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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sleep apnea syndrome (SAS) is often associated with arrhythmias. The study was performed to clarify the characteristics and mechanisms of the heart rate (HR) changes during and after sleep induced apneas. Thirty-one patients with SAS without definitive heart disease, aged 17-78 years (mean 54.2 years), were examined by electroencephalograms, electrocardiograms, electrooculograms, nasal and oral breathing, thoracic and abdominal respiratory movements and arterial oxygen saturation (SaO2). [Results and Discussion] At the onset of sleep apnea, some showed progressive reductions in HR, followed by abrupt tachycardia on the resumption of breathing. Thirty-one patients with SAS were classified into three Groups (A, B, C). Group A demonstrated that HR changes occurred associated with apnea both in stage REM and in stage non-REM. Group B demonstrated that HR changes occurred associated with apnea only in stage REM. Group C demonstrated that HR changes did not occur associated with apnea. In Group A, apnea frequency and apnea index were higher than those of Group C. In Group A, the lowest SaO2 was lower than that of Group C, total time under 90% of arterial oxygen saturation (SaO2) was longer than that of Group C. There was a good negative correlation between oxygen saturation and HR changes. Further, HR changes were augmented by arousal response. This might be related to the arousal response as well as to the cardiostimulatory effects of hypoxia associated with increased ventilation. The arousability in response to apneas might be important in HR changes. In SAS, the degree of HR changes was related to apnea frequency, apnea index, apnea length and sleep stage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Heart rate changes in sleep apnea syndrome]. 226 69

Snoring usually is trivial and unimportant, but it can turn into a social or medical problem. Obesity, hypertension and heart disease are more frequent among snorers than among nonsnorers, and especially snorers with hypersomnia during the day are at risk. Hypersomnia in association with snoring usually signifies obstructive sleep apnea. Increased resistance in the upper airways, together with negative inspiratory pharyngeal pressure and muscular hypotonia during deep non-REM and REM sleep, lead to collapse of the pharynx, hypoxia and hypercapnia. Only after arousal from sleep does muscle tone return, pharyngeal obstruction reopen and airflow resume. Since this process can occur 300 or 400 times a night, repetitive alveolar hypoventilation leads to pulmonary-arterial hypertension and cor pulmonale, and the repetitive sympathetic activations can cause systemic hypertension or serious cardiac arrhythmias. The countless arousals deprive the sufferer of deep non-REM and REM sleep and their consequence is sleep fragmentation. The symptoms are excessive daytime sleepiness, intellectual deterioration and personality and behavioral changes. Oronasomaxillofacial, endocrine and neuromuscular anomalies and diseases predispose to sleep apnea, and alcohol or CNS-depressant drugs can favour its occurrence. Diagnosis is made by nighttime oxymetry, and if this is abnormal, by polysomnography. After polysomnography it is possible to distinguish between obstructive and nonobstructive sleep apnea, and the decisions for an adequate treatment can be made.
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PMID:[Dangerous snoring. Sleep-apnea syndrome]. 331 92

Sleep apnea syndrome is a relatively common disease, with an overwhelmingly male predominance. The female:male ratio is about 1:15-20, depending on the specific age group. In light of findings linking sleep apnea syndrome to essential hypertension, it is hypothesized that the syndrome may contribute to the sex differential in mortality. In most of the developed countries women have longer life expectancy than men even after adjustment for various lifestyles and biologica variables Mortality from heart disease accounts for 40% of the total sex differential. The fact that the 2-5 fold sex differential for heart disease mortality is reduced to much lesser extent by multivariate adjustment than the sex differential for mortality from all causes, and that it is minimally affected by the exclusion of all persons with a history of chronic diseases, indicates that other risk factors should be sought. I propose the hypothesis that Sleep Apnea Syndrome (SAS), which almost exclusively affects males, contributes to the sex differential in mortality from coronary heart disease. Sleep Apnea Syndrome is a relatively common disease. It is the most preponderant finding among patients referred to diagnostic sleep laboratories, particularly among patients complaining of excessive daytime sleepiness. Its incidence among the adult male population (age greater than 21 years) was estimated to be at least 1-1.5%. It is considerably higher than that, at least 5 to 7 fold, in the 40 to 60 years age group, and in specific high-risk populations such as the morbidly obese. The female:male ratio is about 1:15-20, depending on the specific age group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sleep apnea syndrome: is it a contributing factor to the sex differential in mortality? 364 99

