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

As sleep apnea is more prevalent in men and testosterone has known effects on sleep apnea and chemosensitivity, reduction of androgen activity may influence sleep-disordered breathing and respiratory control. We studied the effect of 1 wk of treatment with flutamide, a nonsteroidal antiandrogen, on sleep, respiration, and ventilatory control in eight men with sleep apnea. Results on flutamide were compared with two baseline studies performed before and after the drug treatment period. Although effective androgen blockade was achieved as evidenced by increased hormone levels, flutamide had no effect on sleep architecture or chemoresponsiveness to hypoxia and hypercapnia. There was a trend towards a reduction in respiratory disturbance index in both NREM and REM sleep (41 +/- 4 baseline versus 34 +/- 3 flutamide, p = 0.09 NREM; 53 +/- 4 baseline versus 48 +/- 3 flutamide, p = 0.16 REM), but this was not significant. Our results indicate that androgen blockade had no clinically significant effect on sleep, sleep-disordered breathing, or chemosensitivity in patients with moderate to severe sleep apnea. More specific blockers such as gonadotrophin-releasing hormone analogs may have more clinical effect or, alternatively, androgen blockade may be more beneficial in patients with milder sleep apnea.
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PMID:Androgen blockade does not affect sleep-disordered breathing or chemosensitivity in men with obstructive sleep apnea. 145 53

Sleep apnea syndrome (SAS) in children has been identified only recently. Its incidence is unknown but seems to be rising. The cause is usually an obstruction (enlarged tonsils) that alters the fragile physiologic mechanisms responsible for maintaining the upper airways open when the child is sleeping. Diagnosis of SAS rests on clinical findings. The parents should be questioned as to the frequency over time of the various symptoms, of which most occur during the night: snoring, difficult breathing, respiratory pauses. Sleep polygraphy studies are indicated only in specific situations. The main cause is enlargement of the adenoids and tonsils. Cardiovascular complications may develop; weight gain and statural growth, psychomotor development and development of the face may be altered. Chronic snoring without apneas should be considered as a form of SAS. Treatment rests mainly on surgery (removal of the adenoids and tonsils).
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PMID:[Syndrome of obstructive sleep apnea in children]. 145 81

Delimitation of the sudden unexplained infant death syndrome (SIDS) is difficult as the diagnosis is made by exclusion. The difficulties in the differential diagnosis are concentrated on interpretation of the significance of positive viral and bacterial findings, inflammatory changes in the respiratory organs, heart and central nervous system together with malformations. Classification of SIDS appears, therefore, to vary according to time and place. New techniques, e.g. DNA analysis, have explained the etiology in a few per cent of the cases but have not yet solved the riddle of SIDS. The article reviews hypotheses about apnoea, arrhythmia, overheating and inefficient surveillance of the infant. It is emphasized that assessment of risk factors for SIDS requires valid epidemiological investigations where the basis for the diagnosis is a uniform classification of SIDS infants as compared with other groups of sudden death in infancy. An investigation of this nature has been initiated in the Nordic countries. It is important to examine and treat infants with abnormal sleep apnoea but generalized employment of monitoring has not reduced the number of unexplained infantile deaths.
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PMID:[Sudden, unexplained infant death--sudden infant death syndrome. Forensic pathological aspects]. 146 63

Twenty two patients over the age of 40 with stable spinal cord damage underwent overnight sleep studies to investigate the prevalence of sleep apnoea. Ten patients had some evidence of obstructive sleep apnoea (OSA). Hypoxic events were scored as number of dips of SaO2 more than 4% below the preceding 10 minute average (> 4% SaO2 dip rate). All the patients had more than five such dips per hour and six had clearly abnormal dip rates of more than 15 per hour. Two other patients had dip rates above 10 per hour without apnoeas but periods of central hypoventilation mainly during rapid eye movement (REM) sleep. OSA appears to be more common in older patients with spinal cord injury than in the general population. Possible relevant factors include patient selection, reduced ventilatory function secondary to spinal cord damage, sleep posture and medication.
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PMID:Prevalence of sleep apnoea in patients over 40 years of age with spinal cord lesions. 146 99

