Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two hundred one patients diagnosed as having obstructive sleep apnea (OSA) were interviewed 12-24 months after their evaluation regarding those daytime symptoms associated with sleep apnea: sleepiness, fatigue, impaired memory, and snoring. Continuous positive airway pressure (CPAP) was the treatment most often used by severe sleep apnea patients, and this improved daytime alertness in 84% of the patients. Patients with moderate obstructive sleep apnea often had surgery which led to 85% reporting improved daytime alertness. Patients with mild obstructive sleep apnea usually were treated with weight loss or changing sleep position and also improved 64% and 66%. Patients who declined or failed treatment did not improve. Guidelines for the treatment of sleep apnea are suggested.
 ...
PMID:Treatment outcome of sleep apnea. 158 4

Daytime somnolence and fatigue are frequently ignored symptoms in acromegaly. To examine whether sleep apnea or other abnormalities in the sleep structure is the underlying cause, 9 young patients with active untreated acromegaly for 2-7 years were studied with all night polysomnography. It revealed a decrease in REM sleep time in all the acromegalics compared to age- and sex-matched normal subjects (p less than 0.001) and also a reduction in delta sleep (p less than 0.05). None had obstructive sleep apnea. At reexamination 12-15 months posttreatment the daytime sleepiness had disappeared in all patients. REM sleep time increased in all patients (p less than 0.001) to normal level; delta sleep time increased moderately (p less than 0.05). Thus sleepiness in patients with high fasting level of growth hormone (GH) is not related to sleep apnea but more likely to a reduced amount of REM sleep time. By normalizing the GH concentration, REM sleep time became normal and the daytime sleepiness disappeared in all patients.
 ...
PMID:Sleep in acromegaly before and after treatment with adenomectomy. 204 66

Although the relationship between nasal obstruction and sleep disturbance is variable, either partial or total obstruction of the nasal passages can cause snoring, obstructive sleep apnea, and the sequelae of alveolar hypoventilation. In addition, nasal obstruction can cause sleep fragmentation, sleep deprivation, and the known sequelae of disturbed sleep architecture, including associated daytime tiredness and alterations in normal behavior patterns. Nasal obstruction may produce greater physiologic effects during sleep than during the awake state. A complete examination of the upper respiratory tract should be done in all patients with obstructive sleep apnea and snoring. The degree of nasal obstruction is not directly correlated with the severity of symptoms and findings.
 ...
PMID:Nasal influences on snoring and obstructive sleep apnea. 220 38

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction during sleep. Inspiratory muscles may be subjected to potentially fatiguing loads during an obstructive apnea and this may be related to the termination of obstructive apnea. We have measured transdiaphragmatic pressure (Pdi) and breathing patterns in six male patients with OSA during sleep to characterize respiratory muscle function in OSA and determine whether apnea termination is consistently related to a pressure time index of the diaphragm (PTI) associated with respiratory muscle fatigue. There was a large intersubject variability in Pdi generation during apnea. No consistent level of PTI was associated with apnea termination. During prolonged apneas, the respiratory duty cycle plateaued, which is suggestive of an inhibitory reflex possibly mediated by chest wall afferents. There were intersubject differences in both inspiratory and expiratory muscle recruitment during apnea. In the majority of patients, the diaphragm appeared to be the primary inspiratory muscle during apnea, but in some it appeared to be the intercostal/accessory muscles. The majority of patients demonstrated an increase in gastric pressure and inward abdominal movement during the expiratory phases of an apnea, consistent with abdominal muscle recruitment stimulated by increased ventilatory drive.
 ...
PMID:Respiratory muscle function during obstructive sleep apnea. 202 36

To describe the affective changes associated with sleep restoration we assessed psychologic symptoms using the Profile of Mood States questionnaire before and two months after treatment with nasal continuous positive airway pressure (NCPAP) in seven men with obstructive sleep apnea (OSA). The results were compared with those of a control group of patients with OSA who did not receive NCPAP. Two of six mood factors, depression and fatigue, improved significantly following treatment with NCPAP. Total Mood Disturbance (TMD) score was used to assess global mood differences. The mean TMD score for the patients before treatment was 1.7 and during treatment decreased to -7.6 (p less than 0.05). This mean decrease of 9.3 in the TMD score implies generalized improvement in mood. These findings support the opinion that sleep fragmentation and abnormalities of respiration during sleep are at least partially responsible for affective changes seen in sleep apnea. These psychologic disturbances improve after treatment with NCPAP.
 ...
PMID:Neuropsychologic symptoms in obstructive sleep apnea improve after treatment with nasal continuous positive airway pressure. 305 55

