Comorbid Insomnia and Sleep Apnea: Challenges and Treatments.

Insomnia and obstructive sleep apnea (OSA) are 2 of the most prevalent sleep disorders and frequently co-occur. Cognitive behavioral therapy for insomnia is the first line treatment for insomnia and has been shown to improve compliance with positive airway pressure therapy. Other alternatives to OSA treatment may have higher acceptance in those with comorbid insomnia and sleep apnea (COMISA).

Comorbid Insomnia and Sleep Apnea: Challenges and Treatments.

Insomnia and obstructive sleep apnea (OSA) are 2 of the most prevalent sleep disorders and frequently co-occur. Therapy can be challenging as treatment of 1 disease may worsen the other. Cognitive behavioral therapy for insomnia is the first-line treatment for insomnia and has been shown to improve compliance with positive airway pressure therapy.

OSA and cardiorespiratory fitness: a review.

Unlabelled: The effects of untreated obstructive sleep apnea (OSA) on cardiopulmonary function remain unclear. Cardiorespiratory fitness (CRF), commonly reflected by VO max measured during cardiopulmonary exercise testing, has gained popularity in evaluating numerous cardiopulmonary conditions and may provide a novel means of identifying OSA patients with the most clinically significant disease. This emerging testing modality provides simultaneous assessment of respiratory and cardiovascular function with results helping uncover evidence of evolving pathology in either organ system.

Noise-Induced Hearing Loss Treatment: Systematic Review and Meta-analysis.

Objective: To determine the efficacy of steroid and hyperbaric oxygen therapy (HBOT) in the setting of acute noise-induced hearing loss.

Methods: Systematic review and meta-analysis of noise-induced hearing loss treatment studies that reported on patients who (1) reported individual frequencies up to 8,000 Hz with mean and SDs; (2) were treated only with steroids ± HBOT; and (3) sustained acute acoustic trauma. The Newcastle-Ottawa Scale was used to assess risk of bias across cohorts.

Moderate to Severe Obstructive Sleep Apnea in Military Personnel Is Not Associated With Decreased Exercise Capacity.

Study Objectives: Studies of older and less active patients with obstructive sleep apnea (OSA) have reported decreased exercise capacity as measured by peak oxygen uptake (VO max) during cardiopulmonary exercise testing (CPET). We looked to determine whether VO max was decreased in younger patients with OSA who regularly exercise as would be encountered in the military.

Methods: We evaluated military personnel who had undergone pulmonary function testing (PFT), CPET, and polysomnography (PSG) as part of the larger STAMPEDE III study for comprehensive evaluation of exertional dyspnea.

Comparison of Forced and Slow Vital Capacity Maneuvers in Defining Airway Obstruction.

Background: Obstructive lung disease is diagnosed by a decreased ratio of FEV to the vital capacity (VC). Although the most commonly used VC is FVC, American Thoracic Society guidelines suggest alternative VCs, for example, slow VC (SVC), may offer a more-accurate evaluation of breathing capacity. There is recent evidence that using only FEV/FVC underrecognizes obstruction in subjects at high risk and who are symptomatic.

An Initial Report of Sleep Disorders in Women in the U.S. Military.

Introduction: Sleep disorders are increasingly recognized in active duty service members (ADSM). While there are multiple studies in male ADSM, there are limited data regarding sleep disorders in women in the military. The purpose of this study was to characterize sleep disorders in female ADSM referred for clinical evaluation to provide a better understanding of this unique population.

Approaching chronic sinusitis.

Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings.

Acute sinusitis.

Sinusitis is a common patient complaint that carries with it a large economic burden. It is one of the most common reasons patients visit their primary care physician. Acute bacterial rhinosinusitis (ABRS) can be distinguished from other forms of rhinosinusitis based on symptom duration of <4 weeks in a patient with purulent rhinorrhea associated with facial pain or pressure.

Association of statin use with cataracts: a propensity score-matched analysis.

Importance: Cataracts are a main cause of low vision; with the growing elderly population, the incidence of cataracts is likely to increase. Investigators have previously hypothesized that statin antioxidant effects may slow the natural aging process of the lens.

Objective: To compare the risks for development of cataracts between statin users and nonusers.