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

Polygraphic recordings demonstrated complex tongue movements as unusual phasic phenomena during rapid-eye-movement (REM) sleep in patients with narcolepsy, sleep apnea syndrome, or posterior fossa lesions, and in normal controls. These tongue movements may counteract posterior displacement of the tongue to prevent obstructive sleep apnea, which may otherwise occur in REM sleep because of genioglossal hypotonia. Hypotonia affected not only the genioglossus but also other muscles innervated by pontomedullary neurons during non-REM-sleep-related apnea in patients with sleep apnea syndrome.
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PMID:Phasic tongue movements in human rapid eye-movement sleep. 718 42

Gammahydroxybutyrate was administered to a patient who experienced narcolepsy associated with central sleep apnea. The treatment relieved the major symptoms of narcolepsy, and significantly decreased the number of apneic periods. Gammahydroxybutyrate did not cause the prolonged and potentially fatal apneic periods associated with the use of other hypnotic agents.
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PMID:Treatment of narcolepsy and sleep apnea with gammahydroxybutyrate: a clinical and polysomnographic case study. 723 68

Fifty male subjects were group-matched for age and socioeconomic status. Twenty of the subjects were diagnosed as having sleep apnea and 20 were diagnosed as having narcolepsy on the basis of sleep studies. The remaining 10 subjects served as normal controls. Differences among the groups were evaluated on the bases of two psychological instruments designed to assess personality characteristics and mood states. The findings suggest that narcoleptics and apneics both present discriminatively different psychological profiles than do normals. Moreover, personality characteristics of these two groups are distinguishable from one another. Apneics tend to be individuals with hypochondriacal and hysterical characteristics, whereas narcoleptics are more easily characterized by anxiety and social introversion. Both severity of psychological disturbance (mean Minnesota Multiphasic Personality Inventory elevations) and personality pattern (two-point codes) distinguish the groups. Key Words: Sleep apnea-Narcolepsy-Psychological profiles.
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PMID:Differentiating psychological characteristics of patients with sleep apnea and narcolepsy. 723 70

The Sleep Disorders Clinic at the San Diego Veterans Administration Medical Center provides a diagnostic service within a public hospital. Case records of the first 117 patients receiving polysomnograms in our clinic were reviewed. Of these patients, 44 percent were found to have sleep apnea, 24 percent nocturnal myoclonus and 8 percent narcolepsy. Our experience shows that in a health maintenance organization, a sleep disorders clinic provides diagnostic information (based on a polysomnogram and a sleep history) which is very helpful in the final diagnosis of medical disorders. Very few recordings were noncontributory. In this setting, a sleep disorders clinic is justified by its rich diagnostic yield.
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PMID:Benefits of a sleep disorders clinic in a Veterans Administration Medical Center. 725 75

A group of 27 elderly patients with complaints of either chronic insomnia or excessive daytime sleepiness were studied in the Sleep Evaluation Center of Western Psychiatric Institute and Clinic during the period January 1977-June 1979. On the basis of anamnestic data from patients and bedroom partners, together with polysomnographic findings, sleep disturbances were classified according to the nosology of the Association of Sleep Disorders Centers. Of the 27 patients, 19 had disorders of initiating or maintaining sleep (DIMS), 7 had disorders of excessive somnolence (DOES), and 1 had parasomnia (episodic nocturnal wandering). Of the 19 DIMS patients, two-thirds had either a primary affective disorder (depression) or a persistent psychophysiologic disturbance. Of the 7 DOES patients, 6 had a primary sleep disorder such as a sleep apnea syndrome or narcolepsy-cataplexy. Additional electroencephalographic sleep data are presented on elderly patients with primary nonpsychotic depression. The latency of rapid eye movements (REM) in the depressed patients was shorter (p less than 0.05) than in patients with a persistent psychophysiologic disturbance. The percentage of REM sleep was significantly elevated (p less than 0.05) in the depressed group, and intermittent wakefulness was decreased (p less than 0.01). The causes of sleep disturbance in the elderly are both heterogeneous and complex. The need for accurate differential diagnosis and a multiaxial approach is stressed.
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PMID:Sleep disturbances in a series of elderly patients: polysomnographic findings. 736 75

Regional cerebral flow after inhalation of xenon 133 as well as polysomnography were recorded during daytime sleep and the awake state in patients with narcolepsy and sleep apnea. Brainstem-cerebellar (BSC) gray matter blood flow (Fg) values in the awake state were reduced below normal (p less than 0.05) in both narcolepsy and sleep apnea; in sleep apnea, bihemispheric Fg values were also reduced in the awake state. After sleep onset, Fg paradoxically increased in narcolepsy but decreased further in sleep apnea. Maximal regional Fg changes occurred in BSC regions in both groups of patients. Oral administration of methylphenidate hydrochloride (Ritalin) increased resting Fg values in awake narcoleptics, particularly in BSC regions, but attentuated Fg increases during sleep onset. Regional Fg values during visual dreaming or hypnagogic hallucinations in narcoleptics were maximally increased in right parietooccipital regions. In narcoleptics, impaired control of sleep-wake and REM mechanisms is attentuated by methylphenidate. In patients with sleep apnea, brainstem functional activity is low in the awake state but becomes critically reduced during sleep, culminating in apnea-stimulated arousal followed by repetitive cycles as sleep recurs.
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PMID:Sleep apnea, narcolepsy, and dreaming: regional cerebral hemodynamics. 739 26

