Publications by authors named "E Kunstler"

Article Synopsis
  • Excessive daytime sleepiness can be a symptom of post-COVID syndrome and narcolepsy, a rare sleep disorder that may have an autoimmune cause.
  • A case study of a 25-year-old male showed he developed narcolepsy type II after COVID-19, confirmed through sleep tests and neuropsychological evaluations.
  • Treatment with high-dose corticosteroids led to an immediate improvement in his symptoms, suggesting that immunosuppressive therapy might be a viable option for managing narcolepsy following COVID-19.
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Objective: The pathogenesis of different narcolepsy phenotypes remains unclear. In rare cases, narcolepsy can be attributable to secondary brain pathologies affecting the midbrain. These cases may elucidate the pathological background and the treatment of narcolepsy, but are often limited by poor objective symptom characterization and effects of therapeutic intervention, especially by modern diagnostic standards.

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Purpose: The autonomic nervous system interacts with the immune system via the inflammatory response. Heart rate variability (HRV), a marker of autonomic activity, is associated with inflammation, and nosocomial infections/sepsis, and has clinical implications for the monitoring of at-risk patients. Due to the vagal tone's influence on anti-inflammatory immune response, this association may predominately be reflected by vagally-mediated HRV indices.

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Study Objectives: Persistent insomnia disorder (pID) is linked to neurocognitive decline and increased risk of Alzheimer's Disease (AD) in later life. However, research in this field often utilizes self-reported sleep quality data - which may be biased by sleep misperception - or uses extensive neurocognitive test batteries - which are often not feasible in clinical settings. This study therefore aims to assess whether a simple screening tool could uncover a specific pattern of cognitive changes in pID patients, and whether these relate to objective aspect(s) of sleep quality.

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A 37-year-old male patient was referred to our sleep laboratory with suspected sleep-disordered breathing. His partner reported periods of breathing arrest accompanied by an odd expiratory noise during sleep, occurring on a near to weekly basis. The patient stated that he was able to sleep well, did not have excessive daytime sleepiness, and was not subjectively aware of any disordered breathing at night.

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