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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with obstructive sleep apnoea syndrome are reported where the initial presenting complaint was of lingual ulceration. This unusual presentation has not been reported previously. Both patients experienced frequent apnoeic episodes during sleep with a profound fall in the arterial oxygen saturation. It is postulated that the lingual ulceration resulted from repeated trauma to the tongue by the teeth as the patient made violent inspiratory efforts at the termination of an apnoeic episode. The diagnosis of sleep apnoea syndrome was based upon suggestive symptoms of snoring, morning fatigue and day-time somnolence plus a minimum of 15 apnoeic episodes per hour of sleep. The first-line investigations of this condition are available in all district general hospitals and a diagnosis of sleep apnoea syndrome obtained. Referral to a regional sleep study centre may be appropriate prior to the commencement of therapy. Management is predominantly medical, consisting of weight loss and the administration of nocturnal nasal continuous positive airways pressure.
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PMID:Obstructive sleep apnoea syndrome presenting as lingual ulceration. 151 Sep 3

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.
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PMID:Treatment outcome of sleep apnea. 158 4

The purpose of this study was to examine whether snoring adversely affects sleep architecture and sleep efficiency, and thus may account for the frequent complaints of daytime tiredness and fatigue expressed by heavy snorers. We recruited eight self-confessed heavy snorers and six self-confessed nonsnorers. All subjects had full nocturnal polysomnography, including continuous monitoring of snoring, which was quantified by counting the number of snores per hour of sleep (snoring index), the number of snores per minute of snoring time (snoring frequency), maximal and mean nocturnal sound intensity (dBmax and dBmean, respectively). We found that even the self-confessed nonsnorers snored lightly, with significantly smaller frequency and index than the heavy snorers. Sleep architecture was similar in both groups. Distribution of snoring among the sleep stages differed for light and heavy snorers: light snorers snored uniformly throughout all sleep stages, whereas heavy snorers tended to snore more during slow-wave and REM sleep. Snoring frequency and snoring index were similar during all sleep stages in light snorers, but they were higher during slow-wave sleep in heavy snorers. Wakefulness time after sleep onset and sleep efficiency correlated significantly with the snoring index. We conclude that although snoring does not affect sleep architecture in general, it influences sleep efficiency and wakefulness time after sleep onset; this may have an adverse effect on daytime function of heavy snorers.
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PMID:Snoring and sleep architecture. 198 90

200 of 300 patients who were operated on because of strident snoring or of a sleep apnoea syndrom were examined in a follow-up study. In 93.5% turbinectomy was performed simultaneously, in 50% septum plasty, and in 9.5% endonasal revision of the sinus. On Improvement of snoring was noted in 81.5% of the patients, cessation or improvement of the apnoea in 83%. Daily tiredness was reduced in 65% of the operated patients, and partner problems were solved in 78%. Recommendation for operation was given in 75.5% of the cases. Due postoperative complaints and the lack of results, however, 21.5% could not, and 3% restricted their recommendation to others to undergo surgery. The satisfactory results and the high acceptance of the operation confirmed uvulopalatopharyngoplasty as a solid and efficient operation to help patients suffering from an obstructive sleep apnoea syndrome. If the operation is performed carefully and cautiously, there is no fear of negative consequences such as rhinophonia and difficulties in swallowing.
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PMID:[Results of follow-up after uvulopalatopharyngoplasty]. 205 22

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.
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PMID:Nasal influences on snoring and obstructive sleep apnea. 220 38

