In narcolepsy with https://ecosoberhouse.com/ cataplexy, pharmacological treatment for daytime sleepiness involves modafinil or amphetamine-like stimulants, which likely act through increasing dopamine transmission. Cataplexy and abnormal REM sleep symptoms, sleep paralysis and hallucinations, are typically treated with tricyclic antidepressants or serotonin and norepinephrine reuptake inhibitors. Sodium oxybate, or gamma hydroxybutyric acid, is also used at night to consolidate disturbed nocturnal sleep. Even in the case of narcolepsy in which the disorder is caused by hypocretin deficiency, current treatment does not aim at improving the defective neurotransmission (Mignot et al., 1993; Nishino and Mignot, 1997; Wisor et al., 2001). Behavioral measures, such as napping, support groups, and work arrangements are helpful but rarely sufficient. In most cases, pharmacological treatment is needed (Nishino and Mignot, 1997; Lammers and Overeem, 2003).
Description of studies
In Figure 9, Figure 10, and Figure 11, we observed slight asymmetry in the funnel plot that was probably due to heterogeneity rather than to publication bias. We noted some overlap of data points in some funnel plots, indicating that some of the included studies were of similar size. According to Chapter 10 of the Cochrane Handbook for Systematic Reviews of Interventions (Higgins 2011), a funnel plot asymmetry test should not be used if all studies are of similar size. It is recommended that there should be at least 10 studies reporting each of the subgroups in question (Deeks 2011).
Alcohol Consumption and CHD
Narcolepsy and hypersomnia can affect children, adolescents, adults, and older persons. The prevalence of narcolepsy with definite cataplexy has been documented in adults by numerous population-based studies and occurs in 0.02 to 0.05 percent of the population of Western Europe and North America (Mignot, 1998). In contrast, very little is known about the prevalence of narcolepsy without cataplexy. Recent studies using the MSLT indicate that approximately 3.9 percent of the general population has MSLT score abnormalities consistent with narcolepsy without cataplexy (Singh et al., effects of alcohol on blood pressure 2005).
- Refer to Characteristics of included studies and Table 4 for further details regarding these studies.
- The I² statistic was used to interpret the level of heterogeneity (Higgins 2011).
- For example, during daytime wakefulness, people with OSA have higher sympathetic activity (Somers, et al., 1995) and heightened chemoreflex sensitivity, which in turn generates an increased ventilatory response (Narkiewicz et al., 1999).
- The syndrome is currently the third most common cause of infant death in the United States (CDC, 2006), responsible for approximately 3,000 infant deaths a year in this country (NICHD, 2006b).
- Infections caused by bacterial strains, viruses, and parasites may result in changes to sleep patterns.
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Sleep patterns are affected by abnormalities caused by neurodegeneration in regions of the brain that are involved in regulating the sleep-wake cycle. Dopaminergic neurons in the substantia nigra are dramatically reduced in number, as are noradrenerics neurons in the locus coeruleus (Jellinger, 1986) and cholinergic neurons in the pedunculopontine nucleus (Zweig et al., 1989). They found that Lewy body degeneration begins in the lower brainstem and ascends to involve the substantia nigra only after several years, consistent with observations that REM alterations may precede the movement disorder by several years in many Parkinson’s disease patients. REM sleep behavioral disorder is often seen in patients with Parkin son’s disease and other parkinsonian syndromes, such as multiple systems atrophy and progressive supranuclear palsy. The ability to ameliorate the symptoms of REM sleep behavioral disorder with dopaminergic agonist drugs suggests that it may be an early sign of damage to the dopaminergic system (Trampus et al., 1991).
- According to the World Health Organization (WHO), around 2.3 billion people globally drink alcohol, and most of them are from the European region.
- The Sleep Heart Health Study is a community-based multicenter study of more than 6,000 middle-aged and older adults whose apnea-hypopnea index was measured by polysomnography.
- Snoring, which is produced by vibrations of the soft tissues, is a good marker for OSA (Netzer, et al., 2003).
- We (ST and CT) assessed the risk of bias of included studies independently using the Cochrane risk of bias tool (version 1) according to Chapter 8 of the Cochrane Handbook for Systematic Reviews of Interventions for the following domains (Higgins 2011).
- Catching up on sleep on the weekends—a popular remedy for sleep loss—does not return individuals to baseline functioning (Szymczak et al., 1993; Dinges et al., 1997; Klerman and Dijk, 2005; Murdey et al., 2005).
- Activation of PKCε may protect the myocardium against ischemia−reperfusion injury by stimulating the opening of mitochondrial ATP-sensitive potassium channels.
Because women could be affected differently by alcohol than men, future RCTs in women are needed. If future RCTs include both men and women, it is important that their blood pressure and heart rate readings are reported separately. Although eligible studies included East Asian, Latino, and Caucasian populations, they lacked African, South Asian, and Native Hawaiian/other Pacific Islander representation. Most of the hypertensive participants in the included studies were Japanese, so it is unclear if the difference in blood pressure between alcohol and placebo groups was due to the presence of genetic variants or the presence Substance abuse of hypertension.
Other risk factors for insomnia include family history of insomnia (Dauvilliers et al., 2005), stressful life styles, medical and psychiatric disorders, and shift work (Edinger and Means, 2005). Although adolescent age is not viewed a risk factor, insomnia has rarely been studied in this age group. Many of the studies find graded associations, insofar as the greater the degree of sleep deprivation, the greater the apparent adverse effect (although the difference may not reach statistical significance).
