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)

Our prospective, standardized cohort study was designed to assess the presence of alpha wave intrusions during non-rapid eye movement sleep (alpha-delta sleep) and its relationship to fibromyalgia, major depression, and chronic fatigue syndrome (CFS) in patients with a chief complaint of chronic fatigue. The study group comprised 30 consecutive patients seen at a university hospital referral clinic for evaluation of chronic fatigue. All patients had nocturnal polysomnography, dolorimetric tender point assessment for fibromyalgia, a comprehensive history, physical, and laboratory evaluation, and a structured psychiatric interview. Alpha-delta sleep was identified in 8 of the 30 patients (26%), major depression in 20 (67%), CFS in 15 (50%), and fibromyalgia in 4 (13%). Ten of the 30 patients (33%) had a primary sleep disorder (sleep apnea, periodic limb movements, or narcolepsy). Alpha-delta sleep was not significantly correlated with fibromyalgia, CFS, major depression, or primary sleep disorders, but was significantly more common among patients who had chronic fatigue without major depression. We conclude that primary sleep disorders are relatively common among patients with chronic fatigue and must be diligently sought and treated. Alpha-delta sleep is not a marker of fibromyalgia or CFS, but may contribute to the illness of nondepressed patients with these conditions.
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PMID:Alpha-delta sleep in patients with a chief complaint of chronic fatigue. 797 34

Our earliest findings relating sleepiness to cognitive function revealed that, among patients with the symptom of excessive somnolence, sleep apneics were the most impaired on cognitive tasks. Although the multiple sleep latency test (MSLT) has been the standard diagnostic test for assessing daytime sleepiness, the maintenance of wakefulness test (MWT) has clinical advantages over the MSLT when the assessment of daytime alertness is the primary goal. A number of studies on patients with sleep apnea and narcolepsy indicate that the MWT is more sensitive to treatment-related improvements in sleepiness. However, sleep tendency, as measured by the MSLT, and ability to remain awake, as measured by the MWT, probably represent the same physiological process viewed from different perspectives. Some patients, particularly those who have received suboptimal treatment, will show no treatment-related improvement in daytime sleepiness if they are evaluated only by the MSLT. We believe that the MWT and MSLT measure different aspects of the central problem of abnormal sleep tendency. The MWT may be a useful adjuvant daytime test in clinical situations where it is necessary to quantify degree of impairment or effectiveness of treatment.
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PMID:Daytime sleepiness and cognitive functioning in sleep apnea. 817 31

We report a case of a 54 years old man, treated with Methylphenidate (Ritalin) because of narcolepsy, who was referred with suspected vertebro-basilar insufficiency. In the hospital, apnoea during sleep attacks were observed. A polysomnography showed marked obstructive sleep apnoea with a disturbed hypnogram, but during the apnoeas the oxygen saturation only decreased by three to six percent. If a patient suspected for obstructive sleep apnoea has only small desaturations, an oximetry can be insensitive as the only "sleep examination", and a full polysomnography is recommended.
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PMID:[Pulse oximetry and obstructive sleep apnea]. 823 82

Obstructive sleep apnea syndrome may be just an annoyance to an affected person's bed partner, or it can be a more serious and even dangerous condition for the person involved. One clue to the condition is daytime somnolence, although not all sleepy patients have the syndrome. If obstructive sleep apnea syndrome is confirmed by a polysomnogram, a trial of nasal continuous positive airway pressure (NCPAP) is warranted. If daytime somnolence is unaffected, then it is unlikely that the syndrome is the sole cause of the patient's sleepiness. Alternative diagnoses (eg, narcolepsy, atypical depression) should then be considered. Surgery, orthodontic devices, and pharmacotherapy are generally less effective than NCPAP and are usually reserved for patients who cannot tolerate NCPAP. Surgical techniques may be best suited for patients who have clearly defined craniofacial abnormalities and those who cannot tolerate NCPAP. Weight reduction to near ideal body weight and avoidance of benzodiazepines, opiates, and alcohol should be emphasized in all patients with suspected or confirmed sleep apnea.
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PMID:Obstructive sleep apnea. Treatment improves quality of life--and may prevent death. 830 56

We measured morning plasma concentrations of delta sleep-inducing-peptide-like-immunoreactivity (DSIP-LI) in 9 sleep apnea patients, 10 narcolepsy patients, and 11 normal controls. Comparisons between the three groups showed no significant differences, although there was a trend toward association with low levels of DSIP-LI in the narcoleptic group, particularly in patients not using medications. No differences were found in the morning or evening plasma DSIP-LI levels in a second group of 11 normal controls and 8 sleep apneics. Our findings do not appear to support a biological marker role of disease activity for single measures of plasma DSIP in sleep apnea.
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PMID:Delta sleep-inducing peptide in normal humans and in patients with sleep apnea and narcolepsy. 853 1

