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)

In three children aged 3, 9 and 10 years the syndrome of sleep apnea with typical manifestations of obstructive apnoeic episodes during sleep is described. In two instances the nocturnal periodic apnoeic spells were associated with marked varying hypoxemia, objectively recorded by continuous monitoring of the transcutaneous oxygen tension using a skin oximeter. In one child the cause of airway obstruction during sleep were hypertrophic tonsils and adenoid vegetation, in the other two children in the nocturnal apnoeic spells above all the functional component participated, expressed by increased relaxation of the oropharyngeal musculature during sleep. In the first child adenotonsillectomy was followed by immediate regression of all original symptoms, in the remaining two children therapeutic results were achieved only by removal of the slightly enlarged tonsils, while previous adenotomy did not have a favourable effect on the course of their disturbed sleep. Permanent regression of the apnoeic episodes after tonsillectomy was confirmed by records of a smooth level of the skin oxygen tension during sleep. This syndrome is more frequent than generally assumed and late establishment of the diagnosis may lead to the development of serious cardiopulmonary complications, irreversible neurogenic dysfunctions and psychosomatic retardation of the affected children.
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PMID:[Personal experience with the sleep apnea syndrome]. 275 75

We studied 112 patients with Tourette's syndrome (TS); the male-to-female ratio was 3.8, the mean age of onset was 7.3 years, and the average duration of symptoms prior to the initial evaluation was 15.2 years. Seventy-nine percent of the patients had at least one family member with motor or vocal tics, and an additional 10 percent had a family member with marked obsessive-compulsive behavior. Simple motor tics occurred as the presenting symptom in about one-third of patients; one-third had multiple motor tics at the onset, and another third started with vocal tics. During the course of the illness all patients developed multifocal motor tics and 86 percent had vocal tics. Verbal and mental coprolalia was present in 44 percent of the patients. Copropraxia was seen in 19 percent of patients, and both coprolalia and copropraxia were more frequent among the males than expected. Attentional deficit disorder was diagnosed in 36 percent of the patients and 32 percent had obsessive-compulsive personality. Sleep disturbances were reported by 62 percent of the patients and polysomnographs in 34 patients showed motor and vocal tics during all stage of sleep, sleep apnea, abnormal arousal pattern, and other sleep disturbances. Patients with mild symptoms improved with clonidine or clonazepam, but those with more advanced disorder required fluphenazine, pimozide, haloperidol or tetrabenazine.
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PMID:Motor, behavioral and pharmacologic findings in Tourette's syndrome. 289 Apr 26

The present study reports on polysomnographic findings of sleep apnea syndrome in a representative sample of otherwise healthy middle-aged blue collar workers (age 45.7 +/- 8.5) with normal to borderline blood pressure (systolic 135.5 +/- 16.1; diastolic: 88.3 +/- 10.2), mild overweight (Broca 114.9 +/- 14.7) and with reported nocturnal sleep disturbances. The prevalence of sleep apnea in this sample (N = 20 out of a total of 78 workers with reported sleep disturbances) is 40%. Mean frequency of apnoeic episodes during night was 97.6 +/- 42.7 in the apnea-positive group as compared to 27.1 +/- 19.9 in the apnea-negative group (T = 5.0; p less than 0.0001), with an apnea index of 13.3 +/- 6.2 as compared to 3.5 +/- 2.3 (T = 7.2, p less than 0.0001). Left ventricular hypertrophy (mean diameter of end diastolic left ventricle: 64.0 +/- 9.5 mm) was found in individuals with apnea although manifest hypertension was absent in most individuals.
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PMID:Prevalence of sleep apnea in healthy industrial workers. 293 98

Seven men with central sleep apnea underwent polygraphic monitoring during sleep for at least 3 nights, in combination with other tests. Five patients had complaints of disturbed sleep; the other 2 were selected because they had central sleep apnea caused by bilateral brainstem lesions. The first 5 had a small upper airway, documented by cephalometric roentgenograms. Nasal continuous positive airway pressure, administered to improve the suspected respiratory load during sleep, eliminated the central sleep apnea in the first 5 patients but had, as expected, no positive effect on the central apnea of the 2 patients with brainstem lesions.
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PMID:Central sleep apnea and partial obstruction of the upper airway. 329 46

Advancements in sleep research have led to the development of new standards of what is normal sleep and arousal and new diagnostic tests for the detection of sleep disorders. Millions of adults have frequent or chronic complaints about the quality and quantity of their sleep. Sleep complaints increase with increasing age and are more common in women than in men and in women over 45 than in younger women. Sedative-hypnotic drugs are taken more frequently by women than men, and the incidence of use increases with increasing age. Studies of sleep and sleep disturbances during the perimenopausal period suggest that difficulty falling asleep and frequent nocturnal awakenings result from hormonal changes, vasomotor symptoms, and possibly psychologic factors. Other causes for sleep complaints in menopausal and postmenopausal women are occult sleep disorders, especially periodic leg movements in sleep and sleep apnea syndrome. Sleeping pills are inappropriate for most patients with sleep complaints. If sleep difficulties persist after a trial of good sleep hygiene, further evaluation at a sleep disorders center is indicated.
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PMID:Sleep disorders. 354 46

