Archive for September, 2007

People with early Parkinson’s disease report a higher than anticipated development or worsening of hallucinations, sleepiness, and swelling.

Researchers have identified factors that make people more likely to develop these problems, according to a study published in the July 10, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology.

"By identifying risk factors, it may help guide treatment decisions, allow for early intervention and possibly reduce disability," said study author Kevin Biglan, MD, MPH, with University of Rochester School of Medicine in Rochester, NY, and member of the American Academy of Neurology.

For the study, researchers reviewed the results of a four-year clinical trial involving 301 people with an average age of 61 who had early Parkinson’s disease. Half of the group received the drug levodopa; the other half took pramipexole. No one reported having hallucinations at the beginning of the study.

The study found nearly one-fifth developed hallucinations, more than one-third of the participants developed sleepiness, and nearly half developed swelling within four years of starting treatment. Multiple health problems, along with age, gender, initial type of treatment and cognitive status were identified as risk factors.

Patients with both Alzheimer disease and a sleep-related breathing disorder (SRBD) experience disrupted sleep, resulting in increased nocturnal awakenings and a decreased percentage of REM sleep.

However, in another example of the effectiveness of continuous positive airway pressure (CPAP), CPAP has been found to reduce the amount of time spent awake during the night, increase the time spent in deeper levels of sleep, and improve oxygenation, according to a research abstract presented at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, conducted by Jana R. Cooke, MD, of the University of California at San Diego, was focused on 48 adults, with an average age of 77.8 years, with Alzheimer disease and an SRBD. It was discovered that treating the sleep-related breathing disorder with CPAP resulted in these patients spending less time awake during the night as well as sleeping deeper.

"In general, improved sleep is associated with improvements in quality of life," said Cooke. "Clinicians should consider CPAP treatment for Alzheimer disease patients with a sleep-related breathing disorder, as the potential benefits may be significant."

The research found that snoring is in fact part of the spectrum of childhood allergic diseases.

So whilst the condition looks and sounds similar in adults and children it can have quite different causes and risk factors.

The study published in the latest edition of the international medical journal, Pediatric Pulmonology has established children with rhinitis who were first born, were exposed to maternal tobacco smoke during the first year of life and/or who had asthma and/or eczema at age five years were more likely to snore.

Breastfeeding, birth weight, body mass index at age 4.5 years and respiratory function whilst awake were found to be unrelated.

The study cohort was drawn from participants in the Australian Childhood Asthma Prevention Study (CAPS) - a randomised controlled trial of dietary intervention and house dust mite avoidance during the first five years of life.

219 children within the original study group had rhinitis and of these, 213 could provide information on snoring. Almost 60% of these children snored at least once per week including 26% who snored more than three nights per week. This is a very high prevalence in five year old children and is partly due to all of the children having rhinitis which is often found in children who snore.

A childhood sleep-related breathing disorder (SRBD) is known to have negative consequences on cognitive development, behavior, quality of life and utilization of health care resources.

However, a research abstract presented at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS), finds that breastfeeding may provide long-term protection against the incidence or severity of a childhood SRBD.

The study, conducted by Hawley E. Montgomery-Downs, PhD, of West Virginia University, focused on the parents of those children who underwent overnight polysomnography, who filled out a brief survey about whether the child had been breast, formula or both breast and formula fed as an infant. There were 197 surveys completed.

The average age of the children at the time of polysomnography was 6.7 years. Fifty-two percent of them were formula fed, 10 percent breast fed and 38 percent both breast and formula fed as infants.

It was discovered that children who were breast fed for at least two months as infants had lower rates and less severe measures of an SRBD, and that breast feeding beyond two months provided additional benefits for reduced disorder severity.