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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sarcoidosis can involve any tissue in the body and, consequently, the disease presents to clinicians of many different disciplines. We report two cases of sarcoidosis involvement of the nervous system: one male patient with right facial nerve palsy and a cutaneous involvement (supraorbital subcutaneous nodule) associated with bilateral hilar adenopathy; and a female patient presenting a hypothalamus involvement with diabetes insipidus, obesity, lethargy, sleep disturbances and amenorrhoea. In the later case an upper respiratory tract involvement was also present with nasal and tonsils sarcoidosis. A review of the clinical manifestations of neurosarcoidosis and the criteria for establishing the diagnosis is presented.
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PMID:[Neurosarcoidosis. Comments on 2 cases]. 210 Aug 66

Of 22 patients investigated for sleep disorders, habitual snoring and/or daytime hypersomnolence, 12(10 men) had obstructive sleep apnea syndrome (OSAS). 3 OSAS were mild, 5 moderate and 4 severe. The leading symptoms were daytime hypersomnolence and habitual snoring. As risk factors we found retro-micrognathia in 2 patients, macroglossia secondary to acromegaly in 1, alcohol abuse in 7 and obesity in 6. Conservative measures improved the disorder subjectively in 6 patients. One patient had a relapse 6 months after uvulopalatopharyngoplasty. 4 patients were successfully treated by nasal CPAP. Other diagnoses were idiopathic alveolar hypoventilation (2), Cheyne-Stokes breathing secondary to low cardiac output (1), monosymptomatic narcolepsy (2), sleep disturbances secondary to depression (2), chronic benzodiazepine abuse (1) and chronic bronchitis without nocturnal hypoxemia (1). History, clinical observation and oxymetry make diagnosis possible in most cases of OSAS severe enough to require treatment. Polysomnography is time-consuming and should be reserved for selected cases.
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PMID:[Sleep-apnea syndrome. Elucidation, therapy and course]. 305 35

Obstructive sleep apnea (OSA) is a common syndrome occurring in 1% to 4% of the population. While obesity is the most common predisposition to OSA, metabolic disorders have been associated with this syndrome. We describe a patient who presented with severe OSA while in an advanced untreated uremic state, which resolved following intensive dialysis. We speculate that the sleep disturbances, which are common in uremia, may be accounted for in some patients by OSA and may resolve with specific therapy for advanced renal failure.
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PMID:Reversal of sleep apnea in uremia by dialysis. 360 92

Obesity-related sleep apnea syndrome (SAS) was diagnosed in 13 patients evaluated for gastric bypass surgery. A diagnostic sleep study was performed whenever a specially designed questionnaire revealed characteristic signs of sleep disturbances. Pretreatment polyhypnographic recordings of patients with SAS demonstrated considerable reduction of deep and rapid eye movement (REM) sleep stages with a correspondent prolongation of wake within sleep or non-REM sleep stages I and II. After surgical weight reduction repeated polyhypnographic recordings revealed considerable improvement or even a complete recovery of breathing in sleep and a normalization of sleep structure. Non-REM deep sleep stages (III and IV) augmented from 5.51% +/- 2.53% (mean + SEM) to 22.69% +/- 3.56% (p less than 0.002), and the REM stage increased from 9.91% +/- 1.78% to 18.15% +/- 2.13% (p less than 0.005). Surgical weight reduction in obesity-related SAS is a valuable therapeutic measure for this respiratory derangement, as well as for sleep quality.
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PMID:The effect of surgical weight reduction on sleep quality in obesity-related sleep apnea syndrome. 399 78

Polysomnograms were obtained from two groups of normal subjects (20 medical students and 20 elderly persons). The recordings included the usual sleep parameters (electroencephalograph, electrooculograph, and electromyograph of chin muscles) and respiratory data obtained by means of a pneumotachygraph (tidal volumes and respiratory frequency) and thoracic and abdominal strain gauges. In the older group, sleep was more disturbed and respiratory events (hypopneas and apneas) were more frequent both in non-rapid eye movement (NREM) and in REM sleep. The apneas were predominantly of the obstructive type. A correspondence analysis carried out on the 40 subjects showed that a high frequency of hypopneas and obstructive apneas was linked to old age and age-related parameters (disturbed sleep and obesity) both during NREM and REM sleep. A high frequency of central apneas during light slow-wave sleep was linked to the male sex; a high frequency of central apneas during REM sleep was linked to the amount of REM sleep. No relationship could be demonstrated between the decrease of minute ventilation from wakefulness to steady sleep and the incidence of sleep respiratory events.
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PMID:Breathing during sleep in normal young and elderly subjects: hypopneas, apneas, and correlated factors. 687 80

