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BackgroundWe addressed the impact of patient education followed by frequent visits on compliance with positive airway pressure (PAP) treatment in patients with obstructive sleep apnea (OSA) in a Turkish sleep clinic cohort.Material/MethodsThis single-center, randomized, controlled study was conducted in Istanbul, Turkey between June 2014 and April 2015. Among 115 eligible OSA patients (mean age 51.0±9.3 years; 75.5% men), 63 were randomized to standard support (SS) group (general information about OSA and PAP treatment at baseline), and 52 to educational support (ES) group (additional polysomnography chart viewing from both diagnostic and titration nights). All patients were scheduled to five PAP control visits between two weeks and six months after the PAP prescription. Primary outcome was the PAP compliance (4 hours/night for 70% of all the nights) at the last visit.ResultsAverage PAP usage was 4.2±2.5 hours/night in the SS group, and 5.2±2.1 hours/night in the ES group (p=0.027). PAP compliance was achieved among 68.3% in the SS group, and 86.5% in the ES group (p=0.021). In a multivariate analysis, ES strategy followed by frequent visits predicted PAP compliance (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.2–10.6; p=0.020). Other predictors were obesity (OR 3.4, 95% CI 1.2–9.7; p=0.019) and severe OSA (apnea-hypopnea index ≥30/hour) at baseline (OR 4.7, 95% CI 1.2–17.6; p=0.023). Primary school education level was inversely related with PAP compliance (OR 0.3, 95% CI 0.1–0.9; p=0.036).ConclusionsPatient education with polysomnography chart view followed by frequent visits increased long-term compliance with PAP treatment.

Creutzfeldt-Jakob disease (CJD) is a progressive, degenerative, and fatal disease of the central nervous system. It is caused by abnormal accumulation of prion proteins and is characterized mainly by progressive dementia, myoclonus, and cerebellar, pyramidal, and extrapyramidal findings. Psychiatric symptoms may also accompany CJD and are often the first signs of the disease. The incidence of CJD is approximately 1 in 1 000 000. In certain cases, a diagnosis can be made by demonstrating the accumulation of pathological prion proteins. However, in many cultures brain biopsies or post-mortem evaluations are not welcomed by either the patients or their relatives. In these cases, the importance of additional diagnostic tools increases. Herein, we report on a CJD patient who first consulted a psychiatrist with early psychiatric symptoms. The patient developed neurological symptoms later and was subsequently diagnosed as sporadic CJD based on clinical and laboratory findings rather than brain biopsy. Repeated electroencephalograms (EEG) played a pivotal role in our evaluation of the patient. This case is an interesting presentation of CJD both because of the timing of the symptoms and because of the typical EEG findings that led to the diagnosis.

CTS frequency in OSA patients is significantly higher than that in healthy individuals. In contrast to previous studies that have been performed in the absence of polysomnographic and electrophysiological data, in our study biomechanical factors were not associated with CTS presence. Therefore, we conclude that intermittent hypoxemia is the main etiological factor for CTS in OSA patients. Inflammation may be a common factor for etiopathogenesis for both diseases, but this hypothesis needs further investigation.

Objective: To evaluate the relationship of mean platelet volume and OSAS severity, in OSAS patients without any vascular risk factors and co-morbidites. Method: The patients files and polysomnographies of OSAS patients who admitted to sleep laboratory between January 1st 2011 and April 1st 2012 have been retrospectively evaluated. Inclusion criteria are to have no vascular risk factors and no co-morbidities, to be a non-smoker, to be older than 18 years of age and not be taking any medications. Patients have been grouped as severe and non-severe OSAS according to their apne-hypopne indices. Mean platelet volume (MPV) of patients in the two groups have been compared. Results: Among 81 patients who met the inclusion criteria, 39.6% of the patients had severe OSAS while 60.4% had non-severe OSAS. MPV in the severe group was 9.05+0.89 (fL), while it was 9.00+0.82 (fL) in the non-severe group. The difference of MPV between two groups was not significant (p:0.800). Conclusion: Controversially with the former studies which declared higher MPV in severe OSAS, our study concludes that when all other risk factors are excluded MPV is not an indicator of severity in OSAS.