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Abstract

A third general area of neurology is sleep medicine. The association between sleep medicine and P&S monitoring is very straightforward: daytime sleepiness is associated with parasympathetic excess (PE), and nighttime sleeplessness is associated with sympathetic excess (SE). In this way, P&S monitoring helps to document underlying autonomic involvement which provides more information to guide therapy and improve outcomes. The chapter discusses at length obstructive sleep apnea (OSA). OSA has as its autonomic characteristic, SE. The danger of OSA, as with other chronic conditions that involve SE, is that just treating OSA does not always mean that the SE is relieved. Especially in OSA since the typical therapy is not a sympatholytic. Rather, like pain therapy, CPAP and other typical OSA therapies merely relieve the stress associated with OSA; it does not directly reduce SE, which may leave the patient at continued morbidity or mortality risk. For example, if the patient is a diabetic with hypertension and OSA, the diabetes may involve some SE, the hypertension may involve more SE, and the OSA may involve even more SE. CPAP will only relieve the SE associated with OSA; the SE associated with the other diseases may not be effected and therefore persist. This may be a reason for a significant portion of the OSA patient population experiencing cardiovascular disease even though they are faithful to use CPAP as prescribed.

Keywords

  • Obstructive Sleep Apnea
  • Sleep Apnea
  • Sleep Disorder
  • Chronic Fatigue Syndrome
  • Obstructive Sleep Apnea Syndrome

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Sleep. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_25

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  • DOI: https://doi.org/10.1007/978-3-319-07371-2_25

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