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

Sleep apnea syndrome is a constellation of symptoms resulting from recurrent episodes of apnea during sleep. Often the upper airway becomes obstructed during slumber in this disorder. Symptoms relate to sleep deprivation and include morning headaches, daytime somnolence, personality changes with deteriorating intellectual capacity, nocturnal enuresis, and sexual dysfunction. Diagnosis is assisted by polysomnographic recordings. Therapy is directed at the cause of obstruction when one can be found, weight loss in massively obese patients, tracheostomy in the symptomatic patient. Four patients with documented sleep apnea syndrome are discussed. One patient, a thin adolescent female underwent adenoidectomy without improvement. Two massively obese adult males required tracheostomy with marked amelioration of symptoms. One additional adult male was found to have sleep apnea due to severe, acquired micrognathia; he was significantly improved by tracheostomy. All three adult patients were found by endoscopic visualization to have marked pharyngeal soft tissue collapse with inspiration during apneic episodes. Possible causes of pharyngeal collapse are discussed.
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PMID:Endoscopic findings in sleep apnea syndrome. 23 Nov 20

The sleep apnea syndromes have been recognized clinically in the United States only within the past ten years. The true extent of the problem is not known, but it seems certain that these syndromes are much more common than was generally assumed five years ago. Every clinician should be aware of the signs and symptoms of sleep apnea because of the rapid and prompt response to therapeutic measures. Sleep apnea syndromes, whether obstructive or central, can result in systemic or pulmonary hypertension, arterial blood gas abnormalities, life-threatening cardiac arrhythmias, chronic respiratory failure, sleep disturbances, narcolepsy, excessive daytime somnolence, sexual dysfunction, and the suspicion of mental retardation. The immediate and dramatic improvement produced by tracheostomy in the obstructive type of sleep apnea, or nocturnal ventilatory support in the central type, can not only enhance the quality of life for these patients, but return them to functional and productive lives.
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PMID:Sleep apnea syndromes. 703 20

This study assessed characteristics of sexual dysfunction in sleep apnea and the efficacy of treatment with continuous positive airway pressure (CPAP). Twenty-two men with sleep apnea syndrome and also sexual dysfunction served as subjects in this study. Tests included physical, psychological, neurological, and penile vascular examinations, along with polysomnography, nocturnal penile tumescence (NPT), and penile rigidity. All patients clinically had a history of snoring and difficulty getting and maintaining erections. Results indicate that erectile dysfunction in patients with sleep apnea could be related to patient's age and chronic cerebral hypoxia due to apnea. Treatment with CPAP relieved erectile dysfunction in one-third of these patients.
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PMID:Erectile dysfunction in sleep apnea and response to CPAP. 878 5

Decreased libido is frequently reported in male patients with obstructive sleep apnea (OSA). The decline in morning serum testosterone levels previously reported in these patients was within the normal adult male range and does not explain the frequent association of OSA and sexual dysfunction. We determined serum LH and testosterone levels every 20 min between 2200-0700 h with simultaneous sleep recordings in 10 men with sleep apnea and in 5 normal men free of any breathing disorder in sleep. The mean levels and area under the curve of LH and testosterone were significantly lower in OSA patients compared with controls [LH, 24.9 +/- 10.2 IU/liter.h vs. 43.4 +/- 9.5 (P < 0.005); testosterone, 67.2 +/- 11.5 nmol/liter.h vs. 113.3 +/- 26.8 (P < 0.003)]. Four of 10 patients had hypogonadal morning (0700 h) serum testosterone levels. Analysis of covariance (ANCOVA) revealed that the 2 groups differed significantly in the amount of LH and testosterone secreted at night independent of age or degree of obesity. After partialing out body mass index, there was a significant negative correlation between the amounts of LH and testosterone secreted at night and the respiratory distress index, but not with degree of hypoxia. Our findings suggest that OSA in men is associated with dysfunction of the pituitary-gonadal axis. The relation between LH-testosterone profiles and the severity of OSA suggests that sleep fragmentation and, to a lesser extent, hypoxia in addition to the degree of obesity and aging may be responsible for the central suppression of testosterone in these patients.
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PMID:Decreased pituitary-gonadal secretion in men with obstructive sleep apnea. 1210 56

This article boldly challenges the dynamic psychiatrist to engage directly and vigorously into a matter that many would prefer to regard somewhat passively. That passivity is no longer acceptable. The metabolic syndrome has become a central medical concern because of the epidemic of obesity. It causes cardiovascular disease, diabetes, some cancers, sleep apnea, sexual dysfunction, and infertility. Obesity leads to depression, anxiety, and osteoarthritis. Some atypical antipsychotic medicines contribute to the metabolic syndrome, but the epidemic is widespread independent of atypicals. Practical steps by psychiatrists to monitor metabolic parameters are not as simple as they appear to be. Yet this is an area of clinical practice that cannot be ignored. Psychodynamic therapists need to awaken to the health of patients because the metabolic syndrome is more life-threatening than self-mutilation and many other self-destructive behaviors. The article discusses countertransference and transference issues stirred up when physicians begin to take responsibility for the total health of their patients. Freud oriented us to focus on both sides of the mind body relationship. Recent research on obesity, hypertension, diabetes, sleep, anxiety,depression, exercise and dyslipidemia is reviewed from the viewpoint of how it impinges on the office practice of a dynamic psychiatrist.
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PMID:A psychodynamic approach to screening for the metabolic syndrome. 1701 91

