To evaluate facial 3D stereophotogrammetry's effectiveness as a screening tool for pediatric obstructive sleep apnea (OSA) when used by dental specialists. One hundred forty-four subjects aged 2-17 years, including children fully diagnosed with pediatric OSA through nocturnal polysomnography (nPSG) or at high- or low-risk of pediatric OSA, participated in this study. 3D stereophotogrammetry, Craniofacial Index (CFI) and Pediatric Sleep Questionnaire (PSQ) were obtained from all participants. Ten dental specialists with interest in pediatric sleep breathing disorders classified OSA severity twice. Once, based only on 3D stereophotogrammetry, and then based on 3D stereophotogrammetry, CFI and PSQ. https://www.selleckchem.com/Androgen-Receptor.html Intra-rater and inter-rater reliability, and diagnostic accuracy of pediatric OSA classification, were calculated. A cluster analysis was performed to identify potential homogeneous pediatric OSA groups based on their craniofacial features classified through the CFI. Intra-rater and inter-rater agreement suggest interested in SDB. Some craniofacial traits, more specifically significant sagittal overjet discrepancies and an arched palate, seem to influence participating dental specialist's classification. There is minimal guidance around how to optimize inspiratory positive airway pressure (IPAP) levels during use of adaptive servo ventilation (ASV) in clinical practice. This real-world data analysis investigated the effects of IPAP and minimum pressure support (PSmin) settings on respiratory parameters and adherence in ASV-treated patients. A US-based telemonitoring database was queried for patients starting ASV between 1 August 2014 and 30 November 2019. Patients meeting the following criteria were included US-based patients aged ≥18 years; AirCurve 10 device (ResMed); and ≥1 session with usage of ≥1 hour in the first 90 days. Key outcomes were mask leak and residual apnea-hypopnea index (AHI) at different IPAP settings, adherence and therapy termination rates, and respiratory parameters at different PSmin settings. 63,996 patients were included. Higher IPAP was associated with increased residual AHI and mask leak but did not impact device usage per session (average >6 h/day at all IPAP settings; 6.7 h/day at 95 percentile IPAP 25 cmH O). There were no clinically relevant differences in respiratory rate, minute ventilation, leak and residual AHI across all possible PSmin settings. Patients with a higher 95 percentile IPAP or with PSmin of 3 cmH O were most likely to remain on ASV therapy at 1 year. Our findings showed robust levels of longer-term adherence to ASV therapy in a large group of real-world patients. There were no clinically important differences in respiratory parameters across a range of pressure and pressure settings. Future work should focus on the different phenotypes of patients using ASV therapy. Our findings showed robust levels of longer-term adherence to ASV therapy in a large group of real-world patients. There were no clinically important differences in respiratory parameters across a range of pressure and pressure settings. Future work should focus on the different phenotypes of patients using ASV therapy.Narcolepsy type 1 (NT1) results from probable autoimmune disruption of hypothalamic hypocretinergic neurons. Secondary narcolepsy can occur as a result of other conditions affecting the central nervous system, including limbic paraneoplastic encephalitis (PE). We report the case of a 19-year-old patient presenting with acute-onset diurnal hypersomnolence, hyperphagia, sexual dysfunction and psychiatric disturbances. Further investigations revealed a limbic PE associated with mediastinal thymic seminoma. Tumour removal and immunosuppressive treatment resulted in a partial benefit on psychiatric disturbances but did not improve daytime sleepiness. A comprehensive sleep assessment led to the diagnosis of secondary NT1 with reduced CSF hypocretin-1 levels and revealed the presence of the HLA DQB1*0602 allele, typically associated with idiopathic narcolepsy, for which we hypothesize a possible immunopathogenic role. Sodium oxybate was successfully administered. Narcolepsy is often overlooked in patients with limbic PE. A prompt assessment and an adequate symptomatic treatment can improve the disease burden. References for the evaluation of obstructive sleep apnea (OSA) often exceed the sleep clinic's capacity. We aimed to assess the non-inferiority of a nurse-communicated model, compared with a traditional physician-led model, for the initial management of uncomplicated OSA in the sleep clinic. In this non-inferiority, open-label randomized controlled trial, patients referred to the for the evaluation of uncomplicated OSA (home sleep apnea test with respiratory event index ≥ 20 events/hour), were randomized to a nurse-communicated or a physician-led management. The primary endpoint was non-inferiority in the mean change from baseline of the Epworth Sleepiness Scale (ESS) score at 3 and 6 months, assuming a non-inferiority margin of -2.0 points. Secondary outcomes included quality of life [Quebec Sleep Questionnaire (QSQ)] and positive airway pressure (PAP) adherence. 200 participants were randomized to a nurse-communicated (n=101) or physician-led management (n=99). Overall, 48 participants were lost at fo nurse-communicated management was non-inferior to physician-led management, in terms of sleepiness, quality of life, as well as PAP adherence at 6 months. Whether the association between sleep-disordered breathing (SDB) and cardiovascular disease (CVD) is independent of comorbid risk factors for CVD is controversial. The objective of this study is to elucidate whether the association between SDB severity and the surrogate markers of CVD evets differs in relation to the number of comorbidities. This cross-sectional study included 7731 participants. Severity of SDB was determined by the oxygen desaturation index adjusted by actigraph-measured objective sleep time. Participants were stratified according to SDB severity and the number of comorbidities (hypertension, diabetes, dyslipidemia and obesity), and the associations between the maximum value of intima-media thickness of the common carotid artery (CCA-IMT-max), brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) were evaluated. Among participants with no risk factor, CCA-IMT-max increased according to SDB severity (n = 1022, <0.0001). Even after the matching of background, the median CCA-IMT-max value was 14% higher in moderate-severe SDB cases than those without SDB (n=45 in each group, =0.