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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Primary sleep disorders include narcolepsy, the Pickwickian syndrome, sleep apnea in infants and other rare conditions. Secondary sleep disorders occur in depression, alcoholism, endocrinopathies, heart failure and pregnancy. Medical symptomatology often increases during rapid-eye-movement (REM) sleep, when physiologic activity is high. Insomnia, the most common sleep disorder, requires careful work-up, attempts at environmental manipulation and judicious short-term pharmacotherapy. Pharmacologic manipulation of sleep is beset with complications. A basic understanding of properties and side effects of the sleep-inducing drugs is needed in order to select the optimal agent.
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PMID:Sleep disorders and insomnia. 62 43

The nighttime blood oxygen saturation of 35 abstaining chronic alcoholic men was studied. Regression analyses indicated that various measures of alcohol abuse history (r = -.61, p less than .001) account for significant variance in nighttime hypoxemia. Age (r = -.39, p less than .05) and smoking history (r = .45, p less than .01) were less powerful predictors and both obesity and days abstinent from alcohol failed to correlate with hypoxemia. Possible mechanisms to explain the relationship between alcohol abuse history and hypoxemia are discussed. This and previously reported findings indicate that chronic alcohol abuse may predispose an individual to nighttime hypoxemia and be a risk factor for sleep apnea.
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PMID:Relationship of alcohol abuse history to nighttime hypoxemia in abstaining chronic alcoholic men. 229 46

The all-night blood oxygen saturations (SaO2) of 19 older abstaining male alcoholics and 19 healthy age-matched controls were recorded. The alcohol group had significantly lower nighttime mean and minimum oxygen saturations, significantly greater absolute (mean-minimum) SaO2 desaturations, and significantly more desaturations below 90% compared with the control group. Additionally, the alcohol group had significantly more individuals with nighttime SaO2 means below 95% and nighttime SaO2 minimums below 90%. Finally, within the alcohol group, alcohol history was found to significantly correlate with nighttime mean and minimum SaO2 and absolute SaO2 desaturation. This preliminary study finds evidence that chronic alcohol abuse may predispose an individual to nighttime hypoxemia, and, inferentially, to sleep apnea. However, the effect is modest and it will need to be confirmed in larger, more carefully controlled studies.
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PMID:History of chronic alcohol abuse is associated with increased nighttime hypoxemia in older men. 330 7

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

Sleep apnea and related disorders are not uncommon in abstinent alcoholics. We assessed the relationship between age and the presence and severity of sleep-disordered breathing in alcoholism by performing one night of polysomnography on 75 abstinent alcoholic subjects undergoing treatment for alcoholism. Sleep-disordered breathing (defined as 10 or more apneas plus hypopneas/hr of sleep) was present in 17% of 66 men aged 22-76 and in 0 of 9 women aged 28-63 years. Three percent of men under age 40 years had sleep-disordered breathing compared with 25% of men between ages 40-59 and 75% of those above age 60. Although alcoholics with sleep-disordered breathing had a higher body mass index than those without, the increased frequency over age 40 was statistically significant after controlling for the effects of body mass index. Sleep in subjects with sleep-disordered breathing was significantly more disturbed than in subjects without sleep-disordered breathing. Our findings suggest that sleep-disordered breathing in older male alcoholics is more prevalent than has been reported in most studies of normal men and that the increase in sleep-disordered breathing that occurs with age in alcoholics is greater than the age-related increase in sleep-disordered breathing that occurs in healthy elderly men. Furthermore, sleep-disordered breathing is a significant contributor to sleep disturbance in a substantial proportion of male alcoholics above the age of 40 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sleep-disordered breathing in alcoholics: association with age. 811 27

In many cross-sectional studies an association has been found between snoring and hypertension. However, differing results have been obtained when confounding factors have been taken into account. To establish whether snoring is a risk factor for developing hypertension, a population-based, prospective survey was performed. In 1984 and 1994, 2,668 males, aged 30-69 yrs at baseline, answered questionnaires concerning sleep disturbances and somatic disease. Of the habitual snorers in 1984, 12.5% reported that they had developed hypertension during the period, compared with 7.4% of the remaining subjects (p<0.001). In a multiple logistic regression model persistent snoring, i.e., reported habitual snoring in both 1984 and 1994, was found to be an independent predictor for the development of hypertension among males aged 30-49 yrs (odds ratio 2.6, 95% confidence interval 1.5-4.5) after adjustments for age, body mass index (BMI), weight gain, smoking, alcohol dependence, and physical inactivity. Among the subjects aged 50-69 yrs in 1984, no association between snoring and development of hypertension was found. Although based only on reported data, the results indicate that persistent snoring is an independent risk factor for the development of hypertension among males aged <50 yrs. Prospective surveys, including whole-night sleep recordings, are needed to establish whether this is due to a higher prevalence of obstructive sleep apnoea syndrome among snorers or whether nonapnoeic snorers with increased upper airway resistance also have an increased risk of developing hypertension.
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PMID:Snoring and hypertension: a 10 year follow-up. 962 92

