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Query: UMLS:C0020538 (hypertension)
 170,190 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

Symptoms and signs in 12 patients with severe obstructive sleep apnea (OSA) syndrome have been presented. The most common symptoms were snoring , increased motor activity during sleep and excessive daytime somnolence. The factors predisposing to OSA syndrome were obesity and anatomic abnormalities of the upper airway structure. In some cases the signs of OSA syndrome included hypertension, right heart failure, chronic alveolar hypoventilation and polycythemia. Polysomnography showed sleep fragmentation and the prevalence of light sleep stages. Obstructive sleep apneas repeated 73 +/- 23 times per hour of sleep. The mean apnea duration was 19 +/- 8 s. The mean arterial oxygen saturation during apnea was 72 +/- 14%.
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PMID:[Diagnosis of obstructive sleep apnea syndrome]. 148 56

The diagnosis of obstructive sleep apnea is frequently made by taking a meticulous history coupled with a high index of suspicion. Snoring and hypersomnolence are clinical features common to individuals with sleep apnea. Since snoring is said to be a "disease of listeners," it is not uncommon that bed partners reported an increased incidence of depression and marital displeasure. It is for this reason that the spouse or bed partner should be interviewed, since the patient may not be aware of any sleeping problems. Physicians should also be alert to complaints of excessive daytime somnolence, because studies have shown that patients with obstructive sleep apnea are at increased risk for automobile crashes. It has been estimated that approx 58,000 motor vehicle accidents involving people with sleep apnea will occur in the US each yr. By proper diagnosis and treatment, the physician is in a unique position to prevent at least some of the automobile accidents that result from falling asleep while driving. Polysomnography is the only definitive way to obtain a diagnosis of sleep apnea. This allows the physician not only to diagnosis the disorder, but also helps in the evaluation of the severity of the syndrome and selection of therapy. An ENT evaluation is also important in ruling out anatomic disorders that can cause upper airway obstruction. Certain factors, such as alcohol and sedative ingestion, may aggravate the condition in a person predisposed to sleep apnea, and subtle changes, such as unexplained hypertension, polycythemia, and cor pulmonale, should lead one to investigate the possibility of sleep apnea as the etiology.
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PMID:Diagnosis of obstructive sleep apnea. 229 95

People with snoring, excessive daytime somnolence, and nocturnal breath cessation are very likely to have sleep apnea, particularly if they are obese or hypertensive. We collected epidemiologic data to determine the frequency of these findings in an unselected adult population. Respondents in a random digit dialing telephone survey included 685 people (356 women and 329 men, with a mean age of 50 years). Snoring was reported by 37%, gasping by 8%, excessive daytime somnolence by 36%, and hypertension by 28%; all symptoms were more prevalent in respondents older than 50 years. Snoring and gasping were more common in men than in women. Six persons (1%) had all four risk factors, plus a body mass index of one standard deviation above the mean. Eleven respondents (2%) had all four risk factors, but lower weight. We conclude that all risk factors for sleep apnea are more prevalent in persons over the age of 50 years, and that the incidence of sleep apnea in the general population may be 1%.
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PMID:Sleep apnea: prevalence of risk factors in a general population. 267 53

In the Chicago Western Electric Company study, diet was assessed at the initial examination, in 1957-1958, of 1900 middle-aged men and again at their second examination about one year later. At the first examination, lipid composition of the diet, as summarized by a score based on the formula of Keys, Anderson and Grande (Grande, F. Predicting change in serum cholesterol from change in lipid composition of the diet. In: Lauer RM, Shekelle RB, eds. Childhood Prevention of Atherosclerosis and Hypertension. New York: Raven Press, 1980:145-53), was positively associated with level of serum cholesterol. Between the first and second examinations, however, hypercholesterolemic men were more likely than others to have reduced intake of dietary saturated fatty acids and cholesterol. As a result, at the second examination the cross-sectional linear association between the diet score and serum cholesterol concentration was significantly positive for men with initial levels of serum cholesterol less than 250 mg/dl, significantly negative for men with initial levels of 250 mg/dl or higher and not significantly different from zero for all men together. The bias introduced by change in diet among hypercholesterolemic men differs importantly from bias due to unreliability of measurement and to interindividual differences in intrinsic level of serum cholesterol, because it can produce statistically significant but spurious correlations.
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PMID:Dietary lipids and serum cholesterol level: change in diet confounds the cross-sectional association. 704 32