The objective of this study was to examine the usefulness of home oximetry for the screening of sleep disorders presenting with excessive daytime sleepiness (EDS). This was accomplished by blinded comparison of diagnosis by oximetry alone versus polysomnographic diagnosis carried out at a sleep disorders center at a tertiary referral hospital. This study included three hundred patients who had been referred because of EDS and suspected sleep apnea. A number of measurements were made. The arterial oxygen saturation (SaO2) data were sampled at 2 Hz and stored digitally during polysomnography (PSG). From the SaO2 data recorded onto paper six scorers calculated the number of desaturations > 3% per hour (desaturation index: DI) and then made a diagnosis [normal, DI < 5; mild obstructive sleep apnea (OSA), 5 < DI < 20; moderate OSA, 20 < DI < 40; severe OSA, DI > 40]. Upper airway resistance syndrome (UARS) was diagnosed when DI was < 5 but associated with small fluctuations in SaO2. The diagnosis made by each of six scorers was compared to the clinical diagnosis made independently using PSG. Thirty-one (10.3%) of all the records were rejected by scorers because of inadequate SaO2 signals requiring technologist intervention. Sensitivity of screening for sleep-breathing disorders was 90.0% and specificity was 75.0%. All moderate and severe OSA patients were detected by oximetry. However, among the 66 patients who were classified as normal by oximetry, 1 had mild OSA, 20 had UARS, 9 had periodic limb movements in sleep, 4 had narcolepsy and 2 had a parasomnia. In conclusion, home oximetry may not have sufficient sensitivity and specificity to detect breathing disorders reliably during sleep and is useless for other disorders of sleep.
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PMID:Nocturnal oximetry: is it a screening tool for sleep disorders? 761 Mar 12

Patients with obstructive sleep apnea or narcolepsy report difficulty remaining alert and attentive. To detect impaired vigilance, we designed Steer Clear, a computer program simulating a long and monotonous highway drive that presents 780 obstacles in 30 min. Sixty-two patients with sleep apnea hit a higher percentage of obstacles (4.3 +/- 0.6% [SEM]) than 12 age- and sex-matched subjects without sleep apnea (1.4 +/- 0.3%; p < 0.05) and 10 age- and sex-matched volunteers (1.2 +/- 0.3%; p < 0.05). Ten patients with untreated narcolepsy hit a higher percentage of obstacles while performing on Steer Clear (7.7 +/- 3.2%) than 10 age- and sex-matched subjects without narcolepsy (1.2 +/- 0.3%; p < 0.05). Poor performance on Steer Clear was associated with a higher auto accident rate in the patients with sleep apnea or narcolepsy (p < 0.01). Twenty-one patients who performed normally on Steer Clear had 1 accident in 5 years (0.05 accident/driver/5 yr), and in none of these accidents were they at fault as drivers. Twenty-five patients who performed poorly on Steer Clear had 5 auto accidents in 5 years (0.20 accident/driver/5 yr), and in 20% of these accidents they were at fault as drivers. Twenty-one patients who performed very poorly on Steer Clear had 8 auto accidents in 5 years (0.38 accident/driver/5 yr), and in 38% of these accidents they were at fault as drivers. These 21 patients who performed very poorly on Steer Clear (hitting > 4.5% of obstacles) had a significantly higher auto accident rate than the patients who performed normally (hitting < 1.8%). We conclude: (1) Patients with sleep apnea or narcolepsy performed more poorly on a test of vigilance, Steer Clear, than did control subjects; (2) Impaired vigilance as measured by Steer Clear is associated with a high automobile accident rate in patients with either sleep apnea or narcolepsy.
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PMID:Vigilance and automobile accidents in patients with sleep apnea or narcolepsy. 765 6

The etiology of insomnia remains usually in practice unknown. This article represents basic features of diseases expressed frequently or regularly by disturbances of sleep. Emphasis was layed on psychophysiologic insomnia, narcolepsy, sleep apnea syndrome, periodic legs movements in sleep, restless legs syndrome and on insomnia within circadian dysregulation. Most important neurologic and psychiatric diseases, which can be accompanied by insomnia, are listed.
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PMID:[Insomnia. A short review of the most important etiopathogenic factors]. 767 Dec 83

The development of the Sleep Disorders Questionnaire (SDQ) from the Sleep Questionnaire and Assessment of Wakefulness (SQAW) of Stanford University is described in detail. The extraction of the best question items from the SQAW and their subsequent rewording in the SDQ to insure greater completion rates are described. Two item test-retest reliability studies are reported on 71 controls and on 130 sleep-disorder patients, which confirmed adequate reliability. To create multivariate scoring scales, SDQ was then given in a multicenter study to 519 persons, 435 of whom were sleep-disorder patients with full polysomnography. Canonical Discriminant Function Analysis was employed, which resulted in four clinical-diagnostic scales: SA for sleep apnea, NAR for narcolepsy, PSY for psychiatric sleep disorder and PLM for periodic limb movement disorder. Each was adjusted for male and female responses and transformed to a percentile using the observed distribution of raw scores. Using Receiver Operating Characteristics analysis, cutoff points were determined for each scale to maximize its sensitivity and specificity. Positive and negative predictive values were also calculated. The SA and NAR scales proved to be the most discriminating.
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PMID:The Sleep Disorders Questionnaire. I: Creation and multivariate structure of SDQ. 803 70


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