Editors' note: Sleep-disordered breathing among patients admitted for inpatient video-EEG monitoring
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
In the article “Sleep-disordered breathing among patients admitted for inpatient video-EEG monitoring”, Sivathamboo et al. reported moderate to severe sleep-disordered breathing (SDB, defined by an Apnea-Hypopnea Index ≥15) in 26.5% of 370 consecutive patients with epilepsy and/or psychogenic nonepileptic seizures (PNES) admitted for inpatient video-EEG monitoring in a cross-sectional, single-center study. Additional testing for the participants included polysomnography. In response, Dr. Sethi concurs that identifying and treating SDB in patients with epilepsy and/or PNES can potentially improve their quality of life and epileptic seizure control, but also notes that the cost of inpatient polysomnography in every patient admitted for seizure monitoring is prohibitive. He suggests overnight pulse oximetry as a more practical option to screen for severe obstructive sleep apnea or other SDB with the option of referring identified patients for formal polysomnography. In their reply, the authors agree that overnight oximetry has been evaluated extensively for severe SDB, but note that normal oximetry does not rule out SDB, particularly in this high-risk population. Although acknowledging the additional time and resource commitment needed to acquire and report a full polysomnogram, they argue that when the patients are already being monitored in a hospital, concurrent polysomnography may be preferable to home-based monitoring, particularly given uncertainties about the sensitivity and specificity of such strategies for severe SDB in this population. They note that such enhanced in-hospital monitoring may also help identify relationships between seizures and respiratory events.
In the article “Age and sex differences in burnout, career satisfaction, and well-being in US neurologists,” LaFaver et al. quantitatively and qualitatively analyzed responses to a 2016 survey of US neurologists (1,091 men and 580 women) and found that emotional exhaustion, depersonalization, fatigue, and overall quality of life generally became more favorable among older neurologists despite initial worsening of some of these variables with age. Whereas more women than men met burnout criteria, sex was not an independent predictor of the variables studied after adjusting for age. Women neurologists provided more negative comments regarding workload, work-life balance, leadership, deterioration of professionalism, and erosion of their academic mission by productivity demands. In response, Philip et al. postulate that life experience may mitigate burnout by fostering appreciation for relatively favorable aspects of the profession. They also note the importance of understanding how individual differences in reported factors such as age or sex and understudied aspects such as psychological makeup contribute to differences in professional outcomes, even within similar systems or cultures. In their reply, the authors agree that understanding both external and individual factors associated with burnout can facilitate the design of helpful interventions. They add that lower burnout among older neurologists may also relate to them cutting back clinical responsibilities or to loss of the most burned-out older neurologists from clinical practice. Highlighting the potential dangers of overgeneralizations regarding this issue based on demographic factors, they urge advocacy and action toward better coaching and mentoring for physicians and a more flexible view of work schedules and allocation of needed resources as feasible.
Footnotes
Author disclosures are available upon request (journal{at}neurology.org).
- © 2019 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hastening the Diagnosis of Amyotrophic Lateral Sclerosis
Dr. Brian Callaghan and Dr. Kellen Quigg
► Watch
Related Articles
Alert Me
Recommended articles
-
Article
Burnout, career satisfaction, and well-being among US neurologists in 2016Neil A. Busis, Tait D. Shanafelt, Christopher M. Keran et al.Neurology, January 25, 2017 -
Article
Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016Kerry H. Levin, Tait D. Shanafelt, Christopher M. Keran et al.Neurology, June 30, 2017 -
Article
Age and sex differences in burnout, career satisfaction, and well-being in US neurologistsKathrin LaFaver, Janis M. Miyasaki, Christopher M. Keran et al.Neurology, October 10, 2018 -
Disputes & Debates: Editors' Choice
Editors' note: Age and sex differences in burnout, career satisfaction, and well-being in US neurologistsAravind Ganesh, Steven Galetta et al.Neurology, November 04, 2019