English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Journal of Clinical Sleep Medicine, Vol. 13, No. 11, 2017 apparent on the original visit. She came with a family member who reported sudden onset and rapid worsening of the patient’s cognition with new issues of confusion and disorientation. Short-term memory was poor, but long-term memory remained intact. Mini-Mental Status Examination yielded 2 out of 3 correct for recall. Hyperhidrosis was more prominent occurring during wakefulness hours as well as during sleep. The patient’s sleep-wake schedule was erratic with intermittent brief dozing day and night. Her sleep behaviors, such as dressing herself, combing her hair, and tying her shoes, were more complex. Initially dream enactment behaviors were simpler with calling out and sitting up in bed. She was unresponsive during these periods, amnestic for her actions in sleep, but awoke oriented. Despite efforts to use PAP, the patient would disassemble her interface while asleep. She reported horizontal diplopia, new-action tremor, and a 12-lb weight loss. Her pertinent vital signs were blood pressure 164/108 and heart rate 110 bpm. Comprehensive metabolic panel, thyroid function tests, urinalysis, and head computed tomography were unrevealing. Repeat PSG was attempted on continuous positive airway pressure with the patient demonstrating little sleep (Table 1). A 51-year-old woman presented with insomnia for 2 months and daytime sleepiness for 6 months. The patient attributed the insomnia to stress from recent life events. Her Epworth Sleepiness Scale score was 18 of 24. Observers of the patient reported loud snoring, apneas, kicking, and dream enactment. The patient had hyperhidrosis during sleep. Family history was positive for hypertension and dementia. Social history excluded tobacco, alcohol, or illicit drug usage. Review of symptoms was significant for heart palpitations, headaches, and depression. The patient’s medical history was negative with no medications. Physical examination revealed a blood pressure of 140/90 and body mass index of 30.3 kg/m2. The patient’s Mallampati score was class IV. Physical examination was otherwise unremarkable. Neurological examination showed normal reflexes, gait, and intellect with good recent and remote memory recall. Diagnostic polysomnography (PSG) showed apnea-hypopnea index, 84.4 events/h; periodic limb movement index, 10.7 events/h; reduced total sleep time (140 minutes); increased stage N1 sleep; and no stage N3 or R sleep. Minimum oxygen saturation was 80%. Sleep spindles were absent. The patient refused an in-laboratory positive airway pressure (PAP) titration, and was placed on auto-adjusting PAP therapy for her severe obstructive sleep apnea. At follow-up, 8 weeks after starting auto-adjusting PAP therapy, the patient demonstrated cognitive impairment not SLEEP MEDICINE PEARLS

A Patient With Rapidly Progressing Early-Onset Dementia and Insomnia