The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
James A Feinstein - One of the best experts on this subject based on the ideXlab platform.
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management of Sleep Disorders in children with neurodevelopmental Disorders a review
Pharmacotherapy, 2016Co-Authors: Allison B Blackmer, James A FeinsteinAbstract:Neurodevelopmental Disorders (NDDs) are defined as a group of Disorders caused by changes in early brain development, resulting in behavioral and cognitive alterations in sensory and motor systems, speech, and language. NDDs affect approximately 1-2% of the general population. Up to 80% of children with NDDs are reported to have disrupted Sleep; subsequent deleterious effects on daytime behaviors, cognition, growth, and overall development of the child are commonly reported. Examples of NDDs discussed in this review include autism spectrum disorder, cerebral palsy, Rett syndrome, Angelman syndrome, Williams syndrome, and Smith-Magenis syndrome. The etiology of Sleep Disorders in children with NDDs is largely heterogeneous and disease specific. The diagnosis and management of Sleep Disorders in this population are complex, and little high-quality data exist to guide a consistent approach to therapy. Managing Sleep Disorders in children with NDDs is critical both for the child and for the family but is often frustrating due to the refractory nature of the problem. Sleep hygiene must be implemented as first-line therapy; if Sleep hygiene alone fails, it should be combined with pharmacologic management. The available evidence for the use of common pharmacologic interventions, such as iron supplementation and melatonin, as well as less common interventions, such as melatonin receptor agonists, clonidine, gabapentin, hypnotics, trazodone, and atypical antipsychotics is reviewed. Further, parents and caregivers should be provided with appropriate education on the nature of the Sleep Disorders and the expectation for modest pharmacologic benefit, at best. Additional data from well-designed trials in children with NDDs are desperately needed to gain a better understanding of Sleep pharmacotherapy including efficacy and safety implications. Until then, clinicians must rely on the limited available data, as well as clinical expertise, when managing Sleep Disorders in the population of children with NDDs.
Christopher T Chan - One of the best experts on this subject based on the ideXlab platform.
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Sleep Disorders in end stage renal disease markers of inadequate dialysis
Kidney International, 2006Co-Authors: Jeff Perl, Mark Unruh, Christopher T ChanAbstract:Excessive daytime Sleepiness and Sleep Disorders, including Sleep apnea syndrome, restless legs syndrome, and periodic limb movement disorder, occur with increased frequency in patients with end-stage renal disease (ESRD). The detection and management of Sleep Disorders in ESRD patients is often challenging but may have significant clinical benefits. Some of the poor quality of life in ESRD may be attributed to the presence of concomitant Sleep Disorders, yet the classical symptoms of Sleep Disorders (poor concentration, daytime Sleepiness, and insomnia) are often ascribed to the uremic syndrome itself. Conventional risk factors and screening tools used in the diagnosis of Sleep Disorders seem to have limited applicability in dialysis patients implicating the unique pathophysiology of Sleep Disorders in ESRD. Emerging evidence suggests that Sleep apnea may contribute to the augmented cardiovascular event rates and to the accelerated development of atherosclerosis in ESRD. Whether treatment of Sleep Disorders in ESRD patients can affect the high morbidity and mortality of ESRD patients has yet to be elucidated. To date, conventional renal replacement therapies do not appear to have a significant impact on the treatment of Sleep Disorders in ESRD. The promising therapeutic effects of optimal uremia control in the forms of nocturnal hemodialysis and renal transplantation on Sleep Disorders require further mechanistic and clinical studies.
Gian Luigi Gigli - One of the best experts on this subject based on the ideXlab platform.
