ABSTRACT
Sparse literature exists on the effects of obstructive sleep apnea (OSA) treatment on symptoms of attention deficit hyperactivity disorder (ADHD) in adults. This article aims to bring to the fore the relationship between ADHD and OSA in adults and the implications of the treatment of OSA on the symptoms of ADHD. A case of an adult who was previously diagnosed with attention deficit disorder in childhood with symptom improvement following OSA treatment is reported. Considering the complex relationship between ADHD and sleep problems, the recommendation to screen for OSA and other sleep problems among persons being assessed for ADHD should be upheld. This article advocates for more research on the effect of the treatment of OSA on ADHD symptoms. CITATION: Awadalla TO, Igwe O, Okeafor CU, Attarian HP. Improvement of attention deficit disorder symptoms after treatment of obstructive sleep apnea in an adult: a case report and mini review. J Clin Sleep Med. 2024;20(5):825-827.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Sleep Apnea, Obstructive , Humans , Male , Attention Deficit Disorder with Hyperactivity/complications , Continuous Positive Airway Pressure/methods , Polysomnography , Sleep Apnea, Obstructive/therapy , Sleep Apnea, Obstructive/complications , Treatment Outcome , Young AdultABSTRACT
In recent years, there has been a great deal of interest in the effects of calorie reduction (calorie restriction) and fasting on depression. In the current paper, we have reviewed the literature in this area, with discussion of the possible neurobiological mechanisms involved in calorie restriction and intermittent fasting. Factors which may play a role in the effects of these dietary manipulations on health include changes involving free fatty acids, ketone bodies, neurotransmitters, cyclic adenosine monophosphate response element binding protein (CREB), brain-derived neurotrophic factor (BDNF), cytokines, orexin, ghrelin, leptin, reactive oxygen species and autophagy. Several of these factors are potential contributors to improving symptoms of depression. Challenges encountered in research on calorie restriction and intermittent fasting are also discussed. Although much is now known about the acute effects of calorie restriction and intermittent fasting, further long term clinical studies are warranted.
Subject(s)
Caloric Restriction , Depression/diet therapy , Fasting/physiology , Animals , Brain-Derived Neurotrophic Factor/blood , Cytokines/blood , Humans , Ketone Bodies , OrexinsABSTRACT
OBJECTIVES: This retrospective clinical audit compared changes in community mental health service utilization before and during an economic recession in an oil sands region in Canada which was characterized by a doubling of unemployment rates and poor economic outlook. METHODS: Sociodemographic descriptors, psychiatric antecedents, clinical characteristics and follow-up care were compared before and during the recession for newly assessed patients in community mental health clinics located across a Northern Alberta oil mining region. Data were collected retrospectively as part of a clinical audit process and then analysed with descriptive statistics, cross-tabular univariate analyses with chi-square tests using SPSS version 20. RESULTS: A total of 1,465 patients were included. Sociodemographic factors disproportionately elevated during the recession included male sex, Caucasian ethnicity, own home ownership, higher levels of education and unemployment. More patients seeking mental health care were already taking psychotropic medications (e.g. antipsychotics, benzodiazepines and stimulants). At the same time, disproportionately fewer patients engaged in substance abuse or had a prior formal history of mental health problems. The referral reasons during recession were less likely to be associated with substance abuse or mood concerns and more likely for 'other' reasons. The patients seeking psychiatric help during a recession were disproportionately likely to be diagnosed with personality disorders and 'other' less common diagnostic categories and less likely to suffer from mood or trauma-related diagnoses. Referrals for counselling and social services were also disproportionately more common during the recession. CONCLUSION: This study provides a comprehensive description of longitudinal patterns of mental health service utilization before and during a recession. The findings provide important evidence for policy and planning decisions to encourage resource allocation to help promote accessibility of the most needed community mental health resources.
