Scott R. Bundlie's research while affiliated with University of Minnesota Medical Center, Fairview and other places

Publications (23)

Article
Sleep-related complaints, particularly insomnia and wakefulness at night, are common. The causes are multiple, and include normal, if not ideal, changes in sleep stages and organization with age. The prevalence of sleep disorders is also known to increase with advancing age. These factors are even more exaggerated in the sleep of older individuals...
Article
BACKGROUND- Atrial fibrillation is responsible for approximately one in seven strokes in patients of all ages and for one in four strokes in patients aged >80 years. Warfarin reduces stroke risk by approximately 70% and aspirin by 20%. REVIEW SUMMARY- Although the average annual risk of stroke is approximately 5%, there is substantial risk heteroge...
Article
We retrospectively reviewed 17 polysomnograms (PSG) in symptomatic amyotrophic lateral sclerosis (ALS) patients to assess the type and frequency of sleep disordered events and correlated these findings with pulmonary function tests (PFTs), presenting complaints, presence of bulbar dysfunction, and response to bi-level positive airway pressure (PAP)...
Article
We retrospectively reviewed 17 polysomnograms (PSG) in symptomatic amyotrophic lateral sclerosis (ALS) patients to assess the type and frequency of sleep disordered events and correlated these findings with pulmonary function tests (PFTs), presenting complaints, presence of bulbar dysfunction, and response to bi-level positive airway pressure (PAP)...
Article
Background: The Stroke Prevention in Atrial Fibrillation II study compared warfarin vs aspirin for stroke prevention in atrial fibrillation. Bleeding complications importantly detracted from warfarin's net effectiveness, particularly among older patients. Objectives: To analyze bleeding complications according to assigned therapy. To identify risk...
Article
Background Adjusted-dose warfarin is highly efficacious for prevention of ischaemic stroke in patients with atrial fibrillation (AF). However, this treatment carries a risk of bleeding and the need for frequent medical monitoring. We sought an alternative that would be safer and easier to administer to patients with AF who are at high-risk of throm...
Article
Full-text available
To determine the frequency, location, size, and risk factors for silent cerebral infarctions (SCIs) on brain CT, we identified 629 patients without a history of previous stroke who were enrolled in a multicenter clinical trial of therapy for acute ischemic stroke. On the baseline CT, 143 patients (22.7%) had SCIs; 34.3% of the lesions were in the r...
Article
We report longitudinal data on a group of 29 male patients 50 years of age or older who were initially diagnosed as having idiopathic REM sleep behavior disorder (RBD) after extensive polysomnographic and neurologic evaluations. Thirty-eight percent (11/29) were eventually diagnosed as having a parkinsonian disorder (presumably Parkinson's disease)...
Article
Background: The Stroke Prevention in Atrial Fibrillation II study compared warfarin vs aspirin for stroke prevention in atrial fibrillation. Bleeding complications importantly detracted from warfarin's net effectiveness, particularly among older patients. Objectives: To analyze bleeding complications according to assigned therapy. To identify risk...
Article
The prevention of stroke has undenied merit. Recognition of stroke-inducing conditions (eg, cardiac diseases associated with embolism, polycythemia) provides opportunities for specific prevention strategies. For a larger number of patients, however, risk factors for degenerative vascular disease should be addressed. The evidence for efficacy is str...
Article
Full-text available
Over a 5-yr period, 19 adults presented to our sleep disorders center with histories of involuntary, nocturnal, sleep-related eating that usually occurred with other problematic nocturnal behaviors. Mean age (+/- SD) at presentation was 37.4 (+/- 9.1) yr (range 18-54); 73.7% of the patients (n = 14) were female. Mean age of sleep-related eating ons...
Article
Hypnosis has been described anecdotally to be effective in the treatment of sleepwalking and sleep terror, potentially dangerous parasomnias. The authors report the use of hypnosis in the treatment of 27 adult patients with these disorders. A total of 74% of these individuals reported much or very much improvement when followed over substantial per...
Article
Individuals with nonvalvular atrial fibrillation are at Increased risk of stroke. The Stroke Prevention in Atrial Fibrillation Study is a 15-center randomized clinical trial examining the risks and benefits of low-intensity warfarin (prothrombin time of 1.3-1.8 times control) and aspirin (325 mg/day) in patients with constant or intermittent atrial...
Article
During the past century, infrequent, anecdotal reports of sleep-related violence with forensic science implications have appeared. Recent rapid developments in the field of sleep-disorders medicine have resulted in greater understanding of a variety of sleep-related behaviors, and formal sleep-behavior monitoring techniques have permitted their doc...
Article
A polysomnographic (PSG) and clinical study of 150 patients presenting to a sleep disorders center for evaluation of repeated sleep-related injury identified 8 Ss (aged 19–36 yrs) with dissociative disorders (DDs) as the cause of injuries. The Ss' presenting diagnosis was somnambulism. Two Ss fulfilled Diagnostic and Statistical Manual of Mental Di...
Article
In 100 consecutive adults who came to a sleep disorders center complaining of repeated nocturnal injury, polysomnographic study identified five disorders: night terrors/sleepwalking (N = 54), REM sleep behavior disorder (N = 36), dissociative disorders (N = 7), nocturnal seizures (N = 2), and sleep apnea (N = 1). Ninety-five patients sustained ecch...
Article
Fatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (...
Article
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by intermittent loss of electromyographic atonia during REM sleep with emergence of complex and vigorous behaviors. Punching, kicking, and leaping from bed during attempted dream enactment caused repeated injury in nine of our first ten adult patients. Mean age at onset...
Article
Four men, aged 67-72 years, had 4-month to 6-year histories of injuring themselves or their spouses with aggressive behaviors during sleep, often during attempted dream enactment. A 60-year-old woman had disruptive though nonviolent sleep and dream behaviors. Polysomnography did not detect seizures but did document REM sleep pathology with variable...

