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

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

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

Submucous resection (SMR) for the deviated nasal septum had been criticised to have a higher complication rate and less patient satisfaction than septoplasty. Seventy-five patients who underwent SMR were studied and followed up at 6 months to 56 months post-operatively. The rates of short and long term complications were relatively low: septal haematoma 1.3%, nasal infection 1.3%, epistaxis 2.6%, external nasal deformity 9.3% and septal perforation 2.7%. While most patients achieved short term relief of nasal obstruction (93.4%), about 30% had persistent/recurrent nasal obstruction on long term follow-up. Similar rates had been quoted for the operation of septoplasty. We postulated that this was due to unfavourable airflow patterns as a result of minor residual septal deviation. Some patients had associated pre-operative symptoms of snoring (57.3%), headache (48.0%), rhinorrhoea (38.7%), sneezing (30.7%), hyposmia (30.7%) and epistaxis (21.3%). Frequencies of cure/improvement of these symptoms after SMR were 34.9%, 33.3%, 24.1%, 30.4%, 60.9% and 43.8% respectively. The overall post-operative long term (average 23.5 months) satisfaction rate was almost 70%. SMR, being relatively easy to perform, and having similar complication and patient satisfaction rates as septoplasty, should be retained in the surgical armamentarium for the deviated nasal septum.
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PMID:Submucous resection for deviated nasal septum: a critical appraisal. 148 74

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

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

A 39-year old Chinese man presented with an acute onset of severe headache, accelerated hypertension and subsequently an unexpected extensive right occipital haemorrhage. These were found to be related to a sleep apnoea syndrome which had been unrecognized for many years despite its typical symptoms of loud snoring and excessive daytime sleepiness. Weight reduction led to significant clinical but not polysomnographic improvement of the sleep apnoea syndrome.
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PMID:Sleep apnoea presenting as severe hypertension and silent occipital haemorrhage. 225 42

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

To assess the risk of byssinosis in a cotton textile factory in Cameroon a preliminary study was conducted on a random sample of 125 men from production areas and 68 men from non-production areas. Symptoms were assessed by a questionnaire, which also included questions regarding sleep; peak expiratory flow rate (PEF) was measured with a miniature peak flow meter at the end of a working day and total dust concentrations were assessed by static and personal sampling with Casella dust samplers giving values of 6.4 +/- 2.6 mg/m3 (m +/- SD) in production areas and 1.7 +/- 0.7 mg/m3 in control areas. Exposed subjects had significantly more symptoms (particularly in smokers) and lower PEF values than controls (408 +/- 961/min v 468 +/- 701/min, p less than 0.001). Twenty three exposed subjects (18%) reported chest tightness on returning to work after the weekly break (compared with one control, p less than 0.01). Subjects with byssinosis had lower PEF values than those without chest tightness (356 +/- 501/min v 426 +/- 951/min, p less than 0.01), more chronic bronchitis (52% v 6%, p less than 0.001), they were more often smokers (61% v 31%, p less than 0.05), and came generally, though not exclusively, from the opening carding spinning department with the highest concentrations of total dust (8 +/- 2 mg/m3) and an estimated prevalence of byssinosis of 28%. There were no significant differences in sleep related symptoms between the exposed and controls, though the 23 subjects with byssinosis tended to report more snoring (48%), early morning headache (48%), and sleep improvement over the working week (44%) than all the other subjects (28%, 24%, and 24% respectively, p less than 0.1).
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PMID:Byssinosis in a textile factory in Cameroon: a preliminary study. 321 5

Sleep apnoea syndromes are a frequent disease, with an incidence of more than 1% in the adult population, a strong male predominance, and a maximal frequency between 40 and 60 years. Their clinical manifestations are dominated by snoring and daytime sleepiness, at times associated with morning headaches, intellectual deficiency, sexual impotence. Obesity, hypertension and polycythemia are not uncommon. These patients are at risk for accidents due to sleepiness, sudden death due to sleep apnoea-related cardiac arrhythmias, ischemic attacks related to hypertension and polycythemia and right heart failure secondary to pulmonary hypertension and alveolar hypoventilation. The most frequent form of sleep apnoea syndromes include obstructive and mixed apnoeas. Their mechanism involves both anatomic factors (upper airway narrowing) and functional factors (defective activation of upper airways dilatory muscles) which lead to upper airway occlusion upon inspiration during sleep. Two therapeutic strategies are possible: a surgical one, uvulopalatopharyngoplasty, the efficacy of which is inconstant and unpredictable and nasal continuous positive airway pressure, which is constantly efficacious but constraining. Central sleep apnoea syndromes are rare, less clearly defined and more difficult to treat.
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PMID:[Sleep apnea syndromes in adults]. 332 Dec 51


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