Assuntos
Antidepressivos de Segunda Geração , Transtorno Depressivo Maior , Distúrbios do Início e da Manutenção do Sono , Antidepressivos de Segunda Geração/efeitos adversos , Bupropiona/efeitos adversos , Preparações de Ação Retardada/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Humanos , Distúrbios do Início e da Manutenção do Sono/induzido quimicamente , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológicoAssuntos
Antidepressivos/uso terapêutico , Mirtazapina/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Ideação Suicida , Adulto , Idoso , Transtorno Depressivo/complicações , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/psicologiaRESUMO
ABSTRACT: We present a case of a patient with dissociative identity disorder and symptomatic sleep apnea who was treated with continuous positive airway pressure (CPAP). CPAP use depended upon which personality the patient exhibited but apnea reduction did not. This case illustrates in one individual how personality can positively or negatively affect CPAP adherence.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas/psicologia , Transtorno Dissociativo de Identidade/complicações , Cooperação do Paciente/psicologia , Apneia Obstrutiva do Sono/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Apneia Obstrutiva do Sono/complicaçõesRESUMO
CASE PRESENTATION: A 15-year-old boy presented as a direct referral for polysomnography for evaluation of snoring, unrefreshing sleep, and daytime sleepiness despite a self-reported average of 8 hours of sleep a night. The mother reported he snored intermittently, although there were no witnessed apneic episodes or fragmented sleep. He denied morning headaches. He reported that his sleep was generally unrefreshing and he would experience significant daytime sleepiness, especially after school or when doing his homework. However, his Epworth Sleepiness Scale score was only 3 of 24. He denied any symptoms consistent with a movement disorder, parasomnia, cataplexy, hypnogogic/hypnopompic hallucinations, sleep paralysis, circadian rhythm disorders, or insomnia. He reported a family history of sleep apnea in his grandfather.
Assuntos
Apneia Obstrutiva do Sono/etiologia , Adolescente , Cabeça , Humanos , Masculino , Polissonografia , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/diagnóstico , Ronco/etiologia , Decúbito Dorsal , Gravação em VídeoRESUMO
ABSTRACT: The objective of this report is to present clinical and scientific evidence to support the role of head position in the management of obstructive sleep apnea (OSA) with positive airway pressure. OSA, characterized by repetitive obstruction of the upper is a common medical condition associated with daytime somnolence, morning headaches, mood disturbances, and a variety of cardiopulmonary complications. The role of head position during obstructive respiratory events has been largely overlooked. We present a case where OSA severity decreased significantly with the head rotated in the right lateral position compared to head position in the neutral and left position. This case demonstrates an important influence of head position during continuous positive airway pressure titration, independent of trunk position and sleep stage, in patients with OSA, and highlights the utility of the video polysomnography for identifying the variant.
