Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two epidemiologic features of sudden infant death syndrome, respiratory infections and prolonged sleep apnea, have not been linked by a known mechanism. Muramyl peptide, acting through interleukin-1, is proposed as that link. Both agents produce fever, activation of the immune system, and of particular significance, increased deep or slow wave sleep. Although sleep apnea is universal, prolonged apnea can, if uninterrupted by arousal, lead to hypoxic apnea, coma, and death. Infants in the first six months of life are particularly vulnerable when arousal mechanisms may not be fully developed, after 9 months of fetal life when life does not depend on respiration.
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PMID:Interleukin-1 as intermediary causing prolonged sleep apnea and SIDS during respiratory infections. 278 31

The complications of endotracheal intubation are particularly frequent in patients with obstructive sleep apnoea syndrome (OSAS). We prospectively tested nasal ventilation in such patients admitted for acute respiratory failure. Six consecutive patients, aged 17-70 yrs, were selected for the study. All patients were confused or severely obtunded, Glasgow Coma Score (GCS) 10 (SD 2). With nasal bi-level positive airways pressure (BiPAP) all these patients improved clinical status and arterial blood gas values, avoiding intubation and invasive mechanical ventilation. The median pH increased from 7.26 (SD 0.06) to 7.36 (0.01) and to 7.43 (0.02) after, 1-3 and 24 h of nasal ventilation, respectively. Nasal ventilation lasted an average of 21 (3) h on the first day. All patients were discharged home after a median hospital stay of 28 (11) days.
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PMID:Acute respiratory failure, due to severe obstructive sleep apnoea syndrome, managed with nasal positive pressure ventilation. 771 17

Sleep-related disorders are revisited in the light of the physiological modality of NREM sleep expressed by the cyclic alternating pattern (CAP). Owing to its fluctuating properties on vigilance, muscle tone, and vegetative activities, CAP represents a highly favorable condition for the occurrence of interictal generalized and focal lesional EEG discharges, for motor seizures, and for periodic jerks in nocturnal myoclonus. All these manifestations are significantly associated with the components of activation during CAP, i.e., the A phases. On the contrary, the B phases of CAP appear chronologically linked to inhibitory phenomena in epileptic patients and in nocturnal myoclonus. The two phases of CAP seem especially involved in sleep apnea syndrome, where respiration is interrupted during a phase B and restored during a phase A. CAP rate, that measures the effort of the brain to maintain sleep, is increased by all conditions that induce vigilance instability such as noise, clinical insomnia, interictal EEG paroxysms, nocturnal seizures, periodic leg movements, and in certain extreme pathologic conditions such as Creutzfeldt-Jakob disease and stage 2 coma.
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PMID:Clinical applications of cyclic alternating pattern. 824 61

Quetiapine is an atypical antipsychotic with good tolerability, but has recently been associated with respiratory dysfunction. The aim of this work is to report on moderate to severe respiratory dysfunction after normal oral doses of quetiapine in two obese patients with sleep apnea syndrome (SAS). In the first case, acute respiratory failure and coma occurred after a single normal oral dose of quetiapine in combination with lorazepam (although even higher doses of lorazepam alone were tolerated) in a patient with previously unknown SAS. Intensive care treatment and mechanical ventilation led to full recovery. The second case was a patient with an operated obstructive SAS in which quetiapine was associated with nocturnal respiratory dysfunction and confusion. Respiratory function should be monitored when using quetiapine in patients with possible sleep apnea, particularly in obese patients and when given in combination with benzodiazepines.
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PMID:Respiratory dysfunction in sleep apnea associated with quetiapine. 1848 56

Ondine's curse syndrome primarily refers to cases with congenital central alveolar hypoventilation, but the term can also be used for acquired cases and implies central sleep apnea that occurs as a manifestation or complication of focal lesion in the area of the dorsolateral segment of medulla oblongata. It occurs rarely, but can lead to fatal outcome. Based on our own case report, the aim of this article is to review its clinical symptoms, and appropriate diagnostic and therapeutic procedures. We present a patient who had symptoms of vascular lesion of the dorsolateral segment of the medulla, which was verified by magnetic resonance imaging. On day 12 of his hospital stay, in the early morning, rapid development of coma was observed, which was an expression of serious respiratory failure with dominant hypercapnia. In the beginning, urgent intubation and mechanical ventilation were necessary, while in the later course of the disease breathing was assisted by noninvasive methods of Bilevel Positive Airway Pressure (BiPAP) and Continuous Positive Airway Pressure (CPAP). Throughout the night, polygraph recording confirmed the diagnosis of the central sleep apnea syndrome. The course of the disease was favorable, with a very slow but constant improvement of respiratory function. According to literature data, the disease course is not always favorable. There are published cases where it was concluded that ventilatory support was no longer needed but after a long period of normal breathing hypoventilation and death occurred suddenly during sleep. The treatment of central hypoventilation consists of ventilatory support, but there were also attempts of medicamentous treatment with the common aim of raising alertness and reactibility of the automatic breathing center. It is important to emphasize that patients with the risk of central sleep apnea should not be supplied with oxygen without arterial blood gas monitoring because of the possibility of delaying the right diagnosis. The use of oxygen in patients who already have hypercapnia due to hypoventilation could further intensify hyporeactivity of the breathing center and lead to respiratory arrest.
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PMID:[Central sleep apnea (Ondine's curse syndrome) in medullary infarction]. 2168 13

The successful treatment of a civilian gunshot wound of the vermis and pons is described. A large missile fragment was removed from a depth of 2 cm within the pons at the level of the facial colliculus. Despite initial coma and subsequent irregular respiration with sleep apnea, the patient survived. Neurological, radiographic, and operative findings are correlated with the anatomy of the pons.
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PMID:Survival following gunshot wound of the pons: neuroanatomic considerations. Case report. 2204 50