Citations

... The estimated prevalence of SBI in the general population ranges from 8 to 28%, and this variation appears to depend on age, the study design, the imaging technique used, and the definition of an infarct used [1]. Furthermore, the prevalence of SBI is high in patients with co-morbid diseases, such as, cardiovascular diseases [6], carotid stenosis [7], and hypertension [8,9], and its prevalence among patients with symptomatic stroke, ranging from 11% to 38% on brain CT scan, is generally higher than in the healthy population [10][11][12][13][14][15]. However, most of previous studies have evaluated the presence of SBI by brain CT, and this is likely to be less sensitive than brain MRI for the detection of small lesions. ...
... Based on the evidence from the Framingham Heart Study cohorts [9] and the risk stratification using the CHA 2 DS 2 -VASc score system [10], stroke prevention has become the mainstay treatment strategy in patients with AF [11]. Diverse approaches have shed light on appropriate anticoagulant selections [12]. With an increasing number of published studies favoring the use of NOACs over warfarin, NOACs appear to be the current anticoagulant of choice for patients with AF [13]. ...
... Appropriate metrics were chosen to assess both the clinical and statistical accuracy of the models. An important clinical consideration is that INR has a therapeutic range of ±0.5 in most patients [32] and using tighter target ranges for maintenance dosing does not achieve any therapeutic advantage [33]. The chosen metrics accounted for that, and were consistent with metrics used in related studies -allowing direct results comparisons. ...
... A research found that an adjusted-dose warfarin (PT-INR 2.0-3.0) importantly reduces stroke for high-risk patients in patients with AF and at least one thromboembolic risk factor [18]. The guideline recommend a target PT-INR of 2.0-2.5 for AF patients undergoing percutaneous intervention, because the risk of bleeding will increase sharply when the PT-INR is above the target therapeutic range [19]. ...
... Aproximadamente un 10% de los pacien tes con taquicardia ventricular de diversas causas, así como los pacientes con prolapso valvular mitral y con taquiarritmias atriales, han demostrado las características espera das de la actividad desencadenada. En los pacientes con taquicardia ventricular relacio 83 nada con el ejercicio, arterias coronarias normales y corazón estructuralmente sano, el mecanismo primario de sus taquicardias es la actividad desencadenada. ...
... 9 Although hypertension was a significant risk factor for ischaemic stroke in the primary analysis of the J-RISK AF, 10 it was not always identified as an independent predictor for ischaemic stroke. [11][12][13][14][15] Blood pressure (BP) control status may contribute to an increased risk of adverse events in patients with NVAF, rather than the prior diagnosis of hypertension. Indeed, in the J-RHYTHM Registry, hypertension or baseline BP quartile was not associated with thrombo-embolism, whereas a systolic BP ≥136 mmHg at the time closest to an event or at the end of follow-up (BP-end) was independently associated with a higher incidence of thromboembolism and major haemorrhage. ...
... Sexsomnia needs to be differentiated from the following conditions: (i) Sleep-Related Epileptic Seizures, with a broad array of sexual behaviors during sleep being documented by vPSG/ extended EEG monitoring during epileptic seizures (Schenck et al., 2007;Voges et al., 2019). (ii) Sleep-Related Dissociative Disorders, with sexual behaviors emerging from EEG wakefulness during the sleep period (Schenck et al., 1989;2007); (iii) sleep exacerbation of Persistent Sexual Arousal Syndrome (Wylie et al., 2006;2008); (iv) hypersexuality often found with the Kleine-Levin Syndrome (periodic hypersomnias), and other sleep-related conditions, as reviewed (Schenck et al., 2007). Finally, sexsomnia needs to be distinguished from other sexual arousal disorders that emerge during wakefulness, but at times with nocturnal wakeful manifestations that could be confused with sexsomnia, in particular the paraphilias, involving frotteurism, exhibitionism, fetishism, masochism, sadism, etc. (Wylie et al., 2008). ...
... La reducción de la hipertensión sistólica, redujo la incidencia en un 36%. El tratamiento de los hipertensos leves y lábiles, quienes representan el 70% de este grupo de pacientes debe hacerse fundamentalmente con medidas no farmacológicas, tales como disminución de peso, reducción de la sal de la dieta, abstención del cigarrillo y alcohol y actividad física moderada (10). ...
... A scoping review of available literature was conducted using the methodological guidelines proposed by Arksey and O'Malley and Levac et al (21)(22)(23). Given the overlap between NREM parasomnia types (24)(25)(26)(27), data for all NREM parasomnia subtypes were collected. ...