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

The term "overlap syndrome" was introduced by Flenley to describe the association of sleep apnea syndrome (SAS) with chronic obstructive pulmonary disease (COPD). Epidemiologic data on the prevalence of the overlap syndrome are not available, but the frequency of an associated COPD in SAS patients has been emphasized in almost all the studies analyzing the development of respiratory insufficiency in SAS patients. In a large series (n = 264) of unselected SAS patients who had undergone detailed pulmonary function tests, we observed an obstructive ventilatory defect (FEV1/VC < 60%) in 30 of 264 patients (11%). These patients had lower daytime PaO2 and higher PaCO2 than the other patients and they had higher resting and exercising pulmonary artery mean pressure (right heart catheterization was performed in 215 of 264 patients). We conclude that the risk of developing respiratory insufficiency and cor pulmonale is higher in overlap patients.
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PMID:Chronic obstructive pulmonary disease and sleep apnea syndrome. 147 Aug 5

We describe a twentieth month old infant who had a pycnodysostosis syndrome. This malformation shows a loss of the normal mandible angle with generalized bone hyperdensification. The first produced and airway obstruction, with special relevance during sleeping hours. A polysomnography revealed an obstructive sleep apnea syndrome. The respiratory picture deteriorated with worsening of the airway obstruction, hypoxemia and finally pulmonary hypertension and cor pulmonale. A tracheostomy was performed, with resolution of the sleep apnea and pulmonary hypertension. The etiology, pathophysiologic consequences and surgical treatment of obstructive sleep apnea syndrome is reviewed.
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PMID:[Pyknodysostosis: extreme cause of sleep apnea]. 150 55

The factors that contribute to the development of chronic cor pulmonale (CCP) in sleep apnea syndrome (SAS) are being continuously reviewed, as well as the role played by the coexistence of chronic obstructive pulmonary disease (COPD). Right ventricular function was evaluated in 20 SAS patients, 10 of whom presented associated (COPD). In all of them the following tests were performed while fasting: blood gasometry, spirometry, body mass index and isotopic ventriculography which included the determination of righ ventricular ejection fraction (RVEF). The RVEF of the group presenting COPD (mean +/- DS) (0.43 +/- 0.07) was not significantly different from the group without COPD (0.46 +/- 0.09). When the patients were regrouped according to the presence of hypoxemia during the day (paO2 less than 70 mmHg) a significant difference was evidenced between the mean value of the RVEF group with hypoxemia (n = 10) (0.40 +/- 0.02) and that of the group with normoxemia (n = 10) (0.50 +/- 0.09) (p less than 0.05). There were no statistically significant differences between the degree of obstruction and the BMI in either group. These results suggest that the worsening of RVF is more frequent in SAS patients who present daytime hypoxemia.
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PMID:[Right ventricular function in sleep apnea syndrome and chronic obstructive pulmonary disease]. 178 98

Sleep apnoea (SA) has a prevalence of 1-10% in men. The physiological sleep is disturbed. SA is associated with cardiopulmonary disease (systemic arterial hypertension, cardiac arrhythmics, cor pulmonale) and the quality of the patient's life is reduced. Thirty male patients participated in a study to investigate the influence of an oral dose of theophylline on sleep apnoea. Under theophylline a significant reduction of apnoea events and of the apnoea index was seen.
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PMID:[Therapy of sleep apnea with theophylline (Uniphylline) administration every evening]. 186 10

Oxyhemogloblin affinity (P50 at pH 7.4, PaCO2 = 40 mm Hg, temperature = 37 degrees C) and 2,3-DPG concentration were assessed in 15 nonsmokers (14 men and one woman 46 to 63 yr of age) with sleep apnea syndrome (SAS) and in 10 normal subjects (eight men and two women 22 to 48 yr of age). In patients with SAS, mean nocturnal apnea index was 46 +/- 20/h, and mean nocturnal SO2 was 86 +/- 6% versus 94.6 +/- 1.8% during the daytime. Daytime mean P50 of the patients was 28.5 +/- 1.2 mm Hg versus 27.1 +/- 0.3 mm Hg in the normal subjects (p less than 0.05). Daytime mean 2.3-DPG was 1.23 +/- 0.25 moles DPG/mole hemoglobin versus 0.80 +/- 0.15 (p less than 0.05). Significant correlations were found in patients between P50 and mean nocturnal SO2 (r = -0.62, p less than 0.01) and between P50 and 2,3-DPG (r = 0.68, p less than 0.01). The measurements were repeated in five patients after surgical or positive-pressure treatment. P50 and 2,3-DPG both decreased and returned to normal values. In conclusion, the oxyhemoglobin dissociation curve is shifted to the right in patients with SAS and there is an increase in 2,3-DPG. These could be protective mechanisms against the development of polycythemia, pulmonary hypertension, and cor pulmonale.
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PMID:Decreased oxyhemoglobin affinity in patients with sleep apnea syndrome. 190 Apr 1

