When teams travel back home, every additional 500km reduces the likelihood of winning by approximately 4% (p= 0.038). Finally, after withdrawing the Away-Home sequence, traveling eastward significantly increases the chance of winning (p= 0.024) compared to westward travel but has no significant impact on the probability of winning compared to neutral time zone travel (p= 0.091). The accumulation of travel fatigue and the chronic circadian desynchronization that occurs over the NBA season can acutely disturb sleep and recovery. It appears that tailored sleep and recovery strategies need to be dynamically developed throughout the season to overcome the different challenges of the NBA schedule. The accumulation of travel fatigue and the chronic circadian desynchronization that occurs over the NBA season can acutely disturb sleep and recovery. It appears that tailored sleep and recovery strategies need to be dynamically developed throughout the season to overcome the different challenges of the NBA schedule.Kleine-Levin syndrome (KLS) is a rare disorder of recurrent hypersomnolence. The pathophysiology continues to be poorly understood. Autoimmunity, genetic polymorphisms, dysfunction of the hypothalamic axis, and abnormalities in functional imaging have been proposed. Several triggers have been described, including infection, toxins, head trauma, sleep deprivation, lactation, and menses. We present the first case report in the medical literature of KLS triggered by pregnancy and the first KLS from Armenia. Our patient has a pattern of mostly pregnancy-related episodes of several day sleepiness occurring monthly. This case adds to the published literature as we present a new association and explore the pathophysiology of KLS.We rerpot a case of a 65-year-old obese female who developed a unilateral nasal cerebrospinal fluid (CSF) leak after starting autotitrating positive airway pressure therapy for obstructive sleep apnea. The CSF leak was confirmed by beta-2 transferrin testing of the nasal fluid, as well as by identification of the leak through the anterior cribriform plate after administration of intrathecal fluorescein. The CSF leak was successfully repaired endoscopically, and autotitrating positive airway pressure was reinitiated one month postoperatively. Monitoring electrocardiogram (ECG) is an integral component of pediatric polysomnography (PSG). There is limited data regarding arrhythmia and conduction disturbances in the pediatric population undergoing a PSG. In this work we present abnormal ECG findings during PSG in our sleep center. A retrospective chart review from children who underwent PSG read by a single Sleep Medicine physician in the last year was carried out. Findings in children without cardiac disease and with first or second degree atrioventricular block (AVB) were compared to those from children with premature ventricular contractions (PVC). A total of 1,235 PSGs were included. Twenty-four children (9 girls and 15 boys) aged 2-17 years (median 9 years) were identified with arrhythmias or conduction disturbances (1.9%). Nineteen out of 24 of these children (79.2%) had obstructive apnea-hypopnea index (oAHI) > 1 event/h; this frequency was not significantly different from that found in the whole group of 1,235 children. No statistically significant difference was found between children with AVB or PVC. Seven out of nine children with AVB and seven out of 10 with PVC had oAHI > 1 event/h, while eight children with AVB out of nine and four out of 10 with PVC were males (Fisher exact test p=0.04). None of the children were found to have a structural or conduction abnormality when referred to cardiology. Our study supports that ECG abnormalities are rare in PSGs of children and not associated with cardiac disease or sleep disorders but appear more commonly in males. Our study supports that ECG abnormalities are rare in PSGs of children and not associated with cardiac disease or sleep disorders but appear more commonly in males.The mainstay of treatment for obstructive sleep apnea (OSA) is positive airway pressure (PAP). PAP therapy may be difficult to tolerate for some patients which may compromise adherence, requiring alternative therapies. Hypoglossal nerve stimulation (HGNS) has become an option for those who meet implantation criteria. Implantation of the device is an ambulatory surgical procedure and is generally well-tolerated, though rare adverse events have been reported. We report an unusual complication of HGNS in a patient who had initial success with this therapy. After three years of treatment, the sensor lead penetrated into the pleural space. Components of the HGNS were explanted, and a new sensor lead and generator were reimplanted. The new device was activated, and therapy was successfully resumed. This case demonstrates that there is a potential for a delayed complication of sensor lead penetration into the pleural space which has only rarely been reported. Both obesity and airways disease can lead to chronic hypercapnic respiratory failure, which can be managed with positive airway pressure (PAP) therapy. The efficacy of PAP has been studied in obesity hypoventilation syndrome as well as in chronic hypercapnic COPD patients, but not in patients where both obesity and airway obstruction coexist. This pilot study aims to compare the efficacy of continuous positive airway pressure (CPAP) versus bilevel positive airway pressure spontaneous mode (BPAP S mode) in the treatment of hypoventilation disorder with obesity and obstructive airways disease. We sequentially screened PAP naïve patients with stable chronic hypercapnic respiratory failure (PaCO > 45 mmHg), obesity (BMI > 30 kg/m ) and obstructive airways disease. Subjects were randomized to CPAP or BPAP S mode treatment for 3 months. Subjects were blinded to their PAP allocation. Change in awake PaCO was the primary endpoint. Secondary endpoints included change in lung function, daytime sleepiness, sleep quality, quality of life, PAP adherence and neurocognitive function. A total of 32 subjects were randomized (mean ± SD Age 61 ± 11 years, BMI 43 ± 7 kg/m , PaCO 54 ± 7mmHg, FEV 1.4 ± 0.6L, AHI 59 ± 35 events/h). Sixteen participants in each PAP group were analyzed. https://www.selleckchem.com/products/pds-0330.html BPAP yielded a greater improvement in PaCO compared to CPAP (9.4mmHg, 95% CI 4.3 to 15 mmHg). There were no significant differences in PAP adherence, sleepiness, sleep quality or neurocognitive function between the two therapies. Although both PAP modalities improved hypercapnic respiratory failure in this group of subjects, BPAP S mode showed greater efficacy in reducing PaCO . Although both PAP modalities improved hypercapnic respiratory failure in this group of subjects, BPAP S mode showed greater efficacy in reducing PaCO2.