Sleep is an ubiquitous phenomenon. It is a developmental product, being subjected to the vicissitudes of human behavior and culture. The author will attempt to elaborate on sleep, sleep disorders, and sleep medicine in Korea from various developmental perspectives (i.e. personal, national and scientific). Korea is a rapidly developing industrialized nation and is now experiencing immense cultural changes which force individuals to change their behavior and value systems. For example, shift working is becoming increasingly popular and early working hours are being adopted by more companies as a measure to win competitions in the international market. In the clinical setting it is observed very easily that patients develop and maintain disturbed sleep-wake rhythm and its consequences. More obstructive sleep apnea, presumably due to obesity, are observed and studied in sleep clinics. The nuclear family system, an inevitable outcome of industrialization, produces some profound difference in sleeping arrangement such as children's earlier separation from parental or grandparental sleeping environment. The question is how these and other industrialization-related changes may affect the incidence and the manifestation of sleep and sleep disorders. In the background there is emerging interest in healthy sleep and sleep disorders, exemplified by increasing coverage of the topics in the mass media and the publication business. Development of sleep medicine/research per se also involves a developmental perspective. Interests in sleep and sleep disorders began sporadically decades ago in Korea and are now actively being organized mainly by the Korean Association of Sleep Medicine and Psychophysiology as a unified developing force. Understanding of sleep and of sleep disorders is not complete without in-depth understanding of culture, philosophy, and tradition from developmental perspectives. Traditional ideas and wisdom from the past are the unavoidable resources for further understanding sleep and developing sleep researches/medicine in Korea as well as in Asia.
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PMID:Sleep in Korea: a developmental perspective. 872 26

Previous epidemiological studies have suggested that psychiatric symptoms are associated with obesity and abdominal distribution of body fat in women. The aim of the present study was to examine this in middle-aged men. In 1992 a cluster selected cohort of 1040 men born in 1944 (participation rate 79.9%) was examined. Registrations of symptoms of depression and anxiety, sleep disturbances, psychosomatic disease as well as degree of life satisfaction were analyzed in relation to body mass index (BMI) and the waist/hip circumference ratio (WHR). In univariate analyses both BMI and WHR correlated with these factors. BMI and WHR were, however, closely interrelated (p = 0.61), necessitating analyses of separate, independent relationships in multivariate analyses. When adjusted for WHR all the significant relationships with BMI disappeared. In contrast the WHR, adjusted for BMI, showed remaining significant associations with the use of anxiolytics (p = 0.018), hypnotics (p = 0.029), antidepressive drugs (p = 0.008), degree of melancholy (p = 0.002), and life satisfaction (p = 0.002, negative), difficulties to sleep (p = 0.014) and fall asleep (p = 0.047), tendency to wake up from sleep (borderline, p = 0.070) and dyspepsia (p < 0.001). Since smoking and alcohol are known to influence on the WHR, these factors were, in addition to BMI, entered into the analyses as confounding variables. The mentioned associations then remained statistical significant (use of hypnotics borderline, p = 0.074) except difficulties to fall asleep and tendency to wake up. It was concluded that in contrast to BMI, the WHR is associated with symptoms of depression and anxiety with associated sleep disturbances, as well as psychosomatic symptoms and dissatisfaction. It was hypothesized that the mechanism involved might be increased secretion of cortisol, directing storage fat to central adipose tissue depots.
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PMID:Mental distress, obesity and body fat distribution in middle-aged men. 873 58