From 1967 to 1974 a clinical trial of Teflon injection into the posterior pharyngeal wall for correction of velopharyngeal incompetence (VPI) was conducted in thirty-six patients. Six years after Teflon injection, one of the patients reported the onset of severe snoring punctuated by silences when he seemed not to be breathing, daytime hypersomnolence, and tiredness severe enough to interfere with work and studies. The diagnosis of obstructive sleep apnea (OSA) was confirmed by polysomnographic sleep monitoring, and the dynamics of the obstruction elucidated by cinefluoroscopy performed with the patient asleep. Resection of the lower 3/4 of the Teflon pad, leaving the upper rim to avoid recurrence of his VPI, has eliminated the symptoms of OSA and produced an improvement in his polysomnographic findings.
 ...
PMID:Obstructive sleep apnea following treatment of velopharyngeal incompetence by Teflon injection. 345 60

This report discusses mechanisms causing the airways to open during obstructive sleep apnea (OSAS). In 4 male patients with OSAS, 92 nonrapid eye movement (NERM) sleep apnea episodes and 37 rapid eye movement (REM) sleep apnea episodes were analyzed breath by breath during a one-night study. We calculated the pressure time index of the diaphragm (the product of inspiratory time/cycle duration (Tl/Ttot) and mean transdiaphragmatic pressure swing), evaluated the sleep stages via EEG, and performed frequency spectrum analysis of the EMG of the diaphragm. It was found that with each occluded inspiratory effort the tension time index of the diaphragm (TTdi) increased progressively to reach or slightly exceed the fatigue threshold, 0.15 to 0.18 (during NREM sleep the TTdi of the last occluded breath was 0.195 +/- 0.045 and during REM sleep the TTdi of the last occluded breath was 0.153 +/- 0.037); that a close time relationship was observed as well between the onset of arousal and the opening of the airways. Our data suggest that the airways may be triggered to open by a protective reflex originating in the larynx or the inspiratory muscles upon reaching a certain degree of contraction.
 ...
PMID:Inspiratory muscle activity as a trigger causing the airways to open in obstructive sleep apnea. 381 99

Obstructive sleep apnea is becoming more widely recognized. Otolaryngologists will be called upon to evaluate affected patients and offer consultation as to the appropriateness of surgical intervention. The extent to which this syndrome is attributable to edema of the larynx and hypopharynx is unknown. It may, on occasion, explain chronic fatigue, weight loss, and daytime somnolence seen in some patients following irradiation of the head and neck. Sleep apnea associated with upper airway obstruction can be confirmed by polysomnography during sleep. Monitoring the EEG, electro-oculogram, electromyogram, ECG, airflow, and respiratory effort allows differentiation of obstructive sleep apnea from central or mixed apnea. Once the diagnosis of obstructive sleep apnea is established, treatment consists of correcting the airway obstruction.
 ...
PMID:Sleep apnea syndrome and supraglottic edema. 739 96

A new small-diameter microchip catheter, especially developed for continuous intrathoracic pressure monitoring to assess the degree of respiratory obstruction and effort in patients with sleep-related upper airway obstructions, was investigated. The technical performance and clinical applicability of the catheter was tested in a simplified screening study comprising 122 sleep recordings in patients with varying complaints of snoring and daytime tiredness. In six obese snorers, sensitivity of the catheter to apneas, hypopneas, and nonapneic snoring was compared to the traditional assessment of respiratory events by conventional polysomnography. The catheter was found to be easy to handle and introduce, with technical qualities meeting the demands for overnight recordings of intrathoracic pressure variations. Patient tolerance was high (93%), and sensitivity to apneas and hypopneas was equivalent to that of traditional polysomnography. Periods with upper airway obstruction and increased respiratory effort on the borderline between asymptomatic obstructions and obstructions resulting in significant blood-gas changes could be detected primarily with intrathoracic pressure monitoring. Monitoring the intrathoracic pressure variations in the esophagus has been shown previously to reflect respiratory effort. Increased respiratory effort might be one of the explanations for the fragmented sleep patterns and sleep related daytime symptoms sometimes seen in patients without a pathologic respiratory index. In addition to being applicable for the detection of apneas and hypopneas, continuous nocturnal monitoring of the intrathoracic pressure variations also detects small increases in respiratory effort and thus may constitute a valuable tool for the understanding and diagnosis of upper airway resistance syndrome and obstructive sleep apnea syndrome.
 ...
PMID:Continuous intrathoracic pressure monitoring with a new esophageal microchip catheter in sleep-related upper airway obstructions. 767 41

The prevalence of obstructive sleep apnea (OSA) in women who were being seen for obesity assessment, rather than for assessment of sleep disturbance, was assessed. A consecutive series of referrals to an eating disorders clinic (n = 40) were studied in the sleep laboratory. Their body mass index (BMI) ranged from 29.4 to 66.9 kg/m2. Overnight polysomnograms were carried out, with respiration and oxygen saturation being monitored. Four women (10%), 1 postmenopausal and 3 premenopausal, had significant OSA. They tended to have a higher percentage of body fat and higher BMIs than the nonapnea group. These findings indicate that the prevalence of OSA is higher in the general population of obese women than is generally thought. They highlight the need for professionals who work with obese women to consider the possibility that some of the complaints of fatigue and tiredness may be a result of OSA.
 ...
PMID:Obstructive sleep apnea in a consecutive series of obese women. 775 98


1 2 3 4 5 6 7 8 9 10 Next >>