The prevalence of hypogonadism has been found to be increased in certain chronic illnesses, especially diabetes, hypertension and obesity. Recently, the prevalence of hypogonadism in primary care practices mirrored that in our population of men with erectile dysfunction (ED). In this study, the prevalence of hypogonadism in nearly 1000 men with ED was tabulated, using a retrospective chart review, and analyzed for association with the various contributing medical and psychological factors. The prevalence of hypogonadism was determined in men with a variety of chronic illnesses, and was further characterized by decade. We observed an association between hypertension (P=0.025), tobacco abuse (P=0.0059), sleep apnea (P=0.0001), work stress (P=0.041) and hypogonadism. These data were further analyzed for the odds ratio and confidence interval (Forest plot), which showed strong association for sleep apnea and work stress. We did not observe any significant association between diabetes, atherosclerosis, alcohol abuse, multiple medications, asthma, seizure disorder, anxiety/depression and hypogonadism (P values for Cochran-Mantel-Haenszel general association were 0.48, 0.97, 0.25, 0.69, 0.22, 0.76 and 0.98, respectively). We suggest that a host of chronic illnesses have a high prevalence of secondary hypogonadism. Men who have chronic medical or psychological illnesses should have their testosterone level checked, especially when sexual dysfunction symptoms or signs are present.
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PMID:Hypogonadism in men with erectile dysfunction may be related to a host of chronic illnesses. 1979 59

Age-associated hypothalamic-pituitary-gonadal (HPG) axis hypofunction, or partial androgen deficiency of the aging male, is thought to be responsible for various age-associated conditions such as reduced muscle and bone mass, mobility limitations, frailty, obesity, sleep apnea, cognitive impairment, sexual dysfunction, and depression. It has been difficult to establish consistent correlations between these symptoms and plasma testosterone levels in middle-aged men, but testosterone replacement does lead to improved muscle strength, bone density, and sexual function. This article focuses on the relationship between testosterone and mood in older men, and the treatment of age-related depression with exogenous testosterone.
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PMID:Testosterone and mood in aging men. 2353 87

World Health Organization (WHO) considers obesity as one of the fastest growing metabolic disorders other than diabetes. It is a complex interplay of lifestyle and associated genes. Obesity has been considered as a disease with multiple targets and very often compared in this sense with its sibling disease type 2 diabetes. The disease is pathology of the adipocytes and develops as a result of hypertrophy and hyperplasia of these cells, former being the major concern but its effects could be seen on various organs in the form of cardio-vascular disease, stroke, cancer, diabetes, sexual dysfunction, respiratory problems and many more. An increase in the lipid content of the adipocytes changes the physiology of these cells towards more inflammatory phenotype. The array of molecules or adipokines secreted by these cells varies in concentration and type among healthy and obese subjects. On one hand where adiponectin concentration decreases, the resistin concentration increases resulting in insulin resistance among many other adipokine related effects. Specifically, an obese person develops hyperlipidemia, insulin resistance, vascular blockage, sleep apnoea, cancer etc. This review is an attempt to focus, in detail, about obesity related complications.
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PMID:Obesity: single house for many evils. 2600 99

Obstructive sleep apnea (OSA) is a common condition among middle-aged men and is often associated with reduced testosterone (T) levels. OSA can contribute to fatigue and sexual dysfunction in men. There is suggestion that T supplementation alters ventilatory responses, possibly through effects on central chemoreceptors. Traditionally, it has been recommended that T replacement therapy (TRT) be avoided in the presence of untreated severe sleep apnea. With OSA treatment, however, TRT may not only improve hypogonadism, but may also alleviate erectile/sexual dysfunction.
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PMID:Testosterone Deficiency and Sleep Apnea. 2713 81

World Health Organization (WHO) considers obesity as one of the fastest growing metabolic disorders other than diabetes. It is a complex interplay of lifestyle and associated genes. Obesity has been considered as a disease with multiple targets and very often compared in this sense with its sibling disease type 2 diabetes. The disease is pathology of the adipocytes and develops as a result of hypertrophy and hyperplasia of these cells, former being the major concern but its effects could be seen on various organs in the form of cardio-vascular disease, stroke, cancer, diabetes, sexual dysfunction, respiratory problems and many more. An increase in the lipid content of the adipocytes changes the physiology of these cells towards more inflammatory phenotype. The array of molecules or adipokines secreted by these cells varies in concentration and type among healthy and obese subjects. On one hand where adiponectin concentration decreases, the resistin concentration increases resulting in insulin resistance among many other adipokine related effects. Specifically, an obese person develops hyperlipidemia, insulin resistance, vascular blockage, sleep apnoea, cancer etc. This review is an attempt to focus, in detail, about obesity related complications.
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PMID:Obesity: single house for many evils. 2760 Jun 44


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