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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The obstructive sleep apnea syndrome (OSAS), is a common cause of morbidity during childhood. Childhood OSAS usually stems from adenotonsillar hypertrophy. OSAS in infants is usually related to craniofacial anomalies. Other risk factors include obesity and neuromuscular disease. Symptoms include snoring and difficult breathing during sleep. Infants may have problems with feedings and experience failure to thrive. Definitive diagnosis is made by polysomnography. Normative polysomnographic parameters vary with age; thus age-appropriate norms must be used. In contrast to adults, children often manifest a pattern of persistent partial airway obstruction during sleep, rather than cyclical, discrete obstructive apneas. Most children are cured by tonsillectomy and adenoidectomy. However, some children require further therapy, such as continuous positive airway pressure.
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PMID:Obstructive sleep apnea in infants and young children. 871 40

We studied 176 patients with habitual snoring (HS) and obstructive sleep apnea (OSA) to find out whether Japanese patients with OSA differ from those in western countries. The prevalence and pathophysiology of hypertension may substantially differ between OSA patients in Japan and in western countries: body mass index may be more closely associated with hypertension in western patients. No statistical relationship was found between obesity and hypertension in Japanese patients. Although the reason is unknown, thinner body builds in Japanese patients could account for this difference. However, if Japanese patients complain of severe obesity or excessive daytime sleepiness, or both, and have a saw-tooth sign in the flow-volume curve or hypertension, or both, a polysomuography should be indicated.
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PMID:[Sign and symptoms in Japanese patients with obstructive sleep apnea: present status and problems]. 875 81

The obstructive sleep apnea syndrome is a common cause of morbidity during childhood. Childhood obstructive sleep apnea syndrome is usually secondary to adenotonsillar hypertrophy. Other risk factors include craniofacial anomalies, obesity, and neuromuscular disease. Symptoms include snoring and difficulty breathing during sleep. Definitive diagnosis is made by polysomnography. Normative polysomnographic parameters vary with age; thus age-appropriate norms must be used. In contrast to adults, children often manifest a pattern of persistent partial airway obstruction during sleep, rather than cyclical, discrete obstructive apneas. Most children are cured by tonsillectomy and adenoidectomy. However, some children require further therapy, such as continuous positive airway pressure.
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PMID:Obstructive sleep apnea in children. 879 38

Nocturnal motor breathing and cardiac activity were recorded by using the static charge-sensitive bed, and sleep habits were studied by questionnaire in 24 pairs of monozygotic twins discordant for their body mass index; the mean intrapair difference between co-twins was 6.7 kg/m2. Intrapair differences in sleep characteristics between co-twins were related to intrapair differences in physiological and anthropometric characteristics. Two questions were tested. First, do monozygotic twins discordant for body mass index differ in sleep behavior? Second, if they do, are differences in sleep associated with nongenetic differences in the body weight and metabolism or with other environmental factors? Obese twins had higher nocturnal motor activity levels, less quiet sleep, and more habitual snoring than did their nonobese co-twins. Differences in sleep were associated with obesity-related factors. However, habitual snoring did not explain other intrapair differences in sleep. It was concluded that relatively moderate obesity is associated with disruption of physiological structure of sleep as measured by the static charge-sensitive bed method and that this disruption seems not to be associated with snoring or breathing disturbances.
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PMID:Sleep in monozygotic twin pairs discordant for obesity. 884 94

OSAS, a common cause of disrupted sleep and EDS, result from repetitive closure of the upper airway during sleep. It probably represents the most severe syndrome related to obstruction of the upper airway; less severe forms include UARS, a syndrome characterized by the need for increased effort to breath but no prominent apneas or hypopneas, and primary snoring. Initial clues to the presence of OSAS and related disorders are derived from the history and include loud snoring, EDS or insomnia, and witnessed apneas. Some patients, especially women, may complain mostly of tiredness or fatigue, and children may present with behavioral abnormalities. Obesity, a large neck circumference, and a crowded oropharynx are common on physical examination. Nonobese patients, in particular, often have retrognathia, a high-arched narrow palate, macroglossia, enlarged tonsils, temporomandibular joint abnormalities, or chronic nasal obstruction. The clinical suspicion of obstructed nocturnal breathing is confirmed by overnight polysomnography, and an MSLT may be used to assess sleepiness. Esophageal manometry during polysomnography facilitates diagnosis of UARS. Treatment most commonly consists of nasal CPAP or BPAP, although problems with compliance make surgical treatment preferable in some cases. Although UPPP eliminates sleep apnea only in a minority of patients, combining UPPP with maxillofacial procedures appears to improve outcomes. Other treatments such as the use of dental appliances or medications, weight loss, and positional therapy may be useful as adjunctive therapy for moderate to severe OSAS or as primary treatments for UARS or mild OSAS.
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PMID:Obstructive sleep apnea and related disorders. 887 78

