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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We treated 23 patients with obstructive sleep apnea syndrome (OSAS) by nasal continuous positive airway pressure (NCPAP) at home, and examined the long-term compliance, clinical effects, and complications after NCPAP therapy. Nineteen patients continued and four patients discontinued the therapy during the mean observation period of 15 months, and the compliance was 83%. There was no significant difference in age, weight, and sleep data between the compliant group (C) and non-compliant group (NC). The causes of discontinuation of therapy were lack of adaptation to the apparatus (2 cases), improvement of clinical symptoms due to weight reduction (1 case), and induction of asthma attack (1 case). Disappearance of excessive daytime sleepiness, improvement of sleep quality, and disappearance of nocturia were observed in most cases, and disappearance of morning headache and improvement of sexual ability and emotional instability were also observed in several cases. Nine cases (39%) complained of discomfort due to the nasal mask and 6 cases (26%) complained of dryness of the mouth and nose, whereas 10 cases (43%) experienced no adverse effects. No serious complications were observed. These findings suggest that long-term home NCPAP is an effective and safe treatment for OSAS patients.
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PMID:[Long-term effects and complications of home nasal CPAP therapy for obstructive sleep apnea patients]. 140 75

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

Obstructive sleep apnea (OSA) is a syndrome in which the airflow created from breathing ceases through the upper airway although diaphragm movement continues. Resulting complications include severe daytime sleepiness, morning headaches, loud snoring, and disturbed nighttime sleep. Patients affected with OSA are frequently hypertensive and can have dangerous cardiac arrhythmias. The diagnosis of OSA requires an all-night polysomnographic recording; neither snoring nor other subjective complaints constitute adequate criteria for treatment. The treatment objective for OSA is to maintain airway patency. A potential treatment discussed here is temporary advancement of the mandible or tongue during sleep with the use of dental appliances.
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PMID:Dental appliances for the treatment of obstructive sleep apnea. 265 51

Sleep apnea has been overlooked for many years. However new studies show, that sleep apnea is very prevalent. Approximately 2-5 per cent of the adult population suffer from obstructive sleep apnea. Sleep apnea is related to several symptoms including hypersomnia, headache and cognitive dysfunctions. Sleep apnea is probably a risk factor for cardio- and cerebrovascular complications. Treatment reduce symptoms and the cardio- and cerebrovascular risk. The most effective treatment is Nasal Continuous Positive Airway Pressure (NCPAP), but surgical treatment is effective in selected cases, and includes UvuloPalatoPharyngoPlasty (UPPP), mandibular advancement, nasal surgery and partial tongue resections. No medical treatment is actually know to reduce obstructive sleep apnea.
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PMID:[Sleep apnea]. 279 82

Profound transient nocturnal hypoxemia is common during REM sleep in "blue bloaters" with chronic obstructive lung disease, these patients having hypoxemia and CO2 retention when awake, when breathing air. These hypoxemic episodes appear to be due to a combination of reduced ventilation in REM sleep with a possible increase in the maldistribution of ventilation to perfusion within the alveoli at that time, and a reduction in functional residual capacity. The episodes are associated with exacerbations of pulmonary vasoconstriction, which can be reversed by oxygen therapy throughout sleep. Cardiac arrhythmias and alterations in ST segments are also found in these patients during sleep when breathing air. It is probable that the severity of hypoxemia in REM sleep can be predicted from knowledge of the arterial PO2 when breathing air when awake in patients with COPD. If so, expensive sleep studies are not essential to indicate the presence of hypoxemia in sleep in these patients, but such studies may be required in obese patients, in those who snore, or those who complain of headache following nocturnal oxygen therapy to demonstrate the presence of the overlap syndrome, in which obstructive sleep apnea is combined with chronic obstructive lung disease in the same patient. Nocturnal oxygen therapy may be dangerous in such patients with the overlap syndrome but appears to cause little rise in PCO2, in patients with COPD and REM-associated hypoxemia alone. Hypoxemia and sleep quality can probably be improved by oxygen therapy in "blue bloaters," and this treatment can also reverse pulmonary hypertension in REM sleep. The new ventilatory stimulant almitrine can also correct hypoxemia, without disturbing sleep quality, but the effects of this drug on pulmonary vasoconstriction during REM sleep are as yet unknown.
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PMID:Sleep in chronic obstructive lung disease. 293 59

Obstructive sleep apnea syndrome (OSAS) is a complex disorder characterized by a sleep-related collapse of the upper airway. The most likely candidate for the common pathway linking various abnormalities casually associated with OSAS (such as adenotonsillar hypertrophy, obesity, retro- or micrognathia, acromegaly, or more subtle structural anomalies) is an abnormally small upper airway lumen. Symptoms of OSAS that appear during sleep include snoring, abnormal motor activity, disturbed nocturnal sleep, a sensation of choking, heartburn, nocturia, nocturnal enuresis, and heavy sweating. Daytime waking symptoms are dominated by often profound sleepiness, which may secondarily be associated with automatic behavior, retrograde amnesia, hypnagogic hallucinations, personality changes, sexual difficulties, and headaches. Careful evaluation, both sleeping and waking, are essential to select appropriate treatment. Treatments include nasal continuous positive airway pressure, tracheostomy, weight loss, uvulopalatopharyngoplasty, mandibular advancement, and so forth.
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PMID:Obstructive sleep apnea syndrome. A review. 333 20