Thirty-four patients (32 male, 2 female; mean age 53 +/- 7 years) with confirmed sleep apnea syndrome (SAS) were studied before and after uvulopalatopharyngoplasty (UPPP). Clinical symptoms were tiredness, excessive daytime sleepiness and snoring. All patients were overweight. Patients underwent a thorough physical and oropharyngeal examination and polysomnography before and 3 months after surgery. On the basis of post-operative results, patients are divided into 3 groups: --group 1: 16 cured patients: apnea index (A.I./h) 38 +/- 17 before and 4.4 +/- 4 apneas/h sleep after surgery. Improved nocturnal hypoxemia: mean minimum oxyhemoglobin saturation (SAO2) before and after UPPP in NREM sleep 83 +/- 4% v. 90 +/- 4% in REM sleep 76 +/- 11% v. 85 +/- 7%. Uninterrupted sleep is restored; --group 2: 8 improved patients: A.I./h of 64 +/- 11 before and 20 +/- 6 after UPPP: improved nocturnal hypoxemia: mean minimum SAO2 in NREM sleep 74 +/- 10% before and 86 +/- 6% after UPPP: in REM sleep 59 +/- 9% before and 79 +/- 6% after UPPP, lower amount and percentage of fragmented sleep; --group 3: 10 non-improved patients: A.I./h unchanged 55 +/- 22% before and 50 +/- 20% after UPPP. Persistent nocturnal hypoxemia: mean minimum SAO2 in NREM sleep 76 +/- 13 before and 81 +/- 12% after UPPP: in REM sleep 63 +/- 16% before and 65 +/- 24% after UPPP. Sleep remains fragmented. In this last group patients are more overweight and all suffer from severe SAS with greater nocturnal oxyhemoglobin desaturation. Surgical treatment by UPPP is shown to be effective for 70% of our patients. Better results are obtained when SAS is less severe and overweight less important.
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PMID:[Efficacy of uvulopalatopharyngoplasty (UPPP) and modifications in sleep structure in the sleep apnea syndrome (SAS)]. 261 54

Snoring is an epiphenomenon of obstructive respiration during sleep, which may be caused by higher airway abnormalities and may result in impaired quality of nocturnal sleep, complaints of fatigue and daytime sleepiness, decreased performance level, psychic complaints and cardiovascular problems. The test results of seven patients complaining of excessive snoring and daytime sleepiness are discussed. The importance of multidisciplinary management of the underlying pathology is stressed.
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PMID:[Snoring as a symptom of severe respiratory obstruction during sleep: causes and results]. 279 51

Rare upper airway lesions may be mistaken for asthma. A 16-year-old Hispanic male athlete presented to our allergy clinic with a 4-month history of wheezing and snoring with hoarseness and progressive fatigue on exertion or during sleep. His mother taped periods of harsh stridor and sleep apnea. There was no family history of vocal cord abnormalities. A year before the onset of symptoms, he suffered injury to his oral cavity with a loss of consciousness during a wrestling match. He denied dysphagia or dysphonia. He failed to respond to bronchodilators, cromolyn, or prednisone therapy during 4 weeks. On referral to our clinic, his physical examination and tape recording were characterized by harsh inspiratory stridor. His pulmonary function tests were significant for peak flow depressed out of proportion to FEV1 with reduced FVC, no response to bronchodilator, and flattened inspiratory loop unresponsive to cough or panting. Fluoroscopy and endoscopy of the upper airway was consistent with "marked bilateral limitation of vocal cord abduction." Sleep study demonstrated desaturation with CO2s in the 60s during sleep. He was started on continuous positive airway pressure, 10 cm at night, with no desaturation or sleep disturbance on follow-up.
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PMID:Bilateral abductor paresis masquerading as asthma. 337 24

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.
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PMID:Obstructive sleep apnea following treatment of velopharyngeal incompetence by Teflon injection. 345 60

In a 5-year-old boy the kindergarten-teacher observed an abnormal tiredness and sleepiness. The mother observed noisy breathing and snoring during sleep. The examination showed an hypertrophy of the adenoids and the tonsils, and some signs of cor pulmonale. All symptoms disappeared completely after adeno-tonsillectomy.
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PMID:[Adenotonsillectomy as a cure for sleep apnea syndrome in a 5-year-old boy]. 654 43


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