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In hypoxemia, nifedipine did not affect fetal blood pressure or placental hemodynamics. Both in the sildenafil and nifedipine groups, fetal pO2 remained significantly lower at normoxemia + infusion phase than in the control group. Umbilical artery vascular impedance did not change during the experiment. DISCUSSION In fetal hypoxemia, sildenafil had detrimental effects on placental hemodynamics that disturbed placental gas exchange. Nifedipine did not alter placental hemodynamics in hypoxemia but disturbed placental gas exchange upon returning to normoxemia. Umbilical artery vascular impedance did not reflect alterations in placental hemodynamics. STUDY OBJECTIVES Herbal medicines are frequently used by adults with sleep difficulties. However, evidence of their efficacy is limited. Therefore, the goal of this study was to examine the sleep-enhancing effects of a standardised saffron extract (affron). METHODS This was a 28-day, parallel-group, double-blind, randomised controlled trial. Sixty-three healthy adults aged 18 to 70 with self-reported sleep problems were recruited and randomised to receive either saffron extract (affron, 14mg twice daily) or a placebo. Outcome measures included the Insomnia Severity Index (ISI) (primary outcome measure) collected at baseline, days 7, 14, 21, and 28; Restorative Sleep Questionnaire (RSQ) and Pittsburgh Sleep Diary (PSD) collected on days -1, 0, 3, 7, 14, 27, and 28. RESULTS Based on data collected from 55 participants, saffron was associated with greater improvements in ISI total score (p=.017), RSQ total score (p=.029), and PSD sleep quality ratings (p=.014) than the placebo. Saffron intake was well-tolerated with no reported adverse effects. CONCLUSIONS Saffron intake was associated with improvements in sleep quality in adults with self-reported sleep complaints. Further studies using larger samples sizes, treatment periods, objective outcome measures, and volunteers with varying demographic and psychographic characteristics are required to replicate and extend these findings. © 2020 American Academy of Sleep Medicine.STUDY OBJECTIVES Due to a limited number of pediatric sleep centers, the aim was to test the feasibility of ambulatory polysomnography (PSG-home) in a group of French children suspected of obstructive sleep apnea (OSA). METHODS Children undergoing one-night PSG-home, with device installed at the pediatric sleep physician's office, were prospectively included. General failure was considered when PSG-home recording captured 75% of the recording time. No OSA was defined as obstructive apnea-hypopnea index (OAHI) less then 1/h and respiratory related arousals index (RAI) less then 1/h, OSA was defined as upper airways resistance syndrome (UARS) as OAHI less then 1/h with RAI ≥ 1/h, or mild OSA (OAHI ≥ 1 to 5/h), moderate OSA (OAHI ≥ 5 to 10/h), or severe OSA (OAHI ≥ 10/h). Parents filled Severity Hierarchy Score questionnaire, Conners' Parent Rating Scale and Adapted Epworth Sleepiness Score. RESULTS 57 children aged 3-16 years were included. PSG-home was technically acceptable in 46 (81%). Failure due to nasal cannula was observed in 11% (n=6), oximetry in 7% (n=4), and for both in 2% (n=1) of cases. No difference in feasibility was found according to age, gender, OSA severity, or comorbidities. selleck products 14 (25%) children were categorized as no-OSA, 43 (75%) as OSA; 4 (7%) as UARS, 26 (46%) as mild, 6 (10%) as moderate and 7 (12%) as severe OSA. Neither questionnaires, nor clinical and physical examination predicted OSA diagnosis. CONCLUSION When installed at pediatric sleep's office and under parent monitoring, PSG-home is feasible and technically acceptable in children aged 3 to 16 years old. The short delay and feasibility provided by PSG-home could improve the management of children suspected of OSA. © 2020 American Academy of Sleep Medicine.STUDY OBJECTIVES To describe the feasibility, acceptability and preliminary efficacy of a novel Sleep Intervention for Kids and Parents (SKIP). Parent and child primary sleep outcomes were total sleep time (TST), wake after sleep onset (WASO), sleep efficiency (SE), and bedtime range. METHODS Children aged 6-11 years with asthma and one parent, both with behavioral sleep disturbance, enrolled in this single-group pilot. The 8-week shared management intervention included weekly online educational modules, goal setting, and progress reporting. Feasibility was measured by the number of dyads who were eligible, enrolled, and retained. Acceptability was measured by survey and semi-structured interview. TST, WASO, SE and bedtime range were measured by actigraphy at baseline, post-intervention, and 12-week follow-up. Mixed-effects regression models were used to determine change in sleep outcomes from baseline. RESULTS Thirty-three out of 39 eligible dyads enrolled; of 29 dyads that started the intervention, 25 (86%) completed all study visits. SKIP was acceptable for 61% of children and 92% of parents. Compared to baseline, at follow-up children had significantly improved WASO (-37 min [95% CI = -44.5 to -29.7], p less then .001), SE (5.4% [4.2 to 6.5], p less then .001), and bedtime range (-35.2 min [-42.9 to -27.5], p less then .001). Parents also had significantly improved WASO (-13.9 min [-19.5 to -8.2], p less then .001), SE (2.7% [1.7 to 3.7], p less then .001), and bedtime range (-35.3 min [-51.0 to -19.7], p less then .001). CONCLUSIONS SKIP was feasible, acceptable, and we observed improved child and parent sleep outcomes except TST. Following refinements, further testing of SKIP in a controlled clinical trial is warranted. © 2020 American Academy of Sleep Medicine.STUDY OBJECTIVES 1) to analyse agreement in degree of obstruction and configuration of the upper airway (UA) between jaw thrust and an oral device in situ during drug-induced sleep endoscopy (DISE) 2) to evaluate clinical decision making using jaw thrust or a boil-and-bite MAD, the MyTAP. METHODS single-centre prospective cohort study in obstructive sleep apnea patients who underwent DISE between January - July 2019. RESULTS Sixty-three patients were included. Agreement amongst observations in the supine position for degree of obstruction was 60% (N=36, k=0.41) at the level of the velum, 68.3% (N=41, k=0.35) for oropharynx, 58.3% (N=35, k=0.28) for tongue base, 56.7% (N=34, k=0.14) for epiglottis; in the lateral position 81.7% (N=49, k=0.32), 71.7% (N=43, k=0.36), 90.0% (N=54, k=0.23) and 96.7% (N=58, k= could not be determined) respectively. In the supine position agreement for configuration of obstruction at level of the velum was found in 20 of 29 patients (69.0%, k=0.41), in the lateral position 100%. Thirty patients would have been prescribed a MAD using jaw thrust, 34 using the boil-and-bite MAD as a screening instrument.
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