Polysomnograms have been recorded at our laboratory since 1985 for the diagnosis of sleep apnoea. Until the recent availability of continuous positive airway pressure devices in Johannesburg, it appeared that some of our subjects were receiving only conservative or no treatment. Structured interviews were conducted with 63 patients with positive polysomnographic findings of sleep apnoea/hypopnoea (SAH), and, where possible, with sleeping partners. Information was obtained about the patients' understanding of the diagnosis by the referring doctor, the recommended treatment and psychosocial consequences. The primary reason for the initial consultation was excessive daytime sleepiness (43%). Diagnoses following polysomnography included SAH (65%) and narcolepsy (6%), while 10% were told they had nothing to be concerned about. Some form of treatment was recommended to 80% of patients, usually weight loss (60%) or medication (59%). Psychosocial consequences were prominent and included a perception of reduced work capacity (62%) and compromised safety (56%). At the time of the interview 90% of patients were experiencing one or more symptoms associated with SAH. These findings support the serious nature of SAH and confirm the need for adequate treatment centres in South Africa.
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PMID:Follow-up of conservatively treated sleep apnoea patients. 854 47

To better define the clinical spectra of narcolepsy and idiopathic hypersomnia, we retrospectively compared clinical and polygraphic findings and questionnaire results in groups of subjects with narcolepsy with or without cataplexy, idiopathic hypersomnia, insufficient sleep syndrome, mild sleep apnea, and excessive daytime sleepiness not otherwise specified. Sleep paralysis and sleep-related hallucinations were most frequent in narcolepsy-cataplexy, but their frequency did not differ between narcolepsy without cataplexy and idiopathic hypersomnia. Mean durations of nocturnal sleep, daytime naps, and morning grogginess were not increased in idiopathic hypersomnia compared with other groups. Among subjects without cataplexy, symptoms of sleep paralysis and sleep-related hallucinations were equally common in subjects with and without frequent sleep-onset REM periods. These findings suggest that the occurrence of these symptoms in subjects without classical narcolepsy-cataplexy is a function of factors other than a propensity for early onset of REM sleep and indicate a need to reevaluate diagnostic criteria for narcolepsy and idiopathic hypersomnia.
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PMID:The clinical spectrum of narcolepsy and idiopathic hypersomnia. 861 1

Studies show that persons with sleep disorders, such as sleep apnea and narcolepsy, have an increased incidence of automobile accidents. The goal of this study was to review any regulations or guidelines dealing with fitness to drive of persons with sleep disorders in all the 50 states and countries around the world. Several authorities in the United States and abroad in fact have produced guidelines or regulations stating that certain of these persons are not fit to drive. As of March 1994, only four states in the United States (Maryland, North Carolina, Oregon and Utah) had guidelines for narcolepsy, while two had guidelines for both narcolepsy and sleep apnea (California and Texas). In Maine, guidelines had been proposed for sleep apnea. In contrast, almost all Canadian provinces have guidelines for both sleep apnea and narcolepsy, as does the United Kingdom. There are, however, considerable variations in the nature of the regulations used in different states, Canadian provinces and countries. These variations are not based on scientific data. Currently the impact of these regulations on crash rates or on the practice of sleep medicine has not been assessed.
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PMID:Review of regulations and guidelines for commercial and noncommercial drivers with sleep apnea and narcolepsy. 863 73

Excessive daytime sleepiness (EDS), the primary complaint of patients seen in sleep clinics, affects up to 12% of the general population. The effects of EDS can be debilitating and even life threatening. Patients with EDS may exhibit psychosocial distress, decreased work or school performance, and increased risk for accidents. The differential diagnosis of EDS requires objective assessments, such as polysomnography and the Multiple Sleep Latency Test. There are four major causes of EDS: (1) central nervous system (CNS) pathologic abnormalities, such as narcolepsy and idiopathic CNS hypersomnia; (2) qualitative or quantitative sleep deficiencies, such as sleep apnea and insufficient nocturnal sleep; (3) misalignments of the body's circadian pacemaker with the environment (eg. jet lag or shift work); and (4) drugs, which can increase sleepiness either therapeutically or as a side effect. Depending on etiology, management strategies for EDS include extension of time in bed, naps, surgery, various medical devices (eg, oral appliances, continuous positive airway pressure), and pharmacotherapy. Pharmacotherapy is generally achieved with stimulants, such as amphetamine sulfate, methylphenidate, and pemoline or newer, safer compounds like modafinil.
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PMID:Etiologies and sequelae of excessive daytime sleepiness. 887 87

Narcolepsy is a commonly under diagnosed or misdiagnosed problem that results in severe daytime sleepiness. There is a strong genetic component with some immune system involvement. It may occur in combination with other sleep disorders such as sleep apnea complicating its treatment. An objective diagnosis requires a polysomnogram and Multiple Sleep Latency Test. Management depends on the careful use of stimulant medication to control the sleepiness and other medications to control the auxiiliary symptom of cataplexy.
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PMID:Narcolepsy. 890 46


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