In a study conducted in four family practice units in Toronto, Canada, 2001 subjects reported on snoring and medical conditions in members of their households. For spouses the prevalence of snoring increased with age up to the seventh decade, with a higher prevalence of nearly 85% in husbands. For 11 medical problems an association existed between snoring, its frequency, and the presence of the condition. This association continued when the data were corrected for sex, age, and marital state. For hypertension both men and women who snored between the fifth and 10th decades had a twofold increase over non-snorers. The prevalence of heart disease and other conditions, except for diabetes and asthma, also increased in snorers in this age group. When corrected for smoking and obesity the association between snoring, hypertension, and heart disease persisted. These findings extend those of Lugaresi et al, and if they could be confirmed snoring as a risk factor for conditions other than sleep apnoea and sleep disorders might be considered. Methods of alleviating the acoustic annoyance of snoring may also provide direct medical benefits.
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PMID:Snoring as a risk factor for disease: an epidemiological survey. 392 56

Four infants with Down syndrome developed cor pulmonale and heart failure in association with chronic upper airway obstruction. Features of the sleep apnea syndrome were conspicuous; namely, noisy breathing with retraction, cyanosis and frequent apnea during sleep, and daytime lethargy and somnolence. The clinical picture masqueraded as cyanotic congenital heart disease. Arterial blood gas analyses revealed alveolar hypoventilation, especially during sleep. The nature of the obstructive element was variable. Adenoidectomy provided partial relief in one patient, and tonsillectomy and adenoidectomy resulted in temporary improvement in two others. Three patients were markedly benefitted by tracheostomy. Functional inspiratory pharyngeal closure was demonstrated fluorographically in one patient. Infants with Down syndrome may be predisposed to upper airway obstruction by virtue of hypoplasia of facial and oropharyngeal structures and generalized hypotonia. Additional obstructive elements may be contributed by hypertrophied lymphoid tissue, excessive secretions, and glossoptosis. Removal of the obstructive element is helpful, but functional obstruction may only be relieved by tracheostomy.
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PMID:Alveolar hypoventilation and cor pulmonale associated with chronic airway obstruction in infants with Down syndrome. 645 3

Traffic accidents (TA) are, after heart disease, cancer and stroke, the fourth death cause among the general population. Although the number of AT caused by diseases-excluding alcoholism- seems to be reduced, interaction between organic pathology and functional ability increases the importance of this problem. This paper revises the literature on the relation between AT and specific neurological diseases: epilepsy, obstructive sleep apnea syndrome (SAS), stroke, dementia and Parkinson disease. Also, the problems and the role of the neurologist in assessing driving ability in patients with brain damage is analyzed, with special reference to the legal condition in Spain. The insufficiency of diagnostic labels as predictors of driving ability is stressed; the group of patients affected by these pathologies does not present greater TA risk than young drivers twice that of the general population. In the cases of epilepsy, SAS and ECV, which can cause episodic driving inability, defining recurrence probabilities and finding regulation formulas is the task of clinical epidemiologists and the regulative authorities. In the case of dementia, Parkinson disease and ECV, causing psychomotor performance deterioration, the basic problem, complicated by the presence of comorbility in these patients, is the development of valid clinical scales for driving ability assessment. The regulative authorities need simple measures which are often difficult to develop. Meanwhile, it is the task of the neurologist, as part of the therapeutic intervention during the medical encounter, to discuss driving risks with each patient.
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PMID:[Neurological diseases and driving]. 749 90