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Sleep Disorders in patients with end stage renal disease undergoing dialysis therapy
Nephrology Dialysis Transplantation, 2006Co-Authors: Giovanni Merlino, Antonella Piani, Pierluigi Dolso, Massimo Adorati, Iacopo Cancelli, Mariarosaria Valente, Gian Luigi GigliAbstract:Background. Many patients with end stage renal disease (ESRD) undergoing dialysis therapy suffer from Sleep disturbances. The aim of this study was to investigate the prevalence of Sleep Disorders in a large population of uraemic patients recruited from 20 different dialytic centres in Triveneto. Methods. 883 patients on maintenance dialysis were enrolled in the study. Demographic, lifestyle, renal and dialysis data were recorded. Renal parameters were compared with the database of the Veneto Dialysis Register. Using a self-administered questionnaire we assessed the presence of the following Sleep Disorders: insomnia, restless leg syndrome (RLS), obstructive Sleep apnoea syndrome (OSAS), excessive daytime Sleepiness (EDS), possible narcolepsy, Sleepwalking, nightmares and possible rapid eye movement behaviour Disorders (RBD). Moreover, in order to determine the prevalence of Sleep disturbances and the possible effect of demographic or clinical data on Sleep, we divided our population into two groups: with (Sleepþ) and without (Sleep� ) Sleep Disorders. Results. The questionnaire revealed the presence of insomnia (69.1%), RLS (18.4%), OSAS (23.6%), EDS (11.8%), possible narcolepsy (1.4%), Sleepwalking (2.1%), nightmares (13.3%) and possible RBD (2.3%). Eighty percent demonstrated Sleepþ, having at least one Sleep disorder. Independent risk factors for Sleep Disorders were advanced age (P<0.001), excessive alcohol intake (P<0.04), cigarette smoking (P<0.006), polyneuropathy (P<0.05) and dialysis shift in the morning (P<0.001). Conclusions. The questionnaire showed a high presence of Sleep disruption in dialytic populations. Awareness by Italian nephrologists regarding Sleep disruption seems to be insufficient. Our data might help nephrologists to deal with uraemic patients with possible Sleep Disorders. Concerning the high prevalence of possible narcolepsy, further studies using polysomnographic records are necessary to confirm our results.
Sonia Ancoliisrael - One of the best experts on this subject based on the ideXlab platform.
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Sleep Disorders in the elderly
Indian Journal of Medical Research, 2010Co-Authors: Susan K Roepke, Sonia AncoliisraelAbstract:Nearly half of older adults report difficulty initiating and maintaining Sleep. With age, several changes occur that can place one at risk for Sleep disturbance including increased prevalence of medical conditions, increased medication use, age-related changes in various circadian rhythms, and environmental and lifestyle changes. Although Sleep complaints are common among all age groups, older adults have increased prevalence of many primary Sleep Disorders including Sleep-disordered breathing, periodic limb movements in Sleep, restless legs syndrome, rapid eye movement (REM) Sleep behaviour disorder, insomnia, and circadian rhythm disturbances. The present review discusses age-related changes in Sleep architecture, aetiology, presentation, and treatment of Sleep Disorders prevalent among the elderly and other factors relevant to ageing that are likely to affect Sleep quality and quantity.
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Sleep Disorders in the older adult a mini review
Gerontology, 2010Co-Authors: Ariel B Neikrug, Sonia AncoliisraelAbstract:Approximately 50% of older adults complain of difficulty Sleeping. Poor Sleep results in increased risk of significant morbidity and mortality. The decrements seen in the Sleep of the older adult are often due to a decrease in the ability to get needed Sleep. However, the decreased ability is less a function of age and more a function of other factors that accompany aging, such as medical and psychiatric illness, increased medication use, advances in the endogenous circadian clock and a higher prevalence of specific Sleep Disorders. Given the large number of older adults with Sleep complaints and Sleep Disorders, there is a need for health care professionals to have an increased awareness of these Sleep disturbances to better enable them to assess and treat these patients. A thorough Sleep history (preferably in the presence of their bed partner) is required for a proper diagnosis, and when appropriate, an overnight Sleep recording should be done. Treatment of primary Sleep problems can improve the quality of life and daytime functioning of older adults. This paper reviews the diagnoses and characteristics of Sleep Disorders generally found in the older adult. While aimed at the practicing geriatrician, this paper is also of importance for any gerontologist interested in Sleep.
