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)

Sleep disturbances are common in older adults. These disturbances are often secondary to medical illness and/or medication use or are due to specific problems such as sleep disordered breathing, periodic limb movements in sleep and circadian rhythm disturbances. The prevalence of sleep disordered breathing and periodic limb movement in sleep increases with age. The circadian rhythm tends to advance with age, causing older people to awaken early in the morning. Insomnia is often caused by pain associated with medical illness. Insomnia can also be caused by stimulating medications. In institutionalized elderly, sleep becomes even more disturbed and fragmented than in community-dwelling older adults. Accurate assessment and diagnosis is crucial since effective treatment strategies are available for these sleep disturbances. The effect, prevalence and treatment of each of these conditions is reviewed.
 ...
PMID:Assessment and treatment of sleep disturbances in older adults. 1098 68

Sleep disturbance in patients with epilepsy is frequently overlooked, but may contribute to decreased daytime functioning and increased seizure activity. Although complicated, the relationship between sleep and epilepsy is becoming clearer. Sleep, and particularly deep non-rapid-eye-movement sleep, increase interictal epileptiform activity. Sleep increases certain seizure types and the rate of generalization of partial seizures, however rapid-eye-movement sleep seems to suppress seizures. Sleep disorders, particularly sleep apnea, exacerbate seizures. Seizures, in turn, can disrupt sleep structure, particularly rapid-eye-movement sleep. An understanding of these relationships is important in seizure control and in maximizing the quality of life for patients with epilepsy.
 ...
PMID:Sleep and epilepsy. 1098 75

Sleep disturbances afflict more than 50% of adults age 65 and older. Sleep apnea and periodic limb movements of sleep are the primary sleep disorders in the elderly. Patient assessment tools, a thorough physical examination, and appropriate tests can simplify the diagnostic process; sleep center referral is not always warranted. Ultimately, accurate sleep disorder diagnoses can result in decreased geriatric morbidity and mortality, and increased patient quality of life.
 ...
PMID:Assessing ambulatory geriatric sleep complaints. 1101 41

Narcolepsy is a disabling, chronic sleep-wake disorder that typically starts in a patient's second or third decade of life. Its key features are hypersomnia and cataplexy. Sleep paralysis, hallucinations, and disrupted sleep are nonspecific symptoms and are not always present. Disability relates primarily to sleepiness- related cognitive impairment, accidents, and psychosocial problems. Treatment, which includes counseling, scheduled napping, and pharmacologic intervention, is effective for most patients. Hypersomnia is best treated with such indirect sympathomimetics as mazindol, pemoline, methylphenidate, and amphetamine. Modafinil may become the drug of choice because it has fewer side effects. Cataplexy, sleep paralysis, and hallucinations may be ameliorated by compounds, including clomipramine and imipramine, that suppress rapid eye movement (REM) sleep. Regular follow-up visits enable the clinician to recognize uncommon but serious side effects (tolerance, substance abuse, psychosis, and hypertension) and additional sleep disturbances (sleep apnea, periodic limb movements in sleep, REM sleep behavior disorder), which can be specifically treated.
 ...
PMID:Narcolepsy. 1109 16

Sleep disturbances in the elderly may not be a result of the aging process per se, but rather are likely caused by many factors that are amenable to treatment. These factors include medical and psychiatric problems, medications, and circadian rhythm changes, all of which can cause difficulties during sleep at night, and can lead to complaints of insomnia. Other factors that cause disturbances include a high prevalence of specific sleep disorders such as sleep disordered breathing (SDB), periodic limb movements during sleep (PLMS) and rapid eye movement (REM) sleep behavior disorder (RBD). Although these disorders are more prevalent in the older than younger population, they are not exclusive to this age group, and treatment options that are applicable to young adults are also applicable to older adults. On the other hand, dementia and Parkinson's disease are two neurologic disorders that are almost exclusive to the elderly and most often involve sleep disturbances. Because there are many causes of sleep complaints, when considering treatment options one must identify the underlying problem. If caused by illness, effective treatment of a specific medical or psychiatric problem should help alleviate the sleep problem as well. Changes in the timing of drug administration may improve sleep. For the treatment of chronic insomnia, behavior techniques should always be used in combination with pharmacologic therapy, and sedative-hypnotic medications should be considered when appropriate. The treatment of choice for obstructive sleep apnea is continuous positive airway pressure (CPAP). For PLMS, dopaminergic agents are most effective. For RBD, clonazepam effectively controls the aversive sleep behaviors. Sleep disturbances secondary to dