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VOLUME 13 , ISSUE 1 ( January-March, 2018 ) > List of Articles

REVIEW ARTICLE

Obstructive Sleep Apnea – Insomnia Overlap Syndrome

Keywords : CBT, CPAP, Insomnia, OSA, Overlap, SDB

Citation Information : Obstructive Sleep Apnea – Insomnia Overlap Syndrome. Indian Sleep Med 2018; 13 (1):13-17.

DOI: 10.5005/jp-journals-10069-0017

License: CC BY-SA 4.0

Published Online: 00-03-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Sleep-disordered breathing and insomnia are the most common of the sleep disorders. Both these diseases are well defined, diagnosed and managed as per the current guidelines. The initial isolated reports of an overlap of these two diseases were published in the eighties. With newer studies post-2001, the existence of the comorbid obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) with insomnia has been increasingly recognized. This disease entity has been referred with diverse unstandardized terminologies. UARS is a variant nomenclature of OSA as per International Classification of Sleep Disorders- third edition (ICSD-3). We hereby address it as the OSA–insomnia overlap syndrome throughout the text and review literature. Alike the ununiform terminology, there is lack of clear textbook/guideline definitions, diagnosis, and management of the OSA–insomnia overlap syndrome. Both have an interlinked pathophysiology. The clinical features and evaluation of the OSA–insomnia overlap syndrome share similarities to the diseases in isolation with exacerbation of overlapping features. An active search for the diagnosis of the overlap syndrome in patients visiting the sleep apnea clinic and insomnia clinic is mandatory as the identification helps in optimizing the management and difficulties in poor responders/ failures. Continuous positive airway pressure (CPAP) therapy with cognitive/behavior therapy for insomnia (CBTi) is the treatment of choice. A lot is yet to surface in the research of the OSA–insomnia overlap syndrome.


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  1. Lavie P. Insomnia and sleep-disordered breathing. Sleep Medicine 2007; 8: S21-S25.
  2. Ong JC, Crawford MR. Insomnia and obstructive sleep apnea. Sleep Med Clin 2013; 8: 389-398.
  3. Glidewell RN. Comorbid Insomnia and sleep disordered breathing. Current treatment options in Neurology 2013; 15: 692-703.
  4. Fung CH, Martin JL, Dzierzewski JM, Jouldjian D, Josephson K, Park M et al. Prevalence and Symptoms of Occult Sleep Disordered Breathing among Older Veterans with Insomnia. JCSM 2013; 9(11): 1173-1178.
  5. Guilleminault C, Eldridge FL, Dement WC. Insomnia with sleep apnea: a new syndrome. Science 1973; 181: 856-858.
  6. Guilleminault C, Eldridge FL, Philips JR, Dement WC. Two occult causes of insomnia and their therapeutic problems. Arch GenPsychiatr 1976; 33: 1241-1245.
  7. Krakow B, Melendrez D, Ferreira E, Clark J, Warner TD, Sisley B etal. Prevalence of insomnia symptoms in patients with SDB. Chest 2001; 120: 1923-1929.
  8. Sateia MJ. International Classification of Sleep Disorders -Third Edition highlights and modifications. CHEST 2014; 146 (5): 1387-1394.
  9. The international classification of sleep disorders: diagnostic and coding manual. 2nd edition. American Academy of Sleep Medicine, Westchester (IL); 2005
  10. Soldatos CR, Dikeos DG, Paparrigopoulos TJ. Athens Insomnia scale: validation of an instrument based on ICD-10 criteria. Journal of Psychosomatic Research 2000; 48: 555-560.
  11. Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001; 2(4): 297-307.
  12. Guilleminault C, Abad VC. Obstructive sleep apnea syndromes. Med Clin N Am 2004; 88: 611-630.
  13. Lack LC, Sweetman AM. Diagnosis and treatment of insomnia comorbid with obstructive sleep apnea. Sleep Med Clin 2016; 11: 379-388.
  14. Sweetman AM, Lack LC, Catcheside PG, Antic NA, Chai-Coetzer CL, Smith SS et al. Developing a successful treatment of co-morbid insomnia and sleep apnea. Sleep Medicine Reviews 2017; 33: 28-38.
  15. Smith S, Sullivan K, Hopkins W, Douglas J. Frequency of insomnia report in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS). Sleep Med 2004; 5: 449-456.
  16. Krakow B, Melendrez D, Lee SA, Warner TD, Clark JO, Sklar D. Refractory Insomnia and Sleep-Disordered Breathing: A Pilot Study. Sleep and Breathing 2004; 8: 15-29.
  17. Krell S, Kapur V. Insomnia complaints in patients evaluated for obstructive sleep apnea. Sleep Breath 2005; 9: 104-110.
  18. Chung K. Insomnia subtypes and their relationships to daytime sleepiness in patients with obstructive sleep apnea. Respiration 2005; 72: 460-465.
  19. Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioural and pharmacological therapies for late-life insomnia: a randomized controlled trial. J Am Med Assoc 1999; 281: 991-99.
  20. Bootzin RR, Epstein DR. Understanding and treating Insomnia. Annu Rev Clin Psychol 2011; 7: 435-458.
  21. Spielman AJ, Saskin P, Thorpy MJ. Treatment of chronic insomnia by restriction of time in bed. Sleep 1987; 10(1): 45-56.
  22. Harris J, Lack L, Kemp K, Wright H, Bootzin R. A randomised controlled trial of intensive sleep retraining (ISR): a brief conditioning treatment for chronic insomnia. Sleep 2012; 35(1): 49-60.
  23. Harvey AG, Belanger L, Talbot L, Eidelman P, Bonneau SB, Brochu EF et al. Comparative efficacy of behaviour therapy, cognitive therapy and cognitive behaviour therapy for chronic insomnia: a randomised controlled trial. J Consult Clin Psychol 2014; 82(4): 670-683.
  24. Rose EC, Germann M, Sorchter S, Jonas IE. Case Control study in the treatment of Obstructive sleep disordered breathing with a mandibular protrusive appliance. J Orofac Orthop. 2004; 65:489-500.
  25. Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, et al. Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med. 2004; 170:656-664.
  26. Gotsopoulos H, Kelly JJ, Cistulli PA. Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial. Sleep. 2004; 27(5):934-941.
  27. Marklund M, Stenlund H, Franklin KA. Mandibular advancement devices in 630 men and women with obstructive sleep apnea and snoring: tolerability and predictors of treatment success. Chest. 2004; 125:1270-1278.
  28. Izci B, McDonald JP, Coleman EL, Mackay TW, Douglas NJ, Engleman HM. Clinical audit of subjects with snoring & sleep apnoea/hypopnoea syndrome fitted with mandibular repositioning splint. Respir Med. 2005; 99:337-346.
  29. Vecchierini MF, Léger D, Laaban JP, Putterman G, Figueredo M, Levy J, et al. Efficacy and compliance of mandibular repositioning device in obstructive sleep apnea syndrome under a patient-driven protocol of care. Sleep Med. 2008; 9(7):762-769
  30. Aarab G, Lobbezoo F, Hamburger HL, Naeije M.Oral Appliance Therapy versus Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea: A Randomized, Placebo-Controlled Trial. Respiration. 2011; 81:411– 419.
  31. Holley AB, Lettieri CJ, Shah AA. Efficacy of an Adjustable Oral Appliance and Comparison to Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea Syndrome. Chest. 2011; 140:1511-1516.
  32. Vuorjoki-Ranta TR, Lobbezoo F, Tuomilehto H, Könönen M, Pihakari A, Ahlberg J. Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance. Sleep Disord Ther. 2014; 3:5.
  33. Ballanti F, Ranieri S, Baldini A, Cozza P. Long Term Therapeutic Efficacy of a Soft Monobloc Mandibular Advancement Device in Adults with Obstructive Sleep. Scientific World Journal. 2015, Article ID 408469.
  34. Banno K, Kryger MH. Sleep apnea: clinical investigations in humans. Sleep Med. 2007; 8:400-426.
  35. Tsuchiya M, Lowe AA, Pae EK, Fleetham JA. Obstructive sleep apnoea subtypes by cluster analysis. Am J Orthod Dentofac Orthop. 1992; 101:533-542.
  36. Mayer P, Pépin JL, Bettega G, Veale D, Ferretti G, Deschaux C, et al. Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients. Eur Respir J. 1996; 9:1801–1809.
  37. Kumar PVG, M Bhatia, M Tripathi, AK Srivastava, S Jain. Obstructive sleep apnoea: a case controlled study. Neurology India. 2003; 51(4):497-499.
  38. Lee RW, Chan AS, Grunstein RR, Cistulli PA. Craniofacial phenotyping in obstructive sleep apnoea – A novel quantitative photographic approach. Sleep. 2009; 32(1):37- 45.
  39. Johnston CD, Gleadhill IC, Cinnamond MJ, Peden MW. Oral appliances for management of snoring: a randomized controlled trial. Eur J Orthod. 2001; 23:127-134.
  40. Sharples LD, Clutterbuck-James AL, Glover MJ, Bennett MS, Chadwick R, Pittman MA, et al. Meta-analysis of randomised controlled trials of oral mandibular advancement devices and continuous positive airway pressure for obstructive sleep apnoea-hypopnoea. Sleep Medicine Reviews. 2015.
  41. Pantin CC, Hillman DR, Tennant M. Dental side effects of an oral device to treat snoring and obstructive sleep apnea. Sleep. 1999; 22(2):237-240.
  42. Fritsch KM, Iseli A, Russi EW, Bloch KE. Side effects of mandibular advancement devices for sleep apnea treatment. Am J Respir Crit Care Med. 2001; 164:813-818.
  43. Bondemark L, Lindman R. Craniomandibular status and function in patients with habitual snoring and obstructive sleep apnoea after nocturnal treatment with a mandibular advancement splint: a 2-year follow-up. Eur J Orthod. 2000; 22:53-60.
  44. Almeida FR, Lowe AA, Sung JO, Tsuiki S, Otsuka R. Longterm sequelae of oral appliance therapy in obstructive sleep apnea patients: Part 1. Cephalometric analysis. Am J Orthod Dentofacial Orthop. 2006; 129:195-204.
  45. Marklund M, Franklin KA, Persson M. Orthodontic sideeffects of mandibular advancement devices during treatment of snoring and sleep apnoea. Eur J Orthod. 2001; 23:135-144.
  46. Bhalsing K, Suresh K, Muthane UB, Pal PK. Prevalence and profile of Restless Legs Syndrome in Parkinson's disease and other neurodegenerative disorders: a case-control study. Parkinsonism Relat Disord 2013 Apr;19(4):426-430.
  47. Fereshtehnejad SM, Shafieesabet M, Shahidi GA, Delbari A, Lökk J. Restless legs syndrome in patients with Parkinson's disease: a comparative study on prevalence, clinical characteristics, quality of life and nutritional status. Acta Neurol Scand 2015 Apr;131(4):211-218.
  48. Moccia M, Erro R, Picillo M, Santangelo G, Spina E, Allocca R, Longo K, Amboni M, Palladino R, Assante R, et al. A four-year longitudinal study on restless legs syndrome in Parkinson disease. Sleep 2016 Feb;39(2):405-412.
  49. Högl B, Stefani A. Restless legs syndrome and periodic leg movements in patients with movement disorders: specific considerations. Mov Disord 2017 May;32(5):669-681.
  50. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J; Restless Legs Syndrome Diagnosis and Epidemiology workshop at the National Institutes of Health; International Restless Legs Syndrome Study Group. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology: a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003 Mar;4(2):101-119.
  51. Szatmari S Jr, Bereczki D, Fornadi K, Kalantar-Zadeh K, Kovesdy CP, Molnar MZ. Association of restless legs syndrome with incident Parkinson disease. Sleep 2017 Feb;40(2): zsw065.
  52. Winkelman JW, Armstrong MJ, Allen RP, Chaudhuri KR, Ondo W, Trenkwalder C, Zee PC, Gronseth GS, Gloss D, Zesiewicz T. Practice guideline summary: treatment of restless legs syndrome in adults: report of the Guideline Development Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2016 Dec;87(24):2585-2593.
  53. Splinter MY. Rotigotine: transdermal dopamine agonist treatment of Parkinson's disease and restless legs syndrome. Ann Pharmacother 2007 Feb;41(2):285-295.
  54. Iranzo A, Molinuevo JL, Santamaría J, Serradell M, Martí MJ, Valldeoriola F, Tolosa E. Rapid-eye-movement sleep behaviour disorder as an early marker for a neurodegenerative disorder: a descriptive study. Lancet Neurol 2006 Jul;5(7):572-577.
  55. Howell MJ, Schenck CH. Rapid eye movement sleep behavior disorder and neurodegenerative disease. JAMA Neurol 2015 Jun;72(6):707-712.
  56. Sixel-Döring F, Trautmann E, Mollenhauer B, Trenkwalder C. Rapid eye movement sleep behavioral events: a new marker for neurodegeneration in early Parkinson disease? Sleep 2014 Mar;37(3):431-438.
  57. Vibha D, Shukla G, Goyal V, Singh S, Srivastava AK, Behari M. RBD in Parkinson's disease: a clinical case control study from North India. Clin Neurol Neurosurg 2011 Jul;113(6):472-476.
  58. Vibha D, Shukla G, Singh S, Goyal V, Srivastava AK, Behari M. Lower prevalence of sleep disturbances in familial versus sporadic Parkinson's disease: a questionnaire based study. J Neurol Sci 2010 Aug;295(1-2):27-30.
  59. Abu Alhaija ES, Al-Nimri KS, Al-Khateeb SN. Self perception of malocclusion among Jordanian school children. Eur J Orthod 2005 Jun;27(3):292-295.
  60. Kolawole KA, Otuyemi DE, Jebode SO, Unweni AA. Awareness for malocclusion and desire for orthodontic treatment need in 11-14year old Nigerian school and their parents. Aust Orthod J 2008 May;24(1):21-25.
  61. Cucalon A 3rd, Smith RJ. Relationship between by adolescent orthodontics patients and performance on psychological tests. Angle Orthod 1990 Summer;60(2):107-114.
  62. Southard KA, Tolley EA, Arheart KL, Hackett-Renner CA, Southard TE. Application of the Millon Adolescent Personality Inventory in evaluating orthodontic compliance. Am J Orthod Dentofacial Orthop 1991 Dec;100(6):553-561.
  63. Kharbanda OP. What is the prevalence of malocclusion in India? Do we know orthodontic treatment needs of our country. J Indian Orthod Soc 1999 Apr-Jun;32(2):33-41.
  64. Siddiqui TA, Shaikh A, Fida M. Agreement between orthodontist and patient perception using Index of Orthodontic Treatment Need. Saudi Dent J 2014 Oct;26(4):156-165.
  65. Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour F. Orthodontic treatment needs in an urban Iranian population in epidemiological study of 11-14 years old children. Eur J Paediatr Dent 2009 Jun;10(2):69-74.
  66. Grando G, Young AA, Vedovello Filho M, Vedovello SA, Ramirez-Yañez GO. Prevalence of malocclusions in a young Brazilian population. Int J Orthod Milwaukee 2008 Summer;19(2):13-16.
  67. Nadim R, Aslam K, Rizwan S. Frequency of malocclusion among 12 -15 years old school children in three sectors of Karachi. Pak Oral Dent J 2014 Sep;34(3):510-514.
  68. Reddy ER, Manjula M, Sreelakshmi N, Rani ST, Aduri R, Patil BD. Prevalence of malocclusion among 6 to 10 year old Nalgonda school children. J Int Oral Health 2013 Dec;5(6): 49-54.
