Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 67-year-old man with SIADH complicated by slowly progressing autonomic failure was described. The patient noticed constipation at the age of 57. In the following years, he suffered from urinary incontinence, depletion of sweating, impotence, sleeplessness with snore, and dizziness while walking. Physical examination revealed a masked oily face with slight cerebellar disturbance. Abnormality of autonomic function tests was recognized and he was diagnosed as Shy-Drager syndrome with gradually progressing, diffuse autonomic failure accompanied by slight cerebellar ataxia and Parkinsonism. Both serum sodium level and plasma osmotic pressure were reduced, whereas daily sodium excretion was more than 100mEq and urinary osmolality was about 500mOsm/kgH2O. His renal function was intact, and the adrenocortical and thyroid hormone levels were normal, then criteria of SIADH was fulfilled. SIADH was thought to have occurred on the basis of Shy-Drager syndrome. Water load test showed failure of adequate water diuresis, but intravenous phenytoin administration following the water load test ameliorated the diuresis to normal. The relationship between plasma osmolality and the ADH response indicates that ADH was adequately secreted in response to the increase in plasma osmolality but not suppressed in response to the decrease in plasma osmolality below 280mOsm/kgH2O. These results suggest that ADH synthesis in the hypothalamus and its secretion from the pituitary gland were both intact. The response of ADH secretion to the orthostatic hypotension induced by head-up tilt was quite blunted, being compatible with Shy-Drager Syndrome. Sleep disturbance was studied by polysomnography and laryngoscopy, and was revealed to be based upon severe sleep apnea due to incomplete paralysis of the bilateral vocal cords. Sleep apnea due to vocal cord paralysis is sometimes found to be complicated in patients with multiple system atrophy (MSA) including Shy-Drager syndrome, and is known as Gerhardt syndrome. This is the first report on a case of Shy-Drager syndrome complicated with SIADH and bilateral vocal cord paralysis. In this case, SIADH is caused by impaired afferent pathways from baroreceptors to the hypothalamus, which transfer inhibitory stimuli on ADH secretion. It is suggested that Shy-Drager syndrome should be considered one of the causes of SIADH.
 ...
PMID:[A case of Shy-Drager syndrome complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and incomplete paralysis of bilateral vocal cords]. 795 87

The two broad categories of sleep apnea syndrome are associated with obstructive or mixed events on the one hand, and central events on the other. The pathogenesis of both seems to involve periodic reduction in respiratory drive, although obstructive apneas may also involve an anatomic abnormality of the upper airway. Patients with obstructive sleep apnea syndrome most commonly exhibit resuscitative snoring and daytime sleepiness. Snoring is generally less prominent in the central sleep apnea syndromes; those with daytime hypercapnia generally complain of daytime sleepiness, whereas those without hypercapnia complain of disturbed sleep. The overnight polysomnogram is the preferred method of diagnosing both disorders.
 ...
PMID:Sleep apnea syndromes: overview and diagnostic approach. 802 35

The objective of the study was to evaluate the relation between every-night (habitual) snoring, sleep apnea and cognitive complaints (concentration and memory problems) in an adult population-based sample. In the Dan-MONICA (MONItoring trends in CArdiovascular diseases) 1,504 males and females aged 30, 40, 50 and 60 years were classified according to their snoring habits. Nocturnal respiration was measured in 748 participants. The following measures were regarded as potential confounders: age, gender, unintended sleepiness, insomnia, depression, hypnotic use, alcohol and tobacco consumption by questionnaire, body mass index (BMI) and blood pressure. Concentration and memory problems were both related to depression, insomnia and unintended sleepiness. Snoring and sleep apnea (defined as a respiratory distress index - RDI > or = 5), were associated with concentration problems and unintended sleepiness. The odds ratios (95% confidence intervals) between snoring, concentration and memory problems, calculated by logistic regression analysis after adjustments of the above confounders, were 1.90 (1.23-2.91, p < 0.01) and 1.38 (0.97-1.99, NS). For those with sleep apnea, the odds ratios were 3.53 (1.42-8.73, p < 0.001) and 1.51 (0.81-2.14, NS) for concentration and memory problems, respectively. The main conclusion drawn from this study is that cognitive complaints show a high correlation to mood, insomnia, and hypersomnia. Habitual snoring and sleep apnea show a correlation to concentration problems, but not to memory complaints. This suggests that part of the association between snoring, sleep apnea and cognitive dysfunction is related to the presence of sleep disturbances and daytime sleepiness.
 ...
PMID:Self-assessed cognitive function in snorers and sleep apneics. An epidemiological study of 1,504 females and males aged 30-60 years: the Dan-MONICA II Study. 808 78

