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)

While insomnia is a familiar management problem for most doctors, disorders of hypersomnolence are much less familiar. The evolution of sleep monitoring at a major South African teaching hospital is described and the classification of sleep disorders reviewed. Analysis of the first 5 years' experience revealed that 27 of 46 patients had sleep apnoea (all obstructive, but 13 with a central component), while 3 had narcolepsy. Contributing causes of sleep apnoea included obesity (25 patients), tonsillar enlargement (3), acromegaly (3), rheumatoid cervical spondylosis (1), Hunter's syndrome (1) and haemangioma of the throat (1). Death from sleep apnoea occurred in 3 cases. Treatment of specific causes was effective in abolishing sleep apnoea, although attempts at weight loss were effective in a minority only. Nasal continuous positive airway pressure was effective in achieving symptomatic relief. Sleep monitoring was found to be valuable, provided all-night study facilities are available, and provided that patients who simply snore are excluded by prior clinical evaluation.
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PMID:The diagnosis and management of respiratory sleep disorders--the first 5 years at Groote Schuur Hospital. 225 27

In recent years, therapeutic methods have been effective in the management of snoring and sleep apnea. Successful results have been possible through conservative and surgical approaches when the nature and site of obstruction is ascertained by careful investigation. Sagittal magnetic resonance imaging (MRI) of the upper respiratory tract has been the most valuable diagnostic tool in patients with obstructive sleep apnea. This has made it possible to measure the dimensions and distance of the hard and soft palate and tongue base to the posterior pharyngeal wall. Surgery is only indicated when a site of obstruction can be completely determined. In this study, surgical approaches and results obtained in 50 patients after surgery for sleep apnea are presented. Uvulopalatopharyngoplasty (UPPP) had a higher success rate in patients with obstruction at the level of the soft palate, but this rate decreased when it was associated with hypopharyngeal obstruction or when there was hypopharyngeal obstruction alone. UPPP was found to be beneficial in patients with central apnea. Nasal pathologies also played an important role in sleep apnea. Better results were obtained when UPPP was performed in patients who were young, not obese and an apnea-hypopnea index was below 40. Some unusual pathologies included lingual tonsil hypertrophy in the adult, sublingual dermoid cysts and angioma of soft palate and were found to be the cause of OSA. After surgical excision of these pathologies, apneic periods disappeared.
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PMID:Patient selection and surgical results in obstructive sleep apnea. 906 54

A case of congenital lingual angiodysplasia with macroglossia in a 5-year-old girl is presented. A diffusely enlarged tongue was present at birth and continued to grow as the child aged. It was accompanied by impaired speech, difficulty in eating and breathing, and sleep apnea, necessitating surgical intervention. The fundamental lesion represents a complex vascular malformation of the lymphangioma-hemangioma type, involving extensively the deep musculature of the tongue. Multifocal and multicentric cavernous lymphangioma-like and hemangioma-like areas merge with benign angioendotheliomatous-like foci in a background of variable muscle degeneration and marked fibrosis. Neither a borderline nor an overtly malignant vasoformative neoplasm was present. Because of its distinctively widespread, multicentric intramuscular distribution, this lesion may be construed as a diffuse variant of lingual lymphangioma-hemangioma malformation, closely resembling a previously described case of macroglossal lymphangioendotheliomatosis.
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PMID:Congenital macroglossal angiodysplasia ("Lymphangioendotheliomatosis"). 1097 36

We report a case of PHACES syndrome witch was effectively treated using vincristine. A female infant was referred at 8 months of age for evaluation with a segmental mandibular haemangioma with rapid growing and facial disfigurement. The infant was initially placed on oral prednisone with clinical response but she developed obstructive sleep apnoea. Vincristine was started at about 24 months and continued for 4 months with marked decrease in the size of the haemangioma. The only side effect was constipation.
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PMID:Successful treatment with vincristine in PHACES syndrome. 1746 81

We report a case of a splenic inflammatory pseudotumor (myofibroblastic tumor) in a 43-year-old man with a 5-year history of chronic bronchitis and sleep apnea syndrome. The patient was hospitalized because of a screen-detected splenic mass lesion. His sputum cultures revealed Mycobacterium avium complexes on only one occasion. Imaging studies revealed a 7 cm solitary tumorous lesion, and differential diagnoses of splenic hamartoma, hemangioma, lymphoma, and angiosarcoma were obtained from the radiologist. A splenectomy followed by pathological investigations was performed. By histology, the lesion contained fibroblastic or myofibroblastic spindle cell proliferations, accompanied by variable degrees of inflammatory cell infiltration. Ziehl-Neelsen staining did not reveal acid-fast bacteria. Immunohistochemically, the fibroblastic or myofibroblastic spindle cells were positive for vimentin, human smooth muscle actin, and muscle actin, but negative for desmin, CD8, CD21, CD23, CD35, p80, Epstein-Barr virus LMP, and human herpesvirus type 8. The infiltrating lymphoid cells demonstrated a nonneoplastic pattern. The results of in situ hybridization for Epstein-Barr virus encoded RNA were negative. The postoperative course was uneventful and he has had no recurrence in 22 months. His sleep apnea syndrome and chronic bronchitis have resolved spontaneously since the splenectomy.
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PMID:Splenic inflammatory pseudotumor (inflammatory myofibroblastic tumor). 1804 Jan 48

A 15-year-old girl had no REM sleep presumably due to a pontine cavernous hemangioma was reported. Her brain MRI revealed a cavernous hemangioma extending from the dorsal pontine to the medulla. She manifested truncal ataxia, facial nerve palsy, and ocular motor apraxia. She could not sleep in the supine position due to the sleep apnea accompanied with loud snoring. Overnight polysomnography (PSG) was performed for detection of obstructive sleep apnea syndrome (OSAS). In addition to severe OSAS and Cheyne-Stokes-like respiration at wake after sleep onset, her 1st PSG study revealed no periods with rapid eye movement, EEG characteristic of REM sleep, atonia and variation on respiratory and heart rate. Even after effective therapy for OSAS with non-invasive positive airway pressure ventilation (NPPV), her 2nd PSG also failed to show stage REM. These findings suggest that this pontine cavernous hemangioma disturbed her REM-on system. This is the first report of an individual with long-term loss of REM sleep and a valuable case for the understanding of anatomical structures of the REM-on system and the role of REM in memory consolidation.
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PMID:[Deficiency of REM sleep in a patient with pontine cavernous hemangioma]. 1976 54

Mucosal haemangiomas are unusual and typically involve frequently traumatised areas such as the lip, buccal mucosa and lateral borders of the tongue. Uvular haemangioma is rare and to our knowledge, has never been reported to cause obstructive sleep apnoea (OSA). We report an unusual case of uvular haemangioma causing loud habitual snoring and symptoms suggestive of OSA. This case report illustrates a rare cause of OSA and demonstrates the efficacy of surgery for obvious obstructive lesions of the pharynx.
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PMID:Haemangioma of the uvula causing loud habitual snoring--a rare entity. 1980 2