ABSTRACT
Narcolepsy is the most common cause of excessive daytime sleepiness (EDS) following obstructive sleep apnea. Its treatment aims to reduce EDS and cataplexy, improve nighttime sleep disturbance, sleep paralysis and sleep-related hallucinations. Pitolisant (a histamine H3 receptor antagonist) and solriamfetol (a norepinephrine reuptake inhibitor) have recently been approved effective for narcolepsy in the United States and the European Union. Pitolisant has proved to be effective for both EDS and cataplexy. Besides being effective on EDS, solriamfetol seems to have advantages in abuse potential and withdrawal syndrome. As potential treatments for EDS and cataplexy associated with narcolepsy, several new drugs are being developed and tested. These new drugs include new hydroxybutyrate preparations (controlled release sodium hydroxybutyrate FT218, low sodium hydroxybutyrate JZP-258), selective norepinephrine reuptake inhibitor (AXS-12), and modafinil combined with astroglial junction protein inhibitor (THN102). This paper reviews the recently approved drugs and potential treatments for narcolepsy.
ABSTRACT
OBJECTIVE@#To investigate the clinical features and implication of restless legs syndrome (RLS) in ischemic stroke patients.@*METHODS@#A total of 199 ischemic stroke patients were enrolled and assessed by polysomnography (PSG). RLS was identified according to criteria of International Restless Legs Syndrome Study Group. Epworth Sleepiness Scale (ESS), Mini-mental State Examination (MMSE) and Patient Health Questionnaire (PHQ-9) were used to evaluate the sleep quality, cognitive function and post-stroke depression, respectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological function 3 months after stroke onset. Gender-and age-matched non-ischemic stroke patients with RLS (primary PLS) were selected as controls.@*RESULTS@#Twenty-two cases of RLS were identified among 199 ischemic stroke patients (11.1%). Generalized linear model and logistic regression showed that low serum ferritin level (=-133.3 mg/L, 95%:-200.4--0.1, <0.01), subcortical infarction (=4.05, 95%:1.15-14.18, <0.05) and female (=2.54, 95%:1.04-6.23, <0.05) were identified as the risk factors of RLS in ischemic stroke patients. Compared with ischemic stroke patients without RLS, ESS increased by 4.37 (95%:2.33-6.41, <0.01), PHQ-9 increased by 2.17 (95%:0.39--3.94, <0.05), and reduced NIHSS from the baseline deceased by 0.97 (95%:-1.79--0.15, <0.05) in ischemic stroke patients with RLS. In addition, the incidence of moderate-severe depression increased (=4.27, 95%:1.40-13.10, <0.05) in ischemic stroke patients with RLS. The index of periodic leg movements of sleep (PLMS) with arousal in ischemic stroke patients with RLS was significantly higher than that in patients with primary RLS (=12.85, 95%:2.04-23.67, <0.05).@*CONCLUSIONS@#RLS is common in ischemic stroke patients and has adverse influences on patients.
Subject(s)
Female , Humans , Male , Brain Ischemia , Pathology , Depression , Polysomnography , Restless Legs Syndrome , Pathology , Stroke , PathologyABSTRACT
Objective To investigate the clinical effect of glutamine on parenteral alimentation in patients with severe craniocerebral injury in ICU. Methods 120 patients with severe brain injury in our hospital from November 2013 to November 2014 were selected as the research object.According to the random number table method, the 120 patients were divided into experimental group and control group, 60 cases in each group.The patients in the experimental group received glutamine parenteral nutrition support, while the control group received conventional parenteral nutritional support.The serum total protein, albumin, the complications and malnutrition-inflammation score(MIS) scores of the two groups were compared.Results The serum total protein and serum albumin levels of the experimental group post-treatment were significant higher than those in the control group (P<0.001).The complication rate in the experimental group was 15.0%, significantly lower than the control group of 55.0%(χ2 =21.099,P<0.001).The patients of normal MIS score in the experimental group were obviously superior to the control group ( 70.0% vs.33.3%, χ2 =16.151, P <0.001 ). Conclusion Adding glutamine to parenteral nutrition support therapy in the treatment of patients with severe craniocerebral injury can effectively improve the nutritional status after operation and strengthen nutrition support.