89 of 119 parents of infants with apnea home monitoring answered to a standard questionnaire concerning different aspects of home monitoring. In almost all cases the home monitoring was finished at the begin of the study, lasting from six months to 12 months. The indications for an apnea monitor were: apparent life threatening event (n = 8), SIDS-sibling (n = 24), sleep apnea syndrome (n = 40) and parents pressing request (n = 17). 90% of parents felt to have got enough information about the function of the apnea monitor (mostly Graseby MR-10 monitor) and what they have to do when there is an apnea alarm. 6% of parents changed the monitor because of technical problems. Most of the alarms were registrated by almost all parents between 24 h and 6 h. 35% of parents stimulated their infants in case of an apnea alarm gently to vigorously, one infant had a mouth to mouth resuscitation. Questions concerning the psychological and social impact of home monitoring on parents demonstrated that there was some stress like anxiety, sleep disturbances mainly in the mothers. We conclude from parents experience with apnea home monitoring the need for an adequate medical, technical and psychological support.
 ...
PMID:[Experience of parents in home monitoring of apnea for prevention of sudden infant death (SIDS)]. 824 96

A high prevalence of sleep apnoea was found in a group of men occupationally exposed to organic solvents. Workers with long term exposure to organic solvents often report symptoms such as fatigue, forgetfulness, and concentration difficulties. These symptoms are strikingly similar to those reported by patients with obstructive sleep apnoea syndrome (OSAS). This is a frequently diagnosed disorder characterised by disturbed sleep causing psychic or somatic complications and daytime sleepiness. A study was undertaken to evaluate whether people with long term occupational exposure to organic solvents have a higher prevalence of sleep apnoea than the general population. Patients exposed to solvents (66 men) were invited to participate in a screening for sleep apnoea. A static charge sensitive bed was used for the monitoring of respiration movements and pulse oximetry during one night. A classical sleep apnoea was diagnosed if periodic respiration movement exceeded 45% of estimated sleep time and the oxygen desaturation index exceeded 6. The prevalence of sleep apnoea among the men exposed to solvents was compared with the prevalence in the general population (1.4%). The prevalence among the participating exposed men was 19.7% which gave a conservative relative risk estimate of 14.1 (95% confidence interval (95% CI) 7.5-24.2). The results indicate that exposure to organic solvents causes sleep apnoea. An alternative possibility is that people with sleep apnoea are misdiagnosed as cases of solvent induced toxic encephalopathy. The interpretation has importance for the caring of the patient.
 ...
PMID:Occupational exposure to organic solvents as a cause of sleep apnoea. 845 96

Various research studies show that the amalgam of disordered sleep physiology, chronic fatigue, diffuse myalgia, and cognitive and behavioural symptoms constitutes a non-restorative sleep syndrome that may follow a febrile illness, as in the chronic fatigue syndrome. Where rheumatic complaints are prominent such a constellation of disturbed sleep physiology and symptoms also characterizes the fibromyalgia disorder. In contrast to the chronic fatigue syndrome, fibromyalgia is associated with a variety of initiating or perpetuating factors such as psychologically distressing events, primary sleep disorders (e.g. sleep apnoea, periodic limb movement disorder) and inflammatory rheumatic disease, as well as an acute febrile illness. The chronic fatigue syndrome and fibromyalgia have similar disordered sleep physiology, namely an alpha rhythm disturbance (7.5-11 Hz) in the electroencephalogram (EEG) within non-rapid eye movement (NREM) sleep that accompanies increased nocturnal vigilance and light, unrefreshing sleep. Aspects of cytokine and cellular immune functions are shown to be related to the sleep-wake system. The evidence suggests a reciprocal relationship of the immune and sleep-wake systems. Interference either with the immune system (e.g. by a viral agent or by cytokines such as alpha-interferon or interleukin 2) or with the sleeping-waking brain system (e.g. by sleep deprivation) has effects on the other system and will be accompanied by the symptoms of the chronic fatigue syndrome.
 ...
PMID:Fibromyalgia, sleep disorder and chronic fatigue syndrome. 849 Nov 2