During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored in the Technion sleep laboratories. Their age at the time of diagnosis ranged between 21 and 79 years. Fifty-seven patients (53 men and 4 women) had died by 1990, 53% due to respiratory-cardiovascular causes. The observed/expected (O/E) mortality rates, calculated for men only, revealed excess mortality of patients under 70 years old. Excess mortality was significant in the fourth and fifth decades (3.33, p < 0.002; 3.23, p < 0.0002, respectively). In patients older than 70 O/E was 0.33 (p < 0.0007). Hierarchical multivariate analysis with four fixed variables [age, body mass index (BMI), hypertension and apnea index] and four additional variables added manually one at a time (heart disease, lung disease, diabetes, apnea duration) was used to determine the predictors of death from all causes, cardiopulmonary causes and from myocardial infarction (MI). All four major variables were found to be significant predictors of mortality from all causes, in addition to lung disease and heart disease. Only age and BMI were significant predictors of cardiopulmonary deaths in addition to lung disease. Age, BMI and hypertension predicted MI deaths in addition to lung disease. These results were interpreted to suggest that SAS affects death indirectly, most probably by being a risk factor for hypertension.
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PMID:Mortality in sleep apnea patients: a multivariate analysis of risk factors. 938 Oct 62

Much has been written about snoring and its affects on health, in particular its possible influence on cardiovascular disease. However, there are many assumptions made when linking the report of snoring to any consequences such as hypertension, heart disease or stroke. In particular it is not clear how snoring might influence the cardiovascular system, whether subjective reports of snoring are accurate, and snoring might only be acting as a marker for some common risk factor such as upper body obesity; a particular risk factor for cardiovascular disease, and through neck circumference, snoring. There is much better evidence that snoring is an important cause of sleepiness, even in the absence of conventional sleep apnoea.
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PMID:Epidemiology of snoring and its consequences. 761 44

This article provides an in-depth overview of the relationship between primary hypertension and adult obstructive sleep apnea syndrome. The background data and research are taken from the English-language literature through 1993. Primary hypertension is a common cause of major medical illnesses, including stroke, heart disease, and renal failure, in middle-aged males. Its prevalence in the United States is around 20%, with the rate of newly diagnosed hypertensive patients being about 3% per year. Sleep apnea syndrome is common in the same population. It is estimated that up to 2% of women and 4% of men in the working population meet criteria for sleep apnea syndrome. The prevalence may be much higher in older, non-working men. Many of the factors predisposing to hypertension in middle age, such as obesity and the male sex, are also associated with sleep apnea. Recent publications describe a 30% prevalence of occult sleep apnea among middle-aged males with so called "primary hypertension." Is this association fortuitous, related to a high prevalence of both diseases in the same population, or is it caused by a factor common to both diseases, such as obesity? Should the diagnosis of apnea be actively sought with sleep studies in hypertensive populations? If a diagnosis of "asymptomatic" sleep apnea is made in a hypertensive person, should the apnea be treated? Current research data provide only partial answers to these and other questions regarding the association of apnea and hypertension. Logic dictates that clinically symptomatic patients in hypertensive clinics should receive appropriate evaluation for apnea, but broad populations of hypertensive individuals should not be referred for sleep studies.
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PMID:The relationship between systemic hypertension and obstructive sleep apnea: facts and theory. 784 28

A cross-sectional study of 1385 Saudi females attending 15 health centres in urban and rural areas in the Riyadh region was conducted during September and October 1992 to determine the prevalence of obesity and its associated factors. The mean age was 32.2 +/- 11.7 years and body mass index (BMI) 29.2 +/- 7.0 kg m-2. Only 26.1% of subjects were their ideal weight (BMI < 25 kg m-2), while 26.8% were overweight (BMI 25-29.9 kg m-2), 41.9% were moderately obese (BMI 30-40 kg m-2) and 5.1% were morbidly obese (BMI > 40 kg m-2). High-risk groups for obesity were mostly middle aged, multiparous housewives. Patients living in rural areas had greater BMIs than those living in urban areas (P < 0.01). Thirty per cent of overweight participants did not think they were overweight. The study emphasizes the need for community based programmes for preventing and reducing obesity since weight control is effective in ameliorating most of the disorders associated with obesity such as Type 2 non-insulin dependent diabetes mellitus, hypertension, stroke, heart disease, sleep apnoea syndrome and osteoarthritis of the knees. The focus of efforts should be directed towards young mothers who are at risk of developing obesity and who play a central role in perpetuating it in their offspring.
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PMID:High prevalence of clinical obesity among Saudi females: a prospective, cross-sectional study in the Riyadh region. 800 60


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