Obstructive sleep apnea syndrome (OSAS) is the most common organic disorder of excessive daytime somnolence. In cross-sectional studies the minimum prevalence of OSAS among adult men is about one per cent. Prevalence is highest among men aged 40-65 years. The highest figures for this age group indicate that their prevalence of clinically significant OSAS may be 8.5% or higher. Habitual snoring is the most common symptom of OSAS (70-95%). The most significant risk factor for OSAS is obesity, especially upper body obesity. Other risk factors for snoring, and for OSAS, are male gender, age between 40 and 65 years, cigarette smoking, use of alcohol, and poor physical fitness. Upper airway obstruction with snoring or sleep apnea are commonly seen in children of all ages. Snoring is very common among infants and children with Pierre Robin syndrome and among infants with nasal obstruction. Snoring and obstructive sleep apnea are also very common in men with acromegaly. Many other syndromes or diseases exist in which the upper airway is narrowed. Prevalence of snoring and sleep apnea is increased in all such situations. It has been suggested that sleep apnea may be one mechanism contributing to sleep-related mortality. The prevalence of every night snoring seems to decrease after the age of 65. However, more than 25% of persons over 65 have more than five apneas per hour of sleep. It remains to be seen whether this finding has clinical significance. Partial upper airway obstruction, even without apneas, may influence pulmonary arterial pressure and may cause daytime sleepiness and some health consequences.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiology of obstructive sleep apnea syndrome. 147 Aug

Sleep apnea syndrome (SAS) results from modification in the control of respiration and of upper airway caliber during sleep. Although there is some overlap between central (CSAS) and obstructive (OSAS) sleep apnea syndromes, each syndrome has specific pathological associations. The first part of this review concerns the pathophysiology of OSAS, including periodic breathing and upper airway collapse. In the second part, each specific etiology is examined, and the respective contribution of anatomic narrowing and neuromuscular dysfunction of the upper airway is mentioned. Our experience with about 375 patients with sleep-related breathing disorders is also reported, with regard to the specific etiologies of CSAS and OSAS.
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PMID:Sleep apnea syndromes (SAS) of specific etiology: review and incidence from a sleep laboratory. 147 Aug 4

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

Sleep apnea syndrome (SAS) is a well established sleep disorder with high morbidity and mortality. Patients are most often middle-aged men. SAS occurs in at least 1% of the adult population. Several studies have suggested that SAS is extremely frequent in the elderly, its prevalence ranging from 18 to 73% in this group. However, the generalization of these results to elderly cohorts is questionable because of several limitations of these studies, including lack of standard selection criteria, variation in recording techniques, the night to night variability of sleep apnea and the use of a moderate level of sleep disordered breathing (SDB) to define SAS (5 apneas per hour). The study best designed for valid extrapolation to the whole aged population estimates the frequency of SAS at 18%. However, most of these patients reported satisfactory sleep, and epidemiologic criteria for a causal association between SAS in the elderly and cardiovascular disease have not been satisfied. The conclusions of numerous studies dealing with impairment in cognitive function and SAS in the elderly are controversial. In fact, if the diagnostic threshold is increased from 5 apneas to 10 apneas plus hypopneas per hour, elderly SAS patients have more sleep disturbances, are more depressed and have cognitive deficits as compared to normal old persons. When an appropriate diagnostic index is used, SAS in the elderly resembles SAS described in the middle-aged population. In addition, a high apnea plus hypopnea index is an ominous predictor of mortality in the elderly population, and a very high level of SDB is an extremely significant risk factor for mortality during sleep phase in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sleep apnea syndrome in the elderly. 147 Aug 7

Nasal continuous positive airway pressure (NCPAP) is considered the most effective treatment of obstructive sleep apnea. Its beneficial effects are related to the normalization of breathing during sleep and to the prevention of nocturnal desaturations. NCPAP interacts with the pathophysiologic mechanisms of sleep apnea onset and with the consequences of these apneas. Upper airway patency is maintained with NCPAP by a pneumatic splinting effect while changes in lung volume and pre-apnea SaO2 level may be implicated in the improvement of apnea-related desaturations. An improvement in central chemosensitivity could account for the improvement in diurnal oxygenation observed with long term NCPAP therapy.
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PMID:Mechanisms of the effectiveness of continuous positive airway pressure in obstructive sleep apnea. 147 Aug 9

This review provides a critical analysis of current respiratory monitoring techniques in diagnosis of sleep apnea syndrome. The correct analysis of polysomnography requires knowledge of the limitations of the means of recording used. These limitations, for invasive and noninvasive techniques, are discussed in terms of calculation, differentiation and scoring of respiratory events. Aims and means are stated for monitoring and scoring in research as well as in clinical practice.
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PMID:Respiratory monitoring in sleep apnea syndrome. 147 Aug 10


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