Many states are adopting the use of marijuana for medical purposes even though federal law does not yet support marijuana to be used in this context. Before we discuss its medical use, let’s discuss its use in society both historically and today.
There are differences between adult sleep apnea and pediatric sleep apnea. Adults usually have daytime sleepiness, while children are more likely to have behavioral problems. The underlying cause in adults is often obesity; in children, the most common underlying condition is enlargement of the adenoids and tonsils. However, obesity also plays a role in children. Other underlying factors can be craniofacial anomalies and neuromuscular disorders. Pediatric sleep disorders increasingly interfere with daily patient and family functioning. Interest in and treatment of sleep disturbances in youth continues to grow, but research lags. One survey indicated that pediatricians were more likely to prescribe antidepressant medications for insomnia than psychiatrists. Further investigation is needed to develop fact-based diagnosis and treatment of pediatric sleep disorders.
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In Part I of this article from the Q2 issue of 2018, I discussed the emerging and growing technology of the sleep medicine community. I also talked about the mantra of that time as “entering the field on the cutting edge of technology that would revolutionize the field of sleep medicine.” Just a few decades ago, there were no state licensure laws or any “real” credentialing requirements. And, of course, no HIPAA laws, either.
Despite all this talk of “adherence” or “compliance,” few PAP users or technologists know the precise definition. This can be problematic not only in analyzing the effectiveness of therapy, but also in getting insurance to resupply the patient. For the sake of this article, we will use the more accepted term “adherence” interchangeably with the term “compliance.”