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

Snoring, widespread in this country, has important social and interpersonal ramifications. It may be a symptom of serious associated disorders, or it may be a health hazard in and of itself. The pathophysiology is related to loose vibrating tissue in the pharynx and is often associated with obesity. The assessment of snoring may include polysomnography if symptoms suggest air flow disruption and/or sleep fragmentation. Treatment options include behavioral therapeutic measures as well as surgical approaches. It is important to differentiate primary snoring from OSA and other sleep-related breathing disorders before embarking on surgical intervention.
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PMID:Snoring. The not so silent partner. 890 45

Obstructive sleep apnea syndrome (OSAS) is increasingly recognized in the pediatric population. It is characterized by a combination of partial upper airway obstruction and intermittent obstructive apnea that disrupts normal ventilation and sleep. It is estimated to occur in 1-3% of children with a peak age of 2 to 5 years. Common symptoms include habitual snoring, difficulty breathing during sleep, restlessness, and witnessed apnea. Adenotonsillar hypertrophy is the most common associated condition in otherwise normal children, but cranialfacial abnormalities, neuromuscular diseases, and obesity are also predisposing factors. Severe OSAS can have serious neurobehavioral and cardiorespiratory consequences including excessive daytime sleepiness, growth failure, school failure, behavioral problems, cor pulmonale, or even death. Diagnosis is based on data from the history, physical exam, and laboratory studies that confirm the presence and severity of the upper airway obstruction. Polysomnography has been the diagnostic tool of choice. Treatment depends on the severity of symptoms and the underlying anatomic and physiologic abnormalities. Since childhood OSAS is usually associated with adenotonsillar hypertrophy, the majority of cases are amenable to surgical treatment. However, there is increasing pediatric experience with CPAP therapy when tonsillectomy and adenoidectomy are either unsuccessful or inappropriate.
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PMID:Obstructive sleep apnea syndrome (OSAS) in children: diagnostic challenges. 908 30

Sleep-related breathing disorders (SRBD) include several disorders gradually developing from simple and loud snoring through upper airway resistance syndrome and sleep apnoea up to the Pickwickian syndrome. They are manifestant as a respiratory distress and apnoeic episodes, desaturation of oxygen in the blood and interruption of sleep. These symptoms are demonstrated in a case of a patient with the Pickwickian syndrome. SRBD may result in severe secondary life-threatening cardiovascular complications (nocturnal arrhythmias, sudden cardiac death, stroke and pulmonary oedema). They may contribute also to the development of important disorders of public health such as hypertension, obesity, and traffic accidents resulting from hypersomnolence and fatigue. (Tab. 1, Fig. 3, Ref. 46.)
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PMID:[Sleep-related breathing disorders--an interdisciplinary topic in undergraduate and postgraduate medical education]. 926 12

Excessive daytime sleepiness in the general community is a newly recognized problem about which there is little standardized information. Our aim was to measure the levels of daytime sleepiness and the prevalence of excessive daytime sleepiness in a sample of Australian workers and to relate that to their self-reported sleep habits at night and to their age, sex, and obesity. Sixty-five percent of all 507 employees working during the day for a branch of an Australian corporation answered a sleep questionnaire and the Epworth sleepiness scale (ESS) anonymously. Normal sleepers, without any evidence of a sleep disorder, had ESS scores between 0 and 10, with a mean of 4.6 +/- 2.8 (standard deviation). They were clearly separated from the "sleepy" patients suffering from narcolepsy or idiopathic hypersomnia whose ESS scores were in the range 12-24, as described previously. ESS scores > 10 were taken to represent excessive daytime sleepiness, the prevalence of which was 10.9%. This was not related significantly to age (22-59 years), sex, obesity, or the use of hypnotic drugs but was related significantly but weakly to sleep-disordered breathing (frequency of snoring and apneas), the presence of insomnia, and reduced time spent in bed (insufficient sleep).
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PMID:Daytime sleepiness and sleep habits of Australian workers. 941 43


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