Obesity-related sleep apnea syndrome (SAS) was diagnosed in 13 patients evaluated for gastric bypass surgery. A diagnostic sleep study was performed whenever a specially designed questionnaire revealed characteristic signs of sleep disturbances. Pretreatment polyhypnographic recordings of patients with SAS demonstrated considerable reduction of deep and rapid eye movement (REM) sleep stages with a correspondent prolongation of wake within sleep or non-REM sleep stages I and II. After surgical weight reduction repeated polyhypnographic recordings revealed considerable improvement or even a complete recovery of breathing in sleep and a normalization of sleep structure. Non-REM deep sleep stages (III and IV) augmented from 5.51% +/- 2.53% (mean + SEM) to 22.69% +/- 3.56% (p less than 0.002), and the REM stage increased from 9.91% +/- 1.78% to 18.15% +/- 2.13% (p less than 0.005). Surgical weight reduction in obesity-related SAS is a valuable therapeutic measure for this respiratory derangement, as well as for sleep quality.
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PMID:The effect of surgical weight reduction on sleep quality in obesity-related sleep apnea syndrome. 399 78

The effects of triazolam (0.25 mg) or flurazepam (15 mg) were evaluated in 13 elderly (ages 64-79) insomniacs. Subjects were reasonably healthy, ambulatory, and complained of disturbed sleep. Sleep apnea syndromes were ruled out by nocturnal polysomnogram. Sleep, daytime sleepiness [Multiple Sleep Latency Test (MSLT) and Stanford sleepiness scale (SSS)], performance, and mood [Profile of Mood States (POMS)] were assessed on five consecutive days. Placebo was given on nights 1 and 2; active medications were given on nights 3-5. Sleep time was increased by approximately 1 h in both groups. MSLT showed increased sleepiness with flurazepam and decreased sleepiness with triazolam. MSLT scores were unrelated to nocturnal sleep parameters in the flurazepam group and showed a pattern of correlation, though nonsignificant, in the triazolam group. Vigilance was impaired with flurazepam and unchanged with triazolam. Other performance tests showed slight improvement or no change with drugs. Mood tended to be improved after flurazepam ingestion and unchanged after triazolam. These findings suggest that, although both compounds improve nocturnal sleep in elderly insomniacs, there is significant residual sedation with flurazepam and improved daytime alertness with triazolam. Neither compound had a significant effect on nocturnal respiration in these non-sleep-apneic elderly subjects.
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PMID:Daytime carryover of triazolam and flurazepam in elderly insomniacs. 613 26

The use of tricyclic antidepressants as opposed to hypnotics in treating insomnia is reviewed. Available data indicate that TCAs alleviate sleep disturbances related to depression (often before antidepressant effects are seen) and, in selected cases, may prove effective in disturbed sleep related to sleep apnea, fibrositis, and sleep related bruxism, as well as in adults with childhood onset insomnia or a history of hyperkinesis. However, TCAs share many of the problems reported for hypnotics, as well as having some potentially serious side effects not present with benzodiazepines. The need for determination of the etiology of sleep disorders, and specific pharmacotherapy directed toward identified causes rather than the symptom of insomnia, is stressed.
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PMID:Tricyclic antidepressants in the treatment of insomnia. 635 74

Disturbed nocturnal sleep is considered a symptom of narcolepsy. Polysomnographic recordings of 57 consecutive narcoleptic patients were reviewed for evidence of disturbed sleep. When disrupted sleep was present, it was attributable to recognized sleep disorders: nocturnal myoclonus and sleep apnea. Comparison of standard polysomnographically derived parameters of patients who had narcolepsy without sleep apnea or nocturnal myoclonus with those of a normal control group, showed no evidence of disturbed sleep in the patient population. The narcoleptics that also had nocturnal myoclonus or upper airway sleep apnea did have disturbed sleep in comparison with the normals. Our data suggest disturbed sleep tends to develop in narcolpetic patients with age, but is not an inherent element of the narcolepsy syndrome.
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PMID:Narcolepsy and disturbed nocturnal sleep. 661 86

We have attempted to review the current "state of the art" regarding the ontogenetic course of sleep-wake state organization and possible disruptions in this course from infancy through adolescence. It is becoming increasingly important for clinicians to learn about physiologic functioning during sleep. Much more research is required, directed at the relationship between waking behaviors and sleeping behaviors. Investigations of daytime sleepiness in adolescence, of the relationship of hyperactivity to excessive sleepiness, of the relationship between disorders such as depression and anorexia nervosa with disturbed sleep state organization, and of primary sleep disorders such as narcolepsy and the sleep apnea syndrome only scratch the surface in terms of the future work that needs to be done.
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PMID:Sleep and sleepiness in children and adolescents. 699 Mar 63


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