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Commentary

The Need for a Reliable Sleep EEG Biomarker. 771-772.
Thomas Penzel, PhD1,2; Ingo Fietze, MD, PhD1; Christian Veauthier, MD1
Portable Sleep Monitoring Systems: Broadening the Horizons. 773-774.
Naima Covassin, PhD; Virend K. Somers, MD, PhD
Do Obese Children Require Inpatient Monitoring After Adenotonsillectomy?. 775-776.
Narong Simakajornboon, MD

Scientific Investigations

Sleep Complaints and Sleep Architecture in Children With Idiopathic Central Sleep Apnea. 777-783.
Neepa Gurbani, DO1; Stijn L. Verhulst, MD, PhD2,3; Chee Tan, MD1; Narong Simakajornboon, MD1

BRIEF SUMMARY

Current Knowledge/Study Rationale: ICSA has been described and studied in the adult population but little is known about children with the condition. Our literature review confirms there are no published case descriptions or clinical studies involving children with ICSA.

Study Impact: The description of these cases of children with ICSA may help in increasing the understanding of common clinical presentations, pathophysiology of ICSA in children, and the effects of therapy on central respiratory events, sleep architecture, and quality of life.

Time Trends in the Family Physician Management of Insomnia: The Australian Experience (2000–2015). 785-790.
Christopher B. Miller, PhD1; Lisa Valenti, BEc, MMedStat2; Christopher M. Harrison, B Psych (Hons), MSocHlth2; Delwyn J. Bartlett, PhD1,3; Nick Glozier, MBBS, PhD4; Nathan E. Cross, BSc (Hons)1; Ronald R. Grunstein, MD, PhD1,3,5; Helena C. Britt, PhD2; Nathaniel S. Marshall, PhD1,6

BRIEF SUMMARY

Current Knowledge/Study Rationale: To describe how insomnia has been managed by family physicians in Australia and how this has changed through time.

Study Impact: Insomnia management rates per 100 family physician-patient encounters decreased after 2007–2008, when there was a high level of Australian media reporting of adverse effects of zolpidem. Through 2000–2015 there was a steady rate of approximately 90% of insomnia problems that were managed with pharmacotherapy. However, the pattern of pharmacotherapeutic agents being prescribed through time changed. Temazepam was the most commonly prescribed medication but zolpidem prescriptions notably fell since a peak in 2006–2007, and slow-release melatonin gradually rose in popularity since release in 2009.

Article Is Eligible For CME Credits The Accuracy, Night-to-Night Variability, and Stability of Frontopolar Sleep Electroencephalography Biomarkers. 791-803.
Daniel J. Levendowski, MBA1; Luigi Ferini-Strambi, MD2; Charlene Gamaldo, MD3; Mindy Cetel, MD4; Robert Rosenberg, DO5; Philip R. Westbrook, MD1

BRIEF SUMMARY

Current Knowledge/Study Rationale: The accuracy of autostaged frontopolar electroencephalography (EEG) compared to human-scored polysomnography (PSG) in patients with sleep disorders has not been established. The repeatability of sleep biomarkers acquired in the home of patients with insomnia is not currently known.

Study Impact: This study demonstrates that autoscored multichannel frontopolar EEG is as accurate as human-staged PSG, and ranks sleep biomarkers by variability and stability. The results point toward the use of sleep biomarkers for directing patient care and for assessing the effect of pharmacological interventions on sleep quality.

Article Is Eligible For CME Credits Sleep and Breathing the First Night After Adenotonsillectomy in Obese Children With Obstructive Sleep Apnea. 805-811.
Aliva De, MD1; Temima Waltuch, MD2; Nathan J. Gonik, MD3,4; Ngoc Nguyen-Famulare, MD5,6; Hiren Muzumdar, MD1,7; John P. Bent, MD3; Carmen R. Isasi, MD, PhD8; Sanghun Sin, MS1; Raanan Arens, MD1

BRIEF SUMMARY

Current Knowledge/Study Rationale: Adenotonsillectomy (AT) can be associated with postoperative respiratory complications that can be further compounded by obesity and use of anesthetic medications during surgery. There is marked variation in current practices regarding postoperative management of AT patients.

Study Impact: This study demonstrates the presence of marked residual OSA and sleep architecture abnormalities on the night of AT surgery in a pediatric obese population. It emphasizes the need to closely monitor these patients in the postoperative period.

Review Articles

Efficacy of the New Generation of Devices for Positional Therapy for Patients With Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis. 813-824.
Madeline J.L. Ravesloot, MD, PhD, MSc1; David White, MD2; Raphael Heinzer, MD, MPH3; Arie Oksenberg, PhD4; Jean-Louis Pépin, MD5

Case Reports

Severe Obstructive Sleep Apnea in a Child With Goldenhar Syndrome and Nasal Obstruction. 825-827.
Charlie Abraham, MD, MBA, FACP1; Jordan Virbalas, MD2; Lourdes M. DelRosso, MD, MSEd, FAASM2
Opioids Cause Central and Complex Sleep Apnea in Humans and Reversal With Discontinuation: A Plea for Detoxification. 829-833.
Shahrokh Javaheri, MD1,2; Sanjiv Patel, MD3

Sleep Medicine Pearls

Tympanic Membrane Perforation as a Complication of Continuous Positive Airway Pressure. 835-836.
David W. Chou, BS1; Colin Huntley, MD2; David Rosen, MD2

Letters to the Editor

Free Hypnotics and the Risks of Dementia. 837.
Walter James, MD, FAASM
Free Adverse Effects of Hypnotic Medications. 839.
Michael J. Sateia, MD1; Daniel J. Buysse, MD2; Andrew D. Krystal, MD, MS3; David N. Neubauer, MD4
Free Treatment of PTSD-Related OSA With CPAP is Associated With Only a Modest Improvement in PTSD: Possible Adjunctive Treatment With Mood Stabilizers. 841.
Madhulika A. Gupta, MD, FAASM, RST
Free Advancing Treatment of Comorbid PTSD and OSA. 843-844.
Lizabeth A. Goldstein, PhD1,2; Peter J. Colvonen, PhD3,4,5; Kathleen F. Sarmiento, MD, MPH3,6
Free Challenges in the Management of Sleep Apnea and PTSD: Is the Low Arousal Threshold an Unrealized Target?. 845-846.
Christopher J. Lettieri, MD, FCCP, FAASM; Jacob F. Collen, MD, FACP, FCCP; Scott G. Williams, MD, FACP
Free Should Hyperarousal and Sleep Fragmentation Be Additional Treatment Targets When Treating OSA in PTSD With CPAP?. 847.
Madhulika A. Gupta, MD, FAASM, RST
Free The Continued Search for Optimal Therapy in Patients With OSA and PTSD. 849.
Scott G. Williams, MD, FACP; Jacob F. Collen, MD, FACP, FCCP; Christopher J. Lettieri, MD, FCCP, FAASM

Book Reviews

Book Review of Wild Nights. 851-852.
Carlos H. Schenck, MD

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