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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sleep apnea syndrome is a constellation of symptoms resulting from recurrent episodes of apnea during sleep. Often the upper airway becomes obstructed during slumber in this disorder. Symptoms relate to sleep deprivation and include morning headaches, daytime somnolence, personality changes with deteriorating intellectual capacity, nocturnal enuresis, and sexual dysfunction. Diagnosis is assisted by polysomnographic recordings. Therapy is directed at the cause of obstruction when one can be found, weight loss in massively obese patients, tracheostomy in the symptomatic patient. Four patients with documented sleep apnea syndrome are discussed. One patient, a thin adolescent female underwent adenoidectomy without improvement. Two massively obese adult males required tracheostomy with marked amelioration of symptoms. One additional adult male was found to have sleep apnea due to severe, acquired micrognathia; he was significantly improved by tracheostomy. All three adult patients were found by endoscopic visualization to have marked pharyngeal soft tissue collapse with inspiration during apneic episodes. Possible causes of pharyngeal collapse are discussed.
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PMID:Endoscopic findings in sleep apnea syndrome. 23 Nov 20

A sleep apnea syndrome due to upper airway obstruction was diagnosed in 25 adult men (25 to 65 years of age) using nocturnal polygraphic monitoring. Excessive daytime somnolence, hypnagogic hallucinations, and automatic behavior, personality changes with abnormal behavioral outbursts, impotence, morning headaches, abnormal motor activity during sleep, nocturnal enuresis, and high blood pressure should suggest this diagnosis when any of the symptoms are associated with loud snoring. Respiratory monitoring during sleep and nocturnal cardiovascular evaluation bring prognostic information and indications for therapy. Three types of therapeutic trials, namely, diet, medications with or without diet, and surgery have been performed. Only surgery has been beneficial in these cases.
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PMID:Sleep apnea syndrome due to upper airway obstruction: a review of 25 cases. 55 14

Eight children, 5 to 14 years of age, were diagnosed by means of nocturnal polygraphic monitoring with a sleep apnea syndrome similar to that seen in adults. Excessive daytime sleepiness, decrease in school performance, abnormal daytime behavior, recent enuresis, morning headache, abnormal weight, and progressive development of hypertension should suggest the possibility of a sleep apnea syndrome when any of these symptoms is associated with loud snoring interrupted by pauses during sleep. Surgery may eliminate the clinical symptomatology.
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PMID:Sleep apnea in eight children. 93 81

Nocturnal oxygen desaturation (NOD) is commonly seen not only in sleep apnea syndrome (SAS) but also in chronic lung disease (CLD) including chronic obstructive lung disease even without sleep apnea. However, the relationship of NOD to clinical symptoms such as morning headache, sleep deprivation due to breathlessness, and daytime sleepiness is not known. In this study, we examined by polysomnography the relationship between several NOD indexes, parameters of apnea, and subjective symptoms in 25 patients with SAS and 22 patients with CLD. In addition, the relation between daytime arterial blood gas data and NOD indexes, parameters of apnea, was examined. In the SAS group, there were no differences in any parameters of NOD and apnea between patients with subjective symptoms and those without symptoms. However, in the CLD group, symptomatic patients had significantly lower lowest SaO2, higher mean SaO2, and longer total desaturation time. In both groups, daytime PaCO2 had a significant correlation with several NOD parameters such as mean SaO2, lowest SaO2, and total desaturation time. In the SAS group, daytime PaCO2 was also correlated with the parameters of apnea. On the other hand, daytime PaO2 was significantly correlated with mean SaO2 only in the CLD group. From these data, we conclude that in patients with SAS, daytime PaCO2 is a variable that is related to the degree of NOD, and that in patients with CLD, subjective symptoms and daytime PaO2 in addition to daytime PaCO2 are associated with NOD.
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PMID:[Relationship between clinical symptoms and nocturnal oxygen desaturation in sleep apnea syndrome and chronic lung disease]. 140 71

An awakening has taken place over the last 25 years to the science of sleep disorders. Foremost amongst these, both in the medical world and the public eye, has been Sleep Apnoea Syndrome (SAS). The prevalence is thought to be the order of 1-2%. Males are eight times more commonly affected than females, although after the menopause the gap narrows considerably. Sleep apnoea occurs in children, usually in relation to large tonsils and adenoids, but in adult life patients usually present between the age of 40 and 60 and the prevalence increases with age. Numerous apnoeas or hypopnoeas during the night's sleep result in disordered sleep architecture and unrefreshing sleep. This is usually accompanied by night-long snoring which may lead to marital discord and even complaints from neighbours. Symptoms on waking may be a headache and a feeling of not being refreshed by sleep. Sleepiness during the day can interfere with work and social activities and may produce risks to the patient and others if it occurs while operating dangerous machinery or driving. Over a longer time scale SAS results in intellectual and memory deterioration, a higher incidence of ischaemic heart disease, hypertension, polycythemia and pulmonary hypertension. Right heart failure is particularly likely if there is chronic airflow obstruction contributing to a low arterial oxygen level. Asystolic periods and tachyarrhythmias may occur during apnoeic periods. The increased mortality of SAS relates to coronary and cerebrovascular disease and arrhythmias. Sudden death occurs with greater frequency in patients with SAS, mainly at night.
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PMID:Sleep apnoea: causes, consequences and treatment. 141 52

