Subject(s)
Antidepressive Agents, Second-Generation , Depressive Disorder, Major , Sleep Initiation and Maintenance Disorders , Antidepressive Agents, Second-Generation/adverse effects , Bupropion/adverse effects , Delayed-Action Preparations/therapeutic use , Depressive Disorder, Major/drug therapy , Humans , Sleep Initiation and Maintenance Disorders/chemically induced , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/drug therapySubject(s)
Antidepressive Agents/therapeutic use , Mirtazapine/therapeutic use , Sleep Initiation and Maintenance Disorders/drug therapy , Suicidal Ideation , Adult , Aged , Depressive Disorder/complications , Depressive Disorder/drug therapy , Depressive Disorder/psychology , Humans , Male , Middle Aged , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/psychologyABSTRACT
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.
Subject(s)
Continuous Positive Airway Pressure/psychology , Dissociative Identity Disorder/complications , Patient Compliance/psychology , Sleep Apnea, Obstructive/psychology , Female , Humans , Middle Aged , Sleep Apnea, Obstructive/complicationsABSTRACT
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.
Subject(s)
Sleep Apnea, Obstructive/etiology , Adolescent , Head , Humans , Male , Polysomnography , Severity of Illness Index , Sleep Apnea, Obstructive/diagnosis , Snoring/etiology , Supine Position , Video RecordingABSTRACT
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.
