All Publications

  • Daylight saving time: an American Academy of Sleep Medicine position statement. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine Rishi, M. A., Ahmed, O., Barrantes Perez, J. H., Berneking, M., Dombrowsky, J., Flynn-Evans, E. E., Santiago, V., Sullivan, S. S., Upender, R., Yuen, K., Abbasi-Feinberg, F., Aurora, R. N., Carden, K. A., Kirsch, D. B., Kristo, D. A., Malhotra, R. K., Martin, J. L., Olson, E. J., Ramar, K., Rosen, C. L., Rowley, J. A., Shelgikar, A. V., Gurubhagavatula, I. 2020


    None: The last several years have seen intense debate about the issue of transitioning between standard and daylight saving time. In the United States, the annual advance to daylight saving time in spring, and fall back to standard time in autumn, is required by law (although some exceptions are allowed under the statute). An abundance of accumulated evidence indicates that the acute transition from standard time to daylight saving time incurs significant public health and safety risks, including increased risk of adverse cardiovascular events, mood disorders, and motor vehicle crashes. Although chronic effects of remaining in daylight saving time year-round have not been well studied, daylight saving time is less aligned with human circadian biology - which, due to the impacts of the delayed natural light/dark cycle on human activity, could result in circadian misalignment, which has been associated in some studies with increased cardiovascular disease risk, metabolic syndrome and other health risks. It is, therefore, the position of the American Academy of Sleep Medicine that these seasonal time changes should be abolished in favor of a fixed, national, year-round standard time.

    View details for DOI 10.5664/jcsm.8780

    View details for PubMedID 32844740

  • Socioeconomic Impact of Pediatric Sleep Disorders. Sleep medicine clinics Yuen, K. M., Pelayo, R. 2017; 12 (1): 23-30


    Pediatric disorders tend to affect the immediate support unit, adults and children. High costs for direct consumption of medical care are offset by early diagnosis and treatment of pediatric sleep disorders. Pediatric sleep disorders are underdiagnosed and undertreated. Attention-deficit/hyperactivity disorder may result from insufficient or fragmented sleep. Delaying school start time resulted in decreased car crashes in teen drivers and improved mood.

    View details for DOI 10.1016/j.jsmc.2016.10.005

    View details for PubMedID 28159094

  • Sleep-Disordered Breathing in Ehlers-Danlos Syndrome: A Genetic Model of OSA. Chest Guilleminault, C., Primeau, M., Chiu, H., Yuen, K. M., Leger, D., Metlaine, A. 2013; 144 (5): 1503-1511


    The objective of this study was to investigate the presence of sleep-disordered breathing (SDB) in patients with Ehlers-Danlos syndrome. Ehlers-Danlos syndrome is a genetic disorder characterized by cartilaginous defects, including nasal-maxillary cartilages.A retrospective series of 34 patients with Ehlers-Danlos syndrome and complaints of fatigue and poor sleep were evaluated by clinical history, physical examination, polysomnography (PSG), and, in some cases, anterior rhinomanometry. Additionally, a prospective clinical investigation of nine patients with Ehlers-Danlos syndrome was performed in a specialized Ehlers-Danlos syndrome clinic.All patients with Ehlers-Danlos syndrome evaluated had SDB on PSG. In addition to apneas and hypopneas, SDB included flow limitation. With increasing age, flow limitation decreased in favor of apnea and hypopnea events, but clinical complaints were similar independent of the type of PSG finding. In the subgroup of patients who underwent nasal rhinomanometry, increased nasal resistance was increased relative to normative values. Nasal CPAP improved symptoms. Patients with Ehlers-Danlos syndrome presenting to the medical clinic had symptoms and clinical signs of SDB, but they were never referred for evaluation of SDB.In patients with Ehlers-Danlos syndrome, abnormal breathing during sleep is commonly unrecognized and is responsible for daytime fatigue and poor sleep. These patients are at particular risk for SDB because of genetically related cartilage defects that lead to the development of facial structures known to cause SDB. Ehlers-Danlos syndrome may be a genetic model for OSA because of abnormalities in oral-facial growth. Early recognition of SDB may allow treatment with orthodontics and myofacial reeducation.

