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      Aripiprazol en dosis bajas para somnolencia diurna excesiva asociada a uso de haloperidol: un reporte de caso Translated title: Low dose aripiprazole for excessive daytime sleepiness associated with the use of haloperidol: A case report

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          Abstract

          La somnolencia diurna es un efecto adverso frecuentemente asociado al uso de antipsicóticos en pacientes con esquizofrenia. Presentamos el caso de una mujer de 43 años con esquizofrenia y tratamiento antipsicótico desde hace 24 años, que inicialmente, presentó mala respuesta a antipsicóticos clásicos de baja potencia, llegando a lograr estabilizar los síntomas psicóticos por más de 10 años con uso de haloperidol. Sin embargo, con este tratamiento presentó somnolencia diurna que llegó a ser un efecto adverso importante limitando su funcionalidad y calidad de vida. Luego de añadirse primero 3,75 mg y luego 7,5 mg de aripiprazol, mejoró hasta un 80% la somnolencia sin exacerbación de los síntomas psicóticos

          Translated abstract

          Daily somnolence is a frequent adverse event associated to the use of antipsychotic medication in patients with schizophrenia. We present the case of a 43 years old women with schizophrenia and pharmacological treatment for 24 years, who, at the start of the treatment, showed inadequate response to low potency classical antipsychotics, achieving clinical stability for more than 10 years with the use of haloperidol. However, she presented severe daily somnolence which significantly limited her functionality and quality of life. After the addition of 3.75 mg and later 7.5 mg of aripiprazole the somnolence improved in nearly 80% without exacerbation of psychotic symptoms

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          Most cited references40

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          Sleep and mental disorders: A meta-analysis of polysomnographic research.

          Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record
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            Sleep and psychiatric disorders. A meta-analysis.

            We reviewed the literature on sleep in psychiatric disorders and evaluated the data by meta-analysis, a statistical method designed to combine data from different studies. A total of 177 studies with data from 7151 patients and controls were reviewed. Most psychiatric groups showed significantly reduced sleep efficiency and total sleep time, accounted for by decrements in non-rapid eye movement sleep. Rapid eye movement sleep time was relatively preserved in all groups, and percentage of rapid eye movement sleep was increased in affective disorders. Reduction in rapid eye movement sleep latency was seen in affective disorders but occurred in other categories as well. Although no single sleep variable appeared to have absolute specificity for any particular psychiatric disorder, patterns of sleep disturbances associated with categories of psychiatric illnesses were observed. Overall, findings for patients with affective disorders differed most frequently and significantly from those for normal controls.
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              A systematic review of screening questionnaires for obstructive sleep apnea.

              Obstructive sleep apnea (OSA) may lead to life-threatening problems if it is left undiagnosed. Polysomnography is the "gold standard" for OSA diagnosis; however, it is expensive and not widely available. The objective of this systematic review is to identify and evaluate the available questionnaires for screening OSA. We carried out a literature search through MEDLINE, EMBASE, and CINAHL to identify eligible studies. The methodological validity of each study was assessed using the Cochrane Methods Group's guideline. Ten studies (n = 1,484 patients) met the inclusion criteria. The Berlin questionnaire was the most common questionnaire (four studies) followed by the Wisconsin sleep questionnaire (two studies). Four studies were conducted exclusively on "sleep-disorder patients", and six studies were conducted on "patients without history of sleep disorders". For the first group, pooled sensitivity was 72.0% (95% confidence interval [CI]: 66.0-78.0%; I(2) = 23.0%) and pooled specificity was 61.0% (95% CI: 55.0-67.0%; I(2) = 43.8%). For the second group, pooled sensitivity was 77.0% (95% CI: 73.0-80.0%; I(2) = 78.1%) and pooled specificity was 53.0% (95% CI: 50-57%; I(2) = 88.8%). The risk of verification bias could not be eliminated in eight studies due to insufficient reporting. Studies on snoring, tiredness, observed apnea, and high blood pressure (STOP) and STOP including body mass index, age, neck circumference, gender (Bang) questionnaires had the highest methodological quality. The existing evidence regarding the accuracy of OSA questionnaires is associated with promising but inconsistent results. This inconsistency could be due to studies with heterogeneous design (population, questionnaire type, validity). STOP and STOP-Bang questionnaires for screening of OSA in the surgical population are suggested due to their higher methodological quality and easy-to-use features.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rnp
                Revista de Neuro-Psiquiatría
                Rev Neuropsiquiatr
                Universidad Peruana Cayetano Heredia. Facultad de Medicina (Lima, , Peru )
                0034-8597
                January 2018
                : 81
                : 1
                : 47-53
                Affiliations
                [01] Lima Perú orgnameUniversidad Peruana Cayetano Heredia orgdiv1Facultad de Medicina Alberto Hurtado
                [02] Lima orgnameHospital Cayetano Heredia Perú
                Article
                S0034-85972018000100007
                10.20453/rnp.v81i1.3273
                0b7c07e9-04f9-4090-8c6e-0c2dec97c4fa

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 02 January 2018
                : 29 March 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 43, Pages: 7
                Product

                SciELO Peru

                Categories
                Reporte de casos

                esquizofrenia,somnolencia,antipsicóticos,efectos adversos,schizophrenia,side-effects,antipsychotics,somnolence,Aripiprazol,Aripiprazole

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