Detailed data about sleep habits, sleep complaints, life style, work, past and present health were obtained from 1,502 industrial workers. In agreement with previous studies, one-third of the workers reported having problems with sleep. A relatively large percentage of workers complained of excessive daytime somnolence (EDS), which was unrelated to sex, age, education, and area of origin. Compared to the total population, workers complaining EDS had signficantly more pre- and postsleep complaints, midsleep disturbing phenomena, and work accidents, and they were less satisfied with their work. They also had a significantly higher prevalence of asthma, high blood pressure, headaches, and arthritis and ulcers, and they consumed significantly more medications. Based on the cluster of pre- and postsleep complaints of workers complaining of EDS, and on preliminary results from the second phase of this project (which includes laboratory polysomnographic recordings), it is suggested that in most cases, various forms of breathing disorders in sleep are responsible for EDS.
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PMID:Sleep habits and sleep disturbances in industrial workers in Israel: main findings and some characteristics of workers complaining of excessive daytime sleepiness. 725 75

Excessive daytime sleepiness (EDS) in certain patients with sleep apnea syndrome may be the result of intermittent upper airway obstruction during sleep. The possible occurrence of daytime hypertension and pulmonary hypertension (PH) in these patients has been emphasized. Transient and sometimes severe elevations of systemic and pulmonary arterial pressures during sleep as a result of intermittent upper airway obstruction may lead to EDS, daytime hypertension, and PH. The aim of the present study was to investigate whether daytime hypoxemia and hypoxemia during sleep contribute to EDS, daytime hypertension, and PH. The results indicate that: (1) sleep disturbance and blood gas changes while awake and asleep may play a role for EDS, although these abnormalities were not present in some cases, (2) hypoxemia while awake and asleep is probably not involved in daytime hypertension, and (3) mean resting pulmonary arterial pressure is correlated with daytime PO2, PCO2, %IBW, %FVC, and FEV1.0%, Cardiopulmonary hemodynamic function may return to normal in some patients who receive appropriate treatment.
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PMID:[Sleep apnea syndrome]. 760 17

The National Commission on Sleep Disorders Research, in its report to Congress, concluded that the primary care community generally does not understand sleep disorders. Obstructive sleep apnea carries a risk of substantial morbidity and mortality. Excessive daytime sleepiness results from fragmented sleep and microarousals associated with apneic events. It causes poor work performance and increases the incidence of automobile accidents due to driving while drowsy. The commission estimates that the loss of productivity in the United States from excessive daytime sleepiness is more than $20 billion per year. Obstructive sleep apnea is strongly associated with hypertension, myocardial infarction, and stroke. Risk factors for obstructive sleep apnea include male sex, obesity, older age, craniofacial anomalies, and familial risk. Treatment is based on documenting the disorder by polysomnography. Medical management of the syndrome includes weight loss and nasal continuous positive airway pressure. A network of follow-up and support is necessary to maintain compliance. Surgical treatment is reserved for those for whom nasal airway pressure treatment fails. A surgical protocol is presented that demonstrates efficacy equal to nasal airway pressure treatment. Primary care physicians should assume the responsibility of identifying patients at risk for obstructive sleep apnea and refer them appropriately.
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PMID:Obstructive sleep apnea. Trends in therapy. 772 98

Excessive daytime somnolence is the main symptom of the obstructive sleep apnea syndrome (OSAS). Repetitive upper airway obstructions during sleep are followed by arousals and consequent sleep fragmentation. Furthermore, obstructive apneas or hypopneas and arousals are accompanied by fluctuations of blood pressure and heart rate. Several recent studies have found OSAS to be an independent risk factor for arterial hypertension and cardiovascular diseases.
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PMID:[Sleep apnea syndrome, arterial hypertension and cardiovascular risks]. 853 75


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