The objectives of this study were to describe the prevalence of snoring, observed apneas, and daytime sleepiness in older men and women, and to describe the relationships of these sleep disturbances to health status and cardiovascular diseases (CVD). A cross-sectional design was employed to study sleep problems, CVD, general health, psychosocial factors, and medication use. The subjects were participants in the Cardiovascular Health Study, which included 5,201 adults, aged 65 and older, who were recruited from a random sample of Medicare enrollees in four U.S. communities. Study measures employed were sleep questions, echocardiography, carotid ultrasound, resting electrocardiogram, cognitive function, cardiopulmonary symptoms and diseases, depression, independent activities of daily living (IADLs), and benzodiazepine use. Thirty-three percent of the men and 19% of the women reported loud snoring, which was less frequent in those over age 75. Snoring was positively associated with younger age, marital status, and alcohol use in men, and obesity, diabetes, and arthritis in women. Snoring was not associated, however, with cardiovascular risk factors or clinical CVD in men or women. Observed apneas were reported much less frequently (13% of men and 4% women) than snoring, and they were associated with alcohol use, chronic bronchitis, and marital status in men. Observed apneas were associated with depression and diabetes in women. In both men and women, daytime sleepiness was associated with poor health, advanced age, and IADL limitations. The conclusions of the study were that loud snoring, observed apneas, and daytime sleepiness are not associated cross-sectionally with hypertension or prevalent CVD in elderly persons.
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PMID:Prevalence and correlates of snoring and observed apneas in 5,201 older adults. 889 30

Objective: To determine factors affecting sleep disturbances in children.Background: Factors affecting sleep disturbances have been studied extensively in adults, but relatively few studies have been done in children.Methods: As part of the twelfth survey of the Tucson Epidemiologic Study of Obstructive Airways Disease (TESOAD, 1991-1992), children, ages 3-14, of adult cohort members were administered a health questionnaire which contained items related to sleep problems as well as items related to respiratory diseases and symptoms. Participants were classified as having sleep disturbances if they reported disorders of initiating and maintaining sleep (DIMS), excessive daytime sleepiness (EDS) or snoring. Potential factors affecting sleep included age, gender, obesity, asthma, other bronchial problems, cough and sputum production, wheezing and rhinitis.Results: The overall prevalence rates were 16.8, 4 and 22.9% for DIMS, EDS, and snoring, respectively. We found a significantly higher prevalence of DIMS in 11-14-year-old girls (30.4%) and snoring (32.3%) in 3-6-year-old boys. Certain respiratory factors were more prevalent in children with sleep disturbances. Multivariate analysis revealed that risk factors for DIMS included female gender, age 11-14 and wheezing. The risk for EDS was increased in those children with cough and sputum production. Cough and sputum production also were risk factors for snoring as was rhinitis and age 3-6.Conclusions: We conclude that in children as in adults, respiratory symptoms are associated with sleep disturbances. Further, the increased insomnia seen in adult women may begin in early adolescence.
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PMID:Factors affecting sleep disturbances in children and adolescents. 1076 52

There are many causes leading to breathing disorders in children. In the newborn period the immature central regulation of breathing can result in a pattern with apneas and bradycardias most commonly seen in the very premature infant. Therefore, during hospital stay many of these very tiny preterms and some of the very ill term infants do have severe apneas and do need medication and or mechanical support (nasal CPAP, positive pressure ventilation). In the first two to three months of life central dysmaturity can persist in some infants and apneas of infancy can occur further on. Infants with prolonged apneas and symptoms like paleness, cyanosis, stiffness or limpness are often investigated, treated or monitored. At the age of two to six, every tenth child is a loud snorer. Every fifth snorer at this age suffers from a severe upper airway obstruction. Factors that decrease pharyngeal size or increase pharyngeal compliance may lead to obstruction. Adenotonsillar hypertrophy is the most common associated condition, craniofacial disorders, central nervous system and neuromuscular problems and less obesity are disposing factors. Children may present nocturnal symptoms like snoring, difficult breathing or disturbed sleep, but most of them have daytime problems as initial complaint such as hyperactivity, behavioral problems, growth failure, poor school performance. Excessive daytime sleepiness is not so common in young children. The childhood obstructive sleep apnea syndrome is a common and serious problem. Children with symptoms suggesting severe obstruction should be evaluated and treated. Most children are cured by adenotonsillectomy whilst some require further therapy.
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PMID:[Sleep apneas in children]. 1095 55


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