    View details for DOI 10.1378/chest.13-0174

    View details for PubMedID 23929538

  • Pediatric Sleep Pharmacology CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA Pelayo, R., Yuen, K. 2012; 21 (4): 861-?


    This article reviews common sleep disorders in children and pharmacologic options for them. Discussions of pediatric sleep pharmacology typically focus on treatment of insomnia. Although insomnia is a major concern in this population, other conditions of concern in children are presented, such as narcolepsy, parasomnias, restless legs syndrome, and sleep apnea.

    View details for DOI 10.1016/j.chc.2012.08.001

    View details for Web of Science ID 000311194100010

    View details for PubMedID 23040905

  • Atypical sexual behavior during sleep PSYCHOSOMATIC MEDICINE Guilleminault, C., Moscovitch, A., Yuen, K., Poyares, D. 2002; 64 (2): 328-336


    This article reports a case series of atypical sexual behavior during sleep, which is often harmful to patients or bed partners.Eleven subjects underwent clinical evaluation of complaints of sleep-related atypical sexual behavior. Complaints included violent masturbation, sexual assaults, and continuous (and loud) sexual vocalizations during sleep. One case was a medical-legal case. Sleep logs, clinical evaluations, sleep questionnaires, structured psychiatric interviews, polysomnography, actigraphy, home electroencephalographic monitoring during sleep, and clinical electroencephalographic monitoring while awake and asleep were used to determine clinical diagnoses.Atypical sexual behaviors during sleep were associated with feelings of guilt, shame, and depression. Because of these feelings, patients and bed partners often tolerated the abnormal behavior for long periods of time without seeking medical attention. The following pathologic sleep disorders were demonstrated on polysomnography: partial complex seizures, sleep-disordered breathing, stage 3 to 4 non-rapid eye movement (REM) sleep parasomnias, and REM sleep behavior disorder. These findings were concurrent with morning amnesia.The atypical behaviors were related to different syndromes despite the similarity of complaints from bed partners. In most cases the disturbing and often harmful symptoms were controlled when counseling was instituted and sleep disorders were treated. In some cases treatment of seizures or psychiatric disorders was also needed. Clonazepam with simultaneous psychotherapy was the most common successful treatment combination. The addition of antidepressant or antiepileptic medications was required in specific cases.

    View details for PubMedID 11914450

  • Hypersomnia after head-neck trauma - A medicolegal dilemma NEUROLOGY Guilleminault, C., Yuen, K. M., Gulevich, M. G., Karadeniz, D., Leger, D., Philip, P. 2000; 54 (3): 653-659


    To evaluate the severity of daytime sleepiness in patients with a history of head trauma who complain of daytime somnolence, to investigate polygraphic abnormalities during nocturnal sleep, and to determine whether daytime sleepiness was the cause or consequence of the head trauma.The authors performed a systematic evaluation of 184 patients comprised of clinical interviews, sleep disorders questionnaires, sleepiness and depression scales, medical and neurologic evaluations, sleep logs with actigraphy, nocturnal polysomnography, and the Multiple Sleep Latency Test (MSLT). Assessments of sleepiness before the accident were based on bed partner interviews, coworker and employer reports, health reports, driving records, and employment history that included absenteeism.Post-traumatic complaint of somnolence was associated with variable degrees of impaired daytime functioning in more than 98% of patients. Patients who were in a coma for 24 hours, who had a head fracture, or who had immediate neurosurgical interventions were likely to have scores > 16 points on the Epworth Sleepiness Scale (ESS) and < or = 5 minutes on the MSLT. Pain at night was an important factor in nocturnal sleep disruption and daytime sleepiness. Sleep-disordered breathing was a common finding and was the only finding in whiplash patients with daytime sleepiness. Extensive evaluation of pretrauma behavior supported the conclusion that the onset of symptomatic sleep-disordered breathing was associated with the trauma. The patients who showed a "compulsive presleep behavior" were severely impaired in performing their daily activities.A systematic approach is required when dealing with patients complaining of hypersomnia following a head-neck trauma.

    View details for Web of Science ID 000085160300021

    View details for PubMedID 10680799