Chubby Puffer syndrome produces symptoms such as sleep apnea, cor pulmonale and upper airway obstruction due to adenotonsillar enlargement. We gave anesthesia for adenotonsillectomy in a 6-year-old boy with this syndrome. The child was massively obese. Anesthesia was induced with thiamylal, nitrous oxide and enflurane by monitoring SaO2. Tracheostomy was performed following orotracheal intubation because of possible difficult postoperative course. At the beginning of operation arterial blood studies showed hypoxemia. Positive end-expiratory pressure ventilation was effective to improve oxygenation. After adenotonsillectomy the symptoms were relieved.
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PMID:[Anesthetic management of a patient with Chubby Puffer syndrome]. 194 17

While there are many research questions still requiring performance of research sleep studies in patients with COPD, their use is not advocated in routine clinical practice, except in patients who have symptoms of the sleep apnoea/hypopnoea syndrome or possibly in those without daytime hypoxaemia (PaO2 greater than 60 mmHg) who have marked polycythaemia or marked cor pulmonale.
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PMID:Are sleep studies necessary in COPD? 211 15

The diagnosis of obstructive sleep apnea is frequently made by taking a meticulous history coupled with a high index of suspicion. Snoring and hypersomnolence are clinical features common to individuals with sleep apnea. Since snoring is said to be a "disease of listeners," it is not uncommon that bed partners reported an increased incidence of depression and marital displeasure. It is for this reason that the spouse or bed partner should be interviewed, since the patient may not be aware of any sleeping problems. Physicians should also be alert to complaints of excessive daytime somnolence, because studies have shown that patients with obstructive sleep apnea are at increased risk for automobile crashes. It has been estimated that approx 58,000 motor vehicle accidents involving people with sleep apnea will occur in the US each yr. By proper diagnosis and treatment, the physician is in a unique position to prevent at least some of the automobile accidents that result from falling asleep while driving. Polysomnography is the only definitive way to obtain a diagnosis of sleep apnea. This allows the physician not only to diagnosis the disorder, but also helps in the evaluation of the severity of the syndrome and selection of therapy. An ENT evaluation is also important in ruling out anatomic disorders that can cause upper airway obstruction. Certain factors, such as alcohol and sedative ingestion, may aggravate the condition in a person predisposed to sleep apnea, and subtle changes, such as unexplained hypertension, polycythemia, and cor pulmonale, should lead one to investigate the possibility of sleep apnea as the etiology.
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PMID:Diagnosis of obstructive sleep apnea. 229 95

Adaptation of the heart to the disturbed gas exchange function in chronic diseases of the lung consists of hypertrophy of the right ventricle (cor pulmonale). Prognosis of the chronic cor pulmonale depends on the degree of the pulmonary hypertension. Chronic obstructive diseases of the lung (COLD) are, in accordance with their widespread occurrence, the most frequent contributing causes to the development of chronic cor pulmonale. Sleep apnoea can also lead to pulmonary hypertension, independent of COLD. The diagnostic value of measurement of pulmonary arterial pressure at rest and under stress, compared with noninvasive examination methods such as echocardiography or radionuclide venography, remains indubitable. Treating the underlying pulmonary disease is the therapy of choice. Long-term O2 therapy is the only safely established cardiac therapeutic principle in hypoxaemic patients that prolongs survival times.
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PMID:[The heart in lung diseases]. 236 56

Sleep apnea in children develops when airway obstruction at night is severe; however, lesser degrees of obstruction may also cause problems. The most common cause of nighttime obstruction with or without apnea is hyperplasia of the tonsils and adenoids. Other conditions such as craniofacial anomalies and neuromuscular disorders may predispose children to obstruction of the airway during sleep. Although cor pulmonale, heart failure, and cardiorespiratory arrest are the most dramatic results of obstructive apnea, before these occur many other problems may develop that are detrimental to the child's health, including failure to thrive. A careful history and physical examination are usually sufficient to determine if obstruction and apnea are present at night. Additional studies such as sleep sonography and polysomnography are helpful for documentation of the disorder. The treatment of obstructive apnea, unless associated with central apnea, is surgical. The vast majority of children with obstruction have dramatic resolution of their obstruction following a tonsillectomy and adenoidectomy. Occasionally additional procedures including uvulopalatopharyngoplasty and tracheotomy are needed.
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PMID:Sleep apnea in children. 265 82


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