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evidence based recommendations for the assessment and management of Sleep Disorders in older persons
Journal of the American Geriatrics Society, 2009Co-Authors: Sonia Ancoliisrael, Harrison G Bloom, Imran Ahmed, Cathy A Alessi, Daniel J Buysse, Meir H Kryger, Barbara Phillips, Michael J ThorpyAbstract:Sleep-related Disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between Sleep Disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with Sleep Disorders. Conversely, individuals with any of these diseases are at a higher risk of developing Sleep Disorders. The goals of this article are to help guide clinicians in their general understanding of Sleep problems in older persons, examine specific Sleep Disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of Sleep Disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific Sleep Disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert-based recommendations, developed by a group of Sleep and clinical experts, are presented after each Sleep disorder.
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diagnosis and treatment of Sleep Disorders in older adults
FOCUS, 2009Co-Authors: Sonia Ancoliisrael, Liat AyalonAbstract:Among the most common complaints of older adults are difficulty initiating or maintaining Sleep. These problems result in insufficient Sleep at night, which then results in an increased risk of falls, difficulty with concentration and memory, and overall decreased quality of life. Difficulties Sleeping, however, are not an inevitable part of aging. Rather, these Sleep complaints are often secondary to medical and psychiatric illness, the medications used to treat these illnesses, circadian rhythm changes, or other Sleep Disorders. The task for the geriatric psychiatrist is to identify the causes of these complaints and then initiate appropriate treatment. (Reprinted with permission from American Journal of Geriatric Psychiatry 2006; 14:95–103)
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diagnosis and treatment of Sleep Disorders in older adults
American Journal of Geriatric Psychiatry, 2006Co-Authors: Sonia Ancoliisrael, Liat AyalonAbstract:Among the most common complaints of older adults are difficulty initiating or maintaining Sleep. These problems result in insufficient Sleep at night, which then results in an increased risk of falls, difficulty with concentration and memory, and overall decreased quality of life. Difficulties Sleeping, however, are not an inevitable part of aging. Rather, these Sleep complaints are often secondary to medical and psychiatric illness, the medications used to treat these illnesses, circadian rhythm changes, or other Sleep Disorders. The task for the geriatric psychiatrist is to identify the causes of these complaints and then initiate appropriate treatment.
Allison B Blackmer - One of the best experts on this subject based on the ideXlab platform.
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management of Sleep Disorders in children with neurodevelopmental Disorders a review
Pharmacotherapy, 2016Co-Authors: Allison B Blackmer, James A FeinsteinAbstract:Neurodevelopmental Disorders (NDDs) are defined as a group of Disorders caused by changes in early brain development, resulting in behavioral and cognitive alterations in sensory and motor systems, speech, and language. NDDs affect approximately 1-2% of the general population. Up to 80% of children with NDDs are reported to have disrupted Sleep; subsequent deleterious effects on daytime behaviors, cognition, growth, and overall development of the child are commonly reported. Examples of NDDs discussed in this review include autism spectrum disorder, cerebral palsy, Rett syndrome, Angelman syndrome, Williams syndrome, and Smith-Magenis syndrome. The etiology of Sleep Disorders in children with NDDs is largely heterogeneous and disease specific. The diagnosis and management of Sleep Disorders in this population are complex, and little high-quality data exist to guide a consistent approach to therapy. Managing Sleep Disorders in children with NDDs is critical both for the child and for the family but is often frustrating due to the refractory nature of the problem. Sleep hygiene must be implemented as first-line therapy; if Sleep hygiene alone fails, it should be combined with pharmacologic management. The available evidence for the use of common pharmacologic interventions, such as iron supplementation and melatonin, as well as less common interventions, such as melatonin receptor agonists, clonidine, gabapentin, hypnotics, trazodone, and atypical antipsychotics is reviewed. Further, parents and caregivers should be provided with appropriate education on the nature of the Sleep Disorders and the expectation for modest pharmacologic benefit, at best. Additional data from well-designed trials in children with NDDs are desperately needed to gain a better understanding of Sleep pharmacotherapy including efficacy and safety implications. Until then, clinicians must rely on the limited available data, as well as clinical expertise, when managing Sleep Disorders in the population of children with NDDs.