  69. Onyeaso CO. Prevalence of malocclusion among adolescents in Ibadan, Nigeria. Am J Orthod Dentofacial Orthop 2004 Nov;126(5):604-607.
  70. Kaur H, Pavithra US, Abraham R. Prevalence of malocclusion among adolescents in South Indian population. J Int Soc Prev Community Dent 2013 Jul-Dec;3(2):97-102.
  71. Lauc T. Orofacial analysis on the Adriatic islands: an epidemiological study of malocclusions on Hvar Island. Eur J Orthod 2003 Jun;25(3):273-278.
  72. Zimmermann E, Gamborg M, Holst C, Baker JL, Sørensen TI, Berentzen TL. Body mass index in school-aged children and the risk of routinely diagnosed non-alcoholic fatty liver disease in adulthood: a prospective study based on the Copenhagen School Health Records Register. BMJ Open 2015 May;5(4):e006998.
  73. Singh SP. Non-alcoholic fatty liver disease: the unfolding monster? J Gastroenterol Hepatol 2006 Jan;21(1 Pt 2):199-201.
  74. Reece EA, Hagay Z, Roberts AB, DeGennaro N, Homko CJ, Connolly-Diamond M, Sherwin R, Tamborlane WV, Diamond MP. Fetal Doppler and behavioral responses during hypoglycemia induced with the insulin clamp technique in pregnant diabetic women. Am J Obstet Gynecol 1995 Jan;172(1 Pt 1):151-155.
  75. Patrick J, Campbell K, Carmichael L, Natale R, Richardson B. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. Am J Obstet Gynecol 1982 Feb;142(4):363-371.
  76. Ornoy A, Ratzon N, Greenbaum C, Peretz E, Soriano D, Dulitzky M. Neurobehavior of school age children born to diabetic mothers. Arch Dis Child Fetal Neonatal Ed 1998 Sep;79(2):F94-F99.
  77. Wolf, A. Developmental evaluation on early school age children born to gestational diabetic mothers. Israel: Hebrew University; 1997.
  78. Mulder EJ, Leiblum DM, Visser GH. Fetal breathing movements in late diabetic pregnancy: relationship to fetal heart rate patterns and Braxton Hicks’ contractions. Early Hum Dev 1995 Nov;43(3):225-232.
  79. Schulte FJ, Michaelis R, Nolte R, Albert G, Parl U, Lasson U. Brain and behavioral maturation in newborn infants of diabetic mothers. I. Nerve conduction and EEG patterns. Neuropadiatrie 1969 Jan-Jul;1(1):24-35.
  80. Devoe LD, Youssef AA, Castillo RA, Croom CS. Fetal biophysical activities in third-trimester pregnancies complicated by diabetes mellitus. Am J Obstet Gynecol 1994 Aug;171(2):298-303.
  81. Dierker LJ Jr, Pillay S, Sorokin Y, Rosen MG. The change in fetal activity periods in diabetic and nondiabetic pregnancies. Am J Obstet Gynecol 1982 May;143(2):181-185.
  82. Doherty NN, Hepper PG. Habituation in fetuses of diabetic mothers. Early Hum Dev 2000 Aug;59(2):85-93.
  83. Kainer F, Prechtl HF, Engele H, Einspieler C. Assessment of the quality of general movements in fetuses and infants of women with type-1 diabetes mellitus. Early Hum Dev 1997 Nov;50(1):13-25.
  84. Mulder EJ, O'Brien MJ, Lems YL, Visser GH, Prechtl HF. Body and breathing movements in near-term fetuses and newborn infants of type-1 diabetic women. Early Hum Dev 1990 Nov;24(2):131-152.
  85. Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. I. Early growth patterns. Early Hum Dev 1991 May;25(2):91-106.
  86. Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. II. Emergence of specific movement patterns. Early Hum Dev 1991 May;25(2):107-115.
  87. Mulder EJ, Visser GH. Impact of early growth delay on subsequent fetal growth and functional development: a study on diabetic pregnancy. Early Hum Dev 1992 Dec;31(2):91-95.
