6.9%), being a primary isolated condition in 2. Read More

Sleep Med Clin 2017 Sep 16;12(3):479-487. Epub 2017 Jun 16.

Department of Neurology, Center for Sleep Medicine, Weill Cornell Medical College of Cornell University, 425 East 61st Street, 5th Floor, New York, NY 10065, USA. Electronic address:

Unlike other reviews written on this topic, the focus of this article is primarily on nonpharmacologic treatments for daytime sleepiness that is not secondary to other medical or psychological conditions. To provide an appropriate background on primary excessive daytime sleepiness, what is considered optimal sleep in terms of sleep duration, sleep insufficiency, and sleep need is discussed in detail. This discussion is followed by an examination of the behavioral strategy of banking sleep. Read More

BMJ Open 2017 07 2;7(6):e016396. Epub 2017 Jul 2.

UCL Department of Primary Care and Population Health, UCL Medical School, London, UK.

Studyobjectives: Daytime sleep has been associated with increased risk of cardiovascular disease and heart failure (HF), but the mechanisms remain unclear. We have investigated the association between daytime and night-time sleep patterns and cardiovascular risk markers in older adults including cardiac markers and subclinical markers of atherosclerosis (arterial stiffness and carotid intima-media thickness (CIMT)).

Methods: Cross-sectional study of 1722 surviving men aged 71-92 examined in 2010-2012 across 24 British towns from a prospective study initiated in 1978-1980. Read More

J Sleep Res 2018 Feb 28;27(1):73-77. Epub 2017 Jun 28.

Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany.

Experimental and clinical evidence suggests an association between neuroplasticity, brain-derived neurotrophic factor and sleep. We aimed at testing the hypotheses that brain-derived neurotrophic factor is associated with specific aspects of sleep architecture or sleep stages in patients with sleep disorders. We included 35 patients with primary insomnia, 31 patients with restless legs syndrome, 17 patients with idiopathic hypersomnia, 10 patients with narcolepsy and 37 healthy controls. Read More

Sleep Med Rev 2018 04 4;38:86-100. Epub 2017 May 4.

Sleep-Wake-Epilepsy-Centre, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland.

Road traffic injuries are projected to be the leading cause of death for those aged between 15 and 29 years by the year 2030, and sleepiness is estimated to be the underlying cause in up to 15-20% of all motor vehicle accidents. Sleepiness at the wheel is most often caused by socially induced sleep deprivation or poor sleep hygiene in otherwise healthy individuals, medical disorders, or the intake of drugs. Validated methods for objectifying sleepiness are urgently sought, particularly in the context of driving. Read More

Sleep Med 2017 Jul 22;35:12-16. Epub 2017 Apr 22.

Stanford Sleep Medicine Center, Redwood City, CA, USA; Jazz Pharmaceuticals, Palo Alto, CA, USA.

Objective: To evaluate the effects of JZP-110 on the Maintenance of Wakefulness Test (MWT) with data censored to include only the first 20 min of a 40-min MWT.

Methods: In a 4-week, placebo-controlled crossover design (Study 201; N = 33) and a 12-week parallel-group design (Study 202; N = 93), JZP-110 was evaluated in narcolepsy patients using changes from baseline in the 40-min MWT as the primary endpoint. Effect sizes based on the change from baseline in mean MWT sleep latency were calculated using 20-min censored MWT data and compared to 40-min MWT data. Read More

Sleep 2017 07;40(7)

LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.

Objectives: Daytime sleepiness is a significant public health concern. Early evidence points toward the computerized VIGALL (Vigilance Algorithm Leipzig) as time-efficient tool to assess sleepiness objectively. In the present study, we investigated the association between VIGALL variables of EEG vigilance (indicating brain arousal in resting state) and subjective daytime sleepiness in the LIFE cohort study. Read More

PLoS One 2017 17;12(5):e0176575. Epub 2017 May 17.

Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

We aimed to identify novel molecular associations between chronic intermittent hypoxia with re-oxygenation and adverse consequences in obstructive sleep apnea (OSA). We analyzed gene expression profiles of peripheral blood mononuclear cells from 48 patients with sleep-disordered breathing stratified into four groups: primary snoring (PS), moderate to severe OSA (MSO), very severe OSA (VSO), and very severe OSA patients on long-term continuous positive airway pressure treatment (VSOC). Comparisons of the microarray gene expression data identified eight genes up-regulated with OSA and down-regulated with CPAP treatment, and five genes down-regulated with OSA and up-regulated with CPAP treatment. Read More

Semergen 2018 Mar 13;44(2):114-120. Epub 2017 May 13.

Medicina Familiar y Comunitaria, Universidad de La Sabana, Chía, Colombia.

The narrative review is used as a methodological tool for the presentation of this article. A search was made in the PubMed, Elsevier, Ebsco, and Medline databases using temporal limits (publications from 2005 to 2016), in the Spanish, English, and Portuguese language, and by the type of persons analysed in the study (adolescents), along with the keywords in English: Adolescent/teen, tiredness, fatigue, sleepiness, drowsiness. A total of 33 articles of relevance were obtained for the diagnostic and therapeutic approach of the tired adolescent in Primary Care. Read More

Sleep 2017 01;40(1)

Unité des Troubles du Sommeil Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Hôpital Gui-de-Chauliac, Montpellier F-34000, France.

Study Objectives: To follow the temporal changes of cerebrospinal fluid (CSF) biomarker levels in narcoleptic patients with unexpected hypocretin level at referral.