Five patients with chronic respiratory failure from neuromuscular disease and symptomatic worsening nocturnal hypoventilation were treated with nocturnal ventilation. Home ventilation at night was provided by a volume-cycled positive pressure ventilator attached to a nasal mask originally designed to administer nasal continuous positive airway pressure (CPAP) for obstructive sleep apnea. The device was well tolerated. Symptoms of headache, insomnia/somnolence, and impaired intellectual capacity rapidly disappeared with nocturnal ventilatory support. Daytime arterial PO2 and PCO2 improved after therapy. There are several advantages over commonly used, negative pressure devices for nocturnal ventilation. These include patient synchronization of tidal volume, ease of application, less cumbersome apparatus, more nocturnal patient mobility, and absence of production of upper airway obstruction.
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PMID:Nocturnal positive pressure ventilation via nasal mask. 354 11

We studied the effect of supplemental nocturnal oxygen on blood gases in 15 patients with severe but stable chronic obstructive lung disease (ratio of forced expired volume in one second to forced vital capacity, 37.2 +/- 1.8 [mean +/- S.E.] per cent of predicted; arterial oxygen tension, 50.7 +/- 1.4 mm Hg; and arterial carbon dioxide tension [PCO2], 53.1 +/- 1.5 mm Hg). Sleep variables and measures of gas exchange were determined on two consecutive nights; on the first night the subjects breathed supplemental oxygen, and on the second they breathed room air. Transcutaneous PCO2 was measured with an infrared sensor, and arterial oxygen saturation with an ear oximeter. Breathing of supplemental oxygen sufficient to keep oxygen saturation at or above 90 per cent was associated with only small increases (less than 6 mm Hg) in PCO2 throughout sleep, as compared with values while subjects were breathing room air. The increase in PCO2 occurred early in the night and was not progressive. Only three patients, who were found to have obstructive sleep apnea in addition to obstructive lung disease, had larger increases in PCO2 during sleep and reported morning headaches. We conclude that nocturnal oxygen does not induce clinically important increases in PCO2 during sleep in patients with stable obstructive lung disease and therefore can safely be used to prevent the dangerous consequences of hypoxia.
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PMID:Effect of supplemental nocturnal oxygen on gas exchange in patients with severe obstructive lung disease. 642 Jul

Four hundred forty-one subjects 34 to 69 yr of age were recruited from a random sample of the community. The sample was biased in favor of men, snorers, and subjects with subjective sleep complaints. They answered a questionnaire and were monitored in their homes for sleep-disordered breathing (SDB). This report concerns the presence of symptoms associated with the obstructive sleep apnea (OSA) syndrome in the subjects with SDB detected in this community sample. Most of the symptoms commonly recognized as occurring in OSA were associated with SDB in our sample: snoring that disturbed the sleep of other persons, reports of apnea, reports of gasping or choking sounds during sleep, and finding the bedclothes in disarray in the mornings had significant univariate associations with SDB. Nocturnal choking and morning headache were negatively associated with SDB. Excessive daytime somnolence (EDS) was reported by 41% of those with SDB, but it was also reported by 37% of snorers without SDB and by 37% of nonsnorers. We conclude that the symptoms seen in clinic patients with OSA also occur in subjects with SDB who have not presented for medical attention. Enumeration of these symptoms by questionnaire, however, is a poor test for OSA in the community. EDS was reported by a higher than expected proportion of subjects not affected by SDB, suggesting that causes of self-reported EDS other than SDB may be common.
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PMID:A community study of snoring and sleep-disordered breathing. Symptoms. 763 30

Sleep-disturbed breathing, which includes apneas, hypopneas, and oxygen desaturations, occurs in asymptomatic individuals and increases with age. Obstructive apnea is the most frequent type of respiratory disturbance documented by polysomonography, the gold standard test for assessing sleep-disturbed breathing. Many of the prevalence studies done to date have had one or more methodological weaknesses, including selection biases, varying definitions of obstructive sleep apnea, failure to distinguish types of apneas, failure to control for confounding variables, and small sample size. Although there is consensus on the definitions of sleep-disturbed breathing, the appropriate number of apneas and hypopneas for diagnosing clinically significant obstructive sleep apnea is uncertain. While the cutoff of five or more apneas and hypopneas per hour is historically considered abnormal, the origins of this number are vague, and the longevity of those who have this value on polysomnography is not necessarily reduced. This is particularly true among those without symptoms of obstructive sleep apnea syndrome, which include excessive daytime sleepiness, snoring, nocturnal awakenings, and morning headaches. Investigators should be careful to distinguish symptomatic study subjects from asymptomatic subjects, and to exclude central apneas in calculating their estimates. In addition, various studies have used different definitions of sleep apnea syndrome, making comparisons of point estimates difficult. It would be more appropriate for researchers to estimate morbidity and mortality indices with confidence intervals, using several different cutoff points. Subject selection in all studies should follow a two-stage sampling procedure. All subjects with symptoms compatible with obstructive sleep apnea syndrome and a subsample of asymptomatic individuals should be studied with all-night polysomnography. If portable monitoring is used, the validity and reproducibility of this diagnostic method should be assessed. Subjects with significant comorbidity should be excluded from prevalence studies. Factors that clearly increase the risk of sleep-disturbed breathing and obstructive sleep apnea and its related symptoms include age, structural abnormalities of the upper airway, sedatives and alcohol, and probably family history. Although endocrine changes such as growth hormone, thyroid hormone, and progesterone deficiency also have been suggested as risk factors for exacerbating obstructive sleep apnea syndrome, there is minimal epidemiologic evidence to support this. Case-control studies are recommended to assess the relation of endocrine factors to obstructive sleep apnea syndrome in a rigorous fashion. A limited number of mortality studies have suggested decreased survival in persons with the obstructive sleep apnea syndrome, possibly primarily due to vascular-related disease.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Epidemiology of obstructive sleep apnea. 771 77


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