  88. Mulder EJ, Visser GH, Bekedam DJ, Prechtl HF. Emergence of behavioral states in fetuses of type-1 diabetic women. Early Hum Dev 1987 Jul;15(4):231-251.
  89. Mulder EJ, Visser GH, Morssink LP, de Vries JI. Growth and motor development in fetuses of women with type-1 diabetes. III. First trimester quantity of fetal movement patterns. Early Hum Dev 1991 May;25(2):117-133.
  90. Aberg A, Westbom L, Kallen B. Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes. Early Hum Dev 2001 Mar;61(2):85-95.
  91. Deregnier RA, Nelson CA, Thomas KM, Wewerka S, Georgieff MK. Neurophysiologic evaluation of auditory recognition memory in healthy newborn infants and infants of diabetic mothers. J Pediatr 2000 Dec;137(6):777-784.
  92. Nelson CA, Wewerka S, Thomas KM, Tribby-Walbridge S, deRegnier R, Georgieff M. Neurocognitive sequelae of infants of diabetic mothers. Behav Neurosci 2000 Oct;114(5):950-956.
  93. Reece EA, Homko CJ. Infant of the diabetic mother. Semin Perinatol 1994 Oct;18(5):459-469.
  94. Reece EA, Homko CJ. Why do diabetic women deliver malformed infants? Clin Obstet Gynecol 2000 Mar;43(1):32-45.
  95. Rizzo T, Metzger BE, Burns WJ, Burns K. Correlations between antepartum maternal metabolism and intelligence of offspring. N Engl J Med 1991 Sep;325(13):911-916.
  96. Rizzo TA, Metzger BE, Dooley SL, Cho NH. Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers. Child Dev 1997 Feb;68(1):26-38.
  97. Schwartz R, Teramo KA. Effects of diabetic pregnancy on the fetus and newborn. Semin Perinatol 2000 Apr;24(2):120-135.
  98. Vaarasmaki MS, Hartikainen A, Anttila M, Pramila S, Koivisto M. Factors predicting peri- and neonatal outcome in diabetic pregnancy. Early Hum Dev 2000 Jul;59(1):61-70.
  99. Robertson SS, Dierker LJ. Fetal cyclic motor activity in diabetic pregnancies: sensitivity to maternal blood glucose. Dev Psychobiol 2003 Jan;42(1):9-16.
  100. Accardo PJ, Blondis TA, Whitman BY. Disorders of attention and activity level in a referral population. Pediatrics 1990 Mar;85(3 Pt 2):426-431.
  101. Ornoy A, Uriel L, Tennenbaum A. Inattention, hyperactivity and speech delay at 2-4 years of age as a predictor for ADDADHD syndrome. Isr J Psychiatry Relat Sci 1993;30(3):155-163.
  102. Smyth TR. Impaired motor skill (clumsiness) in otherwise normal children: a review. Child Care Health Dev 1992 Sep-Oct;18(5):283-300.
  103. Petersen MB, Pedersen SA, Greisen G, Pedersen JF, Mølsted- Pedersen L. Early growth delay in diabetic pregnancy: relation to psychomotor development at age 4. Br Med J (Clin Res Ed) 1988 Feb;296(6622):598-600.
  104. Sells CJ, Robinson NM, Brown Z, Knopp RH. Long-term developmental follow-up of infants of diabetic mothers. J Pediatr 1994 Jul;125(1):S9-S17.
  105. Vladareanu R, Lebit D, Constantinescu S. Ultrasound assessment of fetal neurobehaviour in high risk pregnancies. DSJUOG 2012 Apr-Jun;6(2):132-147.
  106. Talic A, Kurjak A, Ahmed B, Stanojevic M, Predojevic M, Kadic AS, Di Renzo GC. The potential of 4D sonography in the assessment of fetal behavior in high-risk pregnancies. J Matern Fetal Neonatal Med 2011 Jul;24(7):948-954.