Sleep apnoea (SA) ist a challenge to clinical research, since it occurs in up to 10% of the male professionally active population. It is indeed a challenge in respect of diagnosis, clinical aspects and therapy. SA is not only responsible for mental handicaps during daytime caused by disturbed sleep (increased tendency to doze or fall asleep, proneness to accidents), it will also enhance morbidity and mortality in aspect of cardiopulmonary and cardiovascular diseases (hypertension, cardiac insufficiency, disturbances of cardiac rhythm). All kinds of secondary and/or subsequent damage are reversible, provided diagnosis and rigidly introduced and maintained treatment have been performed well in time. SA can be diagnosed, treated and followed up by means of methods that can be flexibly employed outside the hospital, i.e. on an outpatient basis, such as questionnaires, MESAM IV, behavioural counselling, drug therapy). Within the framework of the current three-year project a stepwise concept was developed for diagnosis and treatment that also includes outpatient examination procedures. This system integrates anamnesis, outpatient monitoring, sleep laboratory, therapy and therapy control into a comprehensive feedback system of patient care. The following standardised procedural steps are included in the outpatient part of this system: baseline examination, treatment that can be performed on an outpatient basis, short-term, medium-term and long-term therapy follow-up. If these steps do not yield satisfactory results or if there is a high acute risk, the patient is subjected to in-patient treatment. At present, 683 first examinations and 420 follow-ups have been recorded.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Sleep-related respiratory disorders: early detection and follow-up by close patient contact]. 849 58

Sleep disturbances are common complaints of dialysis patients, and sleep studies have suggested that sleep apnea may occur frequently. We performed sleep studies on 18 stable continuous ambulatory peritoneal dialysis (CAPD) patients. Our results indicate that 6 of 18 patients (33%) had a respiratory disturbance index (RDI) greater than 15, which indicates severe sleep apnea. Twelve of 18 patients (67%) had an RDI greater than 5, indicating clinically significant sleep apnea. These results suggest that sleep apnea is common in CAPD patients. The impact of sleep apnea on the patients' quality of life remains to be determined.
 ...
PMID:Sleep apnea in CAPD. 853 84

We examined 67 patients with periodic leg movement (PLM) disorder who were seen in a university-based sleep center. The most common reasons for coming to the sleep center were insomnia, sleepiness and a request for an evaluation for possible sleep apnea. There was a significant positive correlation between PLM arousal index and age but no association with gender. Approximately one-quarter of patients were under age 30. The multiple sleep latency test (MSLT) revealed borderline normal wakefulness in the group as a whole (sleep latency of 10.2 +/- 0.9 minutes), and there was no significant correlation between the PLM arousal index and either the MSLT mean sleep latency or a measure of subjective sleepiness. Similarly, the PLM arousal index did not differentiate those who entered with chief complaints of insomnia or sleepiness. There was no significant difference in the PLM arousal index in those who reported that they did or did not awaken refreshed in the morning. In summary, in this clinical population we found no significant association between the PLM arousal index and the subjective complaint of disturbed sleep, an objective measure of daytime sleepiness or a sense of awakening refreshed in the morning. Other interesting observations included the relatively high frequency of a PLM index > 5 in patients under 30 years old and a relatively high rate of past treatment for depression.
 ...
PMID:Are periodic leg movements associated with clinical sleep disturbance? 912 64

Screening for sleep-disordered breathing is often done in an interview and with a questionnaire. This method is indirect and it appears to underestimate the prevalence of sleep apnea syndrome. Recently, several devices such as the Medilog and Vitalog portable monitoring systems were developed. However, these devices are difficult for patients to operate by themselves, because they include EEG monitoring or measurement of chest and abdominal movement. Therefore, we developed a portable monitoring system that is easier to operate. This system can be used to assess three variables: oronasal airflow, tracheal sound, and electrical activity of the heart. It stores the time of the onset of apnea, apnea duration, and R-R intervals with a built-in microcomputer. Apnea episodes, total apnea time, mean apnea time, and R-R interval are analyzed with a host computer. The sensitivity an specificity of this system are 92.5% and 87.5%, respectively, with an apnea index (AI) of less than 10 episodes/h. Using this device, we found that the prevalence of sleep apnea syndrome among Japanese industrial workers who had an AI of more than 10 episodes was 7.5%. Moreover, from 1984 to 1994 we used this device to monitor 1019 outpatients who complained of sleep disturbances such as snoring, abnormal breathing during sleep, and excessive daytime sleepiness, and found sleep apnea (AI > or = 10) in about 50% of these patients. This monitoring system is useful for screening of outpatients with sleep apnea and for epidemiological studies of sleep apnea. However, it may be necessary to include a non-invasive system for monitoring oxygen saturation in the portable sleep monitor, to detect hypoventilation during sleep.
 ...
PMID:[Portable home monitoring system in screening for sleep-disordered breathing]. 875 82


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>