Methods: From 2007 to 2015, 170 human leukocyte antigen (HLA) DQB1*06:02-positive patients with primary narcolepsy and definite (n = 155, 95 males, 60 females, 36 children) or atypical cataplexy (n = 15, 4 males, 3 children) were referred to our center. Cerebrospinal hypocretin deficiency was found in 95. Read More

Psychopharmacology (Berl) 2017 Jun 7;234(11):1703-1711. Epub 2017 Mar 7.

Merck & Co., Inc., Kenilworth, NJ, USA.

Rationale: Sex-related differences in the clinical profiles of some insomnia medications have been previously reported.

Objective: To evaluate the clinical profile of suvorexant, a novel orexin receptor antagonist approved for treating insomnia at doses up to 20 mg, by sex subgroups.

Methods: Efficacy analyses by sex were based on pooled data from two similar phase 3, randomized, double-blind, placebo-controlled, 3-month trials in elderly (≥65 years) and non-elderly (18-64 years) insomnia patients. Read More

JAMA Neurol 2017 Apr;74(4):411-418

Department of Neurology, Northwestern University, Chicago, Illinois.

Importance: Impaired sleep and alertness are some of the most common nonmotor manifestations of Parkinson disease (PD) and currently have only limited treatment options. Light therapy (LT), a widely available treatment modality in sleep medicine, has not been systematically studied in the PD population.

Objective: To determine the safety and efficacy of LT on excessive daytime sleepiness (EDS) associated with PD. Read More

Nutr Neurosci 2018 Apr 22;21(3):224-228. Epub 2017 Feb 22.

a Faculty of Medicine, Department of Psychiatry , The University of Melbourne , Australia.

Overview: Whilst the majority of evidence supports the adjunctive use of eicosapentaenoic acid (EPA) in improving mood, to date no study exists using low-dose docosahexaenoic acid (DHA) alone as an adjunctive treatment in patients with mild to moderate major depressive disorder (MDD).

Methods: A naturalistic 8-week open-label pilot trial of low-dose DHA, (260 mg or 520 mg/day) in 28 patients with MDD who were non-responsive to medication or psychotherapy, with a Hamilton Depression Rating Scale (HAM-D) score of greater than 17, was conducted. Primary outcomes of depression, clinical severity, and daytime sleepiness were measured. Read More

J Sleep Res 2017 06 1;26(3):255-265. Epub 2017 Feb 1.

Department of Psychology, University of Arizona, Tucson, AZ, USA.

Hypersomnolence plays an important role in the presentation, treatment and course of mood disorders. However, there has been relatively little research that examines objective measures of sleep duration and continuity in patients with depression and hypersomnolence, despite the use of these factors in sleep medicine nosological systems. This study compared total sleep time and efficiency measured by naturalistic actigraphic recordings followed by ad libitum polysomnography (PSG; without prescribed wake time) in 22 patients with major depressive disorder and co-occurring hypersomnolence against age- and sex-matched healthy sleeper controls. Read More

Lancet Neurol 2017 03 25;16(3):200-207. Epub 2017 Jan 25.

Bioprojet Pharma, Paris, France. Electronic address:

Background: Histaminergic neurons are crucial to maintain wakefulness, but their role in cataplexy is unknown. We assessed the safety and efficacy of pitolisant, a histamine H3 receptor inverse agonist, for treatment of cataplexy in patients with narcolepsy.

Methods: For this randomised, double-blind, placebo-controlled trial we recruited patients with narcolepsy from 16 sleep centres in nine countries (Bulgaria, Czech Republic, Hungary, Macedonia, Poland, Russia, Serbia, Turkey, and Ukraine). Read More

Addiction 2017 Jun 28;112(6):1104-1111. Epub 2017 Feb 28.

Department of Psychology, University of California, Berkeley, USA.

Aims: To examine the association between a life-time history of insomnia and hypersomnia compared with no sleep disturbance and substance use patterns and amounts before and after a substance use treatment episode.

Design: Secondary analysis of data from the Drug Abuse Treatment Outcome Studies conducted from 1991 to 1994.

Setting: Data were collected at 96 substance use treatment programs in 11 United States cities, including short-term in-patient, long-term residential, methadone maintenance and out-patient drug-free treatment modalities. Read More

J Clin Sleep Med 2017 Apr 15;13(4):575-582. Epub 2017 Apr 15.

The Health Observatory, Discipline of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, South Australia, Australia.

Study Objectives: To determine whether undiagnosed obstructive sleep apnea (OSA) and/or excessive daytime sleepiness are associated with symptomatic depression in Australian men.

Methods: Participants were randomly selected, urban community dwelling men aged 40 to 88 years without a prior diagnosis of OSA. Clinically significant depressive symptoms were assessed using the Beck Depression Inventory-1A or Centre for Epidemiological Studies Depression Scale (2007-2010). Read More

Rheumatology (Oxford) 2017 04;56(4):570-580

School of Health Sciences, University of East Anglia, Norwich, UK.

Objectives: To identify whether sleep disturbances are more prevalent in primary SS (pSS) patients compared with the general population and to recognize which specific sleep symptoms are particularly problematic in this population.

Methods: Electronic searches of the literature were conducted in PubMed, Medline (Ovid), Embase (Ovid), PsychINFO (Ovid) and Web of Science and the search strategy registered a priori . Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria, reference lists were examined and a narrative synthesis of the included articles was conducted. Read More