  107. Bekedam DJ, Visser GH, de Vries JJ, Prechtl HF. Motor behaviour in the growth retarded fetus. Early Hum Dev 1985 Nov;12(2):155-165.
  108. Cioni G, Prechtl HF. Preterm and early postterm motor behaviour in low-risk premature infants. Early Hum Dev 1990 Sep;23(3):159-191.
  109. Seme-Ciglenecki P. Predictive value of assessment of general movements for neurological development of highrisk preterm infants: comparative study. Croat Med J 2003 Dec;44(6):721-727.
  110. Abo-Yaqoub S, Kurjak A, Mohammed AB, Shadad A, Abdel-Maaboud M. The role of 4-D ultrasonography in prenatal assessment of fetal neurobehaviour and prediction of neurological outcome. J Matern Fetal Neonatal Med 2012 Mar;25(3):231-236.
  111. Athanasiadis AP, Mikos T, Tambakoudis GP, Theodoridis TD, Papastergiou M, Assimakopoulos E, Tarlatzis BC. Neurodevelopmental fetal assessment using KANET scoring system in low and high-risk pregnancies. J Matern Fetal Neonatal Med 2013 Mar;26(4):363-368.
  112. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012 Jan;97(1):28-38.e25
  113. Sirmans SM, Pate KA. Epidemiology, diagnosis and management of polycystic ovary syndrome. Clin Epidemiol 2014; 6:1-13.
  114. Fauser BC, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, et al. Contemporary genetic technologies and female reproduction. Human Reproduction Update 2011 Nov;17(6):829-847.
  115. Balen A, Conway G, Kaltsas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995 Aug;10(8):2107-2111.
  116. Azziz R, Sanchez L, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 2004 Feb;89(2):453-462.
  117. Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000 May;52(5):595-600.
  118. Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril 2007 Jun;87(6): 1369-1376.
  119. Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome. In: Givens JHF, Merriman G, editors. The polycystic ovary syndrome. Cambridge, MA: Blackwell Scientific; 1992. p. 377-384.
  120. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004 Jan;81(1):19-25.
  121. Azziz R, Carmina E, DeWailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, et al. Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 2006 Nov;91(11):4237-4245.
  122. Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod 2013 May;28(5):1361-1368.
  123. Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. Int J Womens Health 2011 Feb;3:25-35.
  124. ACOG Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No 108: Polycystic ovary syndrome. Obstet Gynecol 2009 Oct;114(4):936-949.
  125. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril 2008 Mar;89(3): 505-522.
  126. Balen AH. Ovulation induction in the management of anovulatory polycystic ovary syndrome. Mol Cell Endocrinol 2013 Jul;373(1-2):77-82.
  127. Berridge DL, Winter TC. Saline infusion sonohysterography: technique, indications, and imaging findings. J Ultrasound Med 2004 Jan;23(1):97-112.
  128. Allison SJ, Horrow MM, Kim HY, Lev-Toaff AS. Salineinfused sonohysterography: tips for achieving greater success. Radiographics 2011 Nov-Dec;31(7):1991-2004.
  129. O'Neill MJ. Sonohysterography. Radiol Clin North Am 2003 Jul;41(4):781-797.
  130. Bonnamy L, Marret H, Perrotin F, Body G, Berger C, Lansac J. Sonohysterography: a prospective survey of results and complications in 81 patients. Eur J Obstet Gynecol Reprod Biol 2002 Apr;102(1):42-47.
  131. Lindheim SR, Adsuar N, Kushner DM, Pritts EA, Olive DL. Sonohysterography: a valuable tool in evaluating the female pelvis. Obstet Gynecol Surv 2003 Nov;58(11):770-784.
  132. Lindheim SR, Sprague C, Winter TC. Hysterosalpingography and sonohysterography: lessons in technique. AJR Am J Roentgenol 2006 Jan;186(1):24-29.
  133. Jeanty P, Besnard S, Arnold A, Turner C, Crum P. Air-contrast sonohysterography as a first step assessment of tubal patency. J Ultrasound Med 2000 Aug;19(8):519-527.
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