Bipolar Disorder, Religion, and Spirituality: A Scoping Review.

Mental health clinicians frequently study the religion and spirituality (R/S) of their patients. There is, however, a paucity of empirical research concerning R/S of patients with bipolar disorder. This lack is exacerbated by the absence of an evaluation of how these studies relate to each other.

Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).

Study Objectives: Hypocapnia is an important mediator of sleep-dependent respiratory instability. Positive pressure-associated ventilatory control instability results in poor control of sleep apnea and persistent sleep fragmentation. We tested the adjunctive efficacy of low volumes of dead space (enhanced expiratory rebreathing space [EERS]) using a non-vented mask to minimize sleep hypocapnia.

Differentiating obstructive from central and complex sleep apnea using an automated electrocardiogram-based method.

Study Objectives: Complex sleep apnea is defined as sleep disordered breathing secondary to simultaneous upper airway obstruction and respiratory control dysfunction. The objective of this study was to assess the utility of an electrocardiogram (ECG)-based cardiopulmonary coupling technique to distinguish obstructive from central or complex sleep apnea.

Design: Analysis of archived polysomnographic datasets.

Before depression: the medieval vice of acedia.

Given renewed interest in the role of human action in the development of depression, I re-examine a tradition in the West which interpreted phenomena akin to the symptoms and signs of modern depression as "a spiritual disease." In medieval Europe, acedia was a vice, an undesirable trait of character acquired in the course of living a life. Persons suffering from the vice of acedia were implicated as agents in its development and to some extent responsible for overcoming it.

Recognition and management of complex sleep-disordered breathing.

Purpose Of Review: The recent rapid evolution of our understanding of the mechanisms involved in control of respiration during sleep has yielded new insights to guide our care of difficult-to-treat sleep apnea patients with complex sleep-disordered breathing. This review will describe these recent advances in the literature and suggest a model for their incorporation into clinical practice.

Recent Findings: Control of respiration during sleep shows amplified instability relative to that seen during wake in these difficult patients.

Low-concentration carbon dioxide is an effective adjunct to positive airway pressure in the treatment of refractory mixed central and obstructive sleep-disordered breathing.

Objectives: To assess the efficacy of added carbon dioxide as adjunctive therapy to positive airway pressure-refractory mixed obstructive and central sleep-disordered breathing, using a prototype device-the positive airway pressure gas modulator.

Design: Open-label evaluation of low concentrations of carbon dioxide added to a positive airway pressure circuit.

Setting: Physician-attended polysomnographic titration in a free-standing sleep laboratory with end-tidal and transcutaneous carbon-dioxide monitoring.