Sleep apnea and related disorders contribute to disturbed sleep in abstinent alcoholics. In an earlier report from our group, sleep-disordered breathing was common and increased with age in a cohort of 75 abstinent alcoholics. We now report an extension of the previous work that includes studies of an additional 103 abstinent alcoholics undergoing treatment for alcoholism (total sample = 188) and a comparison group of 87 normal subjects. The presence and severity of sleep-disordered breathing was assessed with polysomnography. Among the alcoholics, sleep-disordered breathing (defined as 10 or more apneas plus hypopneas per hour of sleep) was present in 3% of 91 subjects under age 40, 17% of 83 subjects age 40 to 59, and 50% of 14 subjects age 60 or over. Subjects with sleep-disordered breathing were more likely to be male and had more severe sleep disruption and nocturnal hypoxemia and more complaints related to daytime sleepiness than subjects without sleep-disordered breathing. In a multiple linear regression analysis, age and body mass index were significant predictors of the presence of sleep-disordered breathing, whereas smoking history and duration of heavy drinking were not predictors after controlling for the effects of age and body mass index. Our findings suggest that sleep-disordered breathing contributes significantly to sleep disturbance in a substantial proportion of older alcoholics and that symptomatic sleep-disordered breathing increases with age in alcoholics. Sleep-disordered breathing, when combined with existing cardiovascular risk factors, may contribute to adverse health consequences in alcoholics.
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PMID:Sleep-disordered breathing in alcoholics. 1002 14

Sleep apnea syndromes in conjunction with dementia have attracted considerable interest among geropsychiatrists in recent years. This clinical case report describes a demented and delirious elderly patient with a history of alcoholism who developed a sleep apnea syndrome under treatment with chlormethiazole. The risk of chlormethiazole treatment may be underestimated in vulnerable patients, e.g. those suffering from severe respiratory diseases or dementia. Alternative treatments for delirious states need to be evaluated instead.
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PMID:Apnea syndrome in a patient with Alzheimer dementia under chlormethiazole treatment: a clinical experience report. 1049 93

Despite an initial sedative effect, alcohol disrupts sleep persistently and should not be used as a sleeping aid. Nocturnal withdrawal symptoms may lead to an increased duration of wakefulness, and to tachycardia and sweating in the second half of the night. It is not known by which mechanism alcohol affects sleep; however, effects do not appear to depend on the stimulation of benzodiazepine receptors or the antagonism at adenosine receptors. Alcohol can exacerbate primary sleep disturbances such as sleep apnea and nocturnal myoclonus, and thereby contribute to excessive daytime sleepiness. The sleep of alcoholic patients is characterized by increased sleep latency, and reduced sleep efficiency, total sleep time, slow wave sleep and non-REM sleep. Even during abstinence, the changes in sleep architecture can persist for months or years, and might contribute to a relapse into alcoholism. The use of benzodiazepines or other hypnotics to treat alcohol-related sleep disturbances is not recommended.
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PMID:[Alcohol and sleep disorders]. 1080 84

This article deals with the effects of alcohol on sleep and sleep EEG of healthy individuals and alcohol-dependent patients during different phases of alcohol dependency. Healthy individuals initially experience an improvement in sleep, although a greater quantity of alcohol can lead to problems of sleep maintenance during the second half of the night. Pre-existing sleep deprivation or sleep restriction potentiates the effects of alcohol. Alcohol-dependent patients are found to be more prone to sleep problems than healthy individuals, which can facilitate the development of alcoholism. These patients experience difficulty falling asleep and suffer from a reduced total sleep time during all phases of the disorder, often accompanied by other sleep disorders such as sleep apnea syndrome or periodic leg movements during sleep. Certain predictors for the risk of relapse in abstinent alcoholics have been identified. Neurobiological findings in sleep and alcohol dependency are discussed. The cholinergic-aminergic reciprocal interaction model of REM and non-REM sleep regulation is significant in this context. Therapeutic implications are discussed.
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PMID:[The importance of sleep for healthy alcohol consumers and alcohol dependent patients]. 1525 83


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