In order to determine whether the clinical features of obstructive sleep apnoea (OSA) are the same in men and women we reviewed the records of 22 women with OSA. The women were matched with 44 men of similar age (+/- 5 years) and frequency of respiratory events (less than or equal to 15/hr, 16-40/hr, 41-70/hr and greater than 70/hr). The degree of daytime somnolence was similar in men and women. Women are more likely than men to complain of morning fatigue and morning headache, and less likely to report restless sleep or to have been told of apnoea during sleep. Difficulty initiating sleep (DIS) was twice as common in women as in men (p less than 0.05). Most of these differences were also seen when women and men who snored but did not have OSA were compared. Arterial hypertension was less common in women (3/22) than in men (18/44), (p less than 0.001). More striking than the differences between men and women in the prevalence of single symptoms was the existence of a subgroup of women (9/22) with no complaint of either apnoea, choking arousals or restless sleep, and normal blood pressure, complaining only of fatigue and morning headache, and in three cases DIS as well. We concluded that OSA may be commoner in women than previous reports suggest, and that the clinical features may be misleading in women.
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PMID:Differences in the symptoms of men and women with obstructive sleep apnoea. 181 45

In a Rehabilitation Clinic for Diseases of the Respiratory Organs we examined 497 male patients aged 45.9 +/- 11.1 years with a relative weight of 109 +/- 16.7% who were suffering from chronic diseases of the respiratory tract (66.2% chronic bronchitis, 33.8% asthma bronchiale, 49.6% obstruction of the respiratory tract). They were subjected to a detailed physical examination and were given an anamnestic questionnaire for the purpose of diagnosing sleep-related respiratory disturbances (Siegrist et al., 1987). In addition, whole body plethysmography was performed in all patients as well as a pulse-oximetric examination during night sleep. Using factor analysis, it was possible to extract 5 factors from the 23 items of the anamnesis questionnaire. With these 5 factors, 60.5% of the total variance could be explained. These factors describe: 1. Dyspnoea (35.3%); 2. Vigilance (8.5%); 3. Sleep disturbances (6.3%); 4. Headache (5.8%) and 5. Snoring (4.7%). Different factor patterns are seen for different groups of patients. In patients suspected of an obstructive sleep apnoea syndrome, however, it will always be necessary to perform further stage-wise diagnosis to safeguard the diagnosis.
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PMID:[Evaluation of an anamnesis questionnaire for the diagnosis of sleep apnea in patients with chronic diseases of the respiratory organs]. 186 94

Sleep-disordered breathing may occur in a wide variety of neuromuscular syndromes, and may present with diverse, often isolated, symptoms or findings such as excessive daytime sleepiness, pulmonary hypertension, congestive heart failure, morning headaches, or hypoxia-induced nocturnal seizures. The authors report two sisters with congenital muscular dystrophy in whom central sleep apnoea resulted in the isolated symptom of nocturnal seizures in one, and morning headaches in the other. Review of the literature reveals that sleep-disordered breathing may be common in neuromuscular disorders, and may often be present when clinical weakness is mild, and insufficient to result in diurnal respiratory dysfunction.
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PMID:Central sleep apnoea in congenital muscular dystrophy. 194 Sep 43

An association exists between bruxism, tension headache, and sleep disorders, particularly sleep apnea, in the craniomandibular dysfunction patient. Understanding the relationship of these three entities provides the clinician with valuable information that enhances one's ability to make a differential diagnosis. A review of sleep disorders is presented so that a clearer understanding of them can be gained, with emphasis on obstructive sleep apnea. Current theories regarding bruxism, morning headache, and sleep disorders relate closely to altered muscle activity, altered breathing and fluctuation in oxygen saturation levels, which in turn can contribute to a patient's complaints of various types of facial pain.
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PMID:Tension headache and bruxism in the sleep disordered patient. 207 98

A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its test-retest reliability and the interobserver variability of the items. The results indicate the existence of three orders of variables. The first (class A) was characterized by good intra- and inter- observer reliability. It included all interval variables (i.e. weight, height, arterial pressure) and most ordinal variables (i.e. grading of snoring, excessive daytime somnolence, morning headache, smoking, etc.). The second (class B) was characterized by good intra-observer and poor inter-observer reliability. It included snoring onset time and morning somnolence. The third class (class C) was characterized by both poor intra- and inter-observer reliability. It included sleep apnea. For large epidemiological survey purposes the authors suggest that only class A variables be used.
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PMID:[Test-retest reliability of anamnestic data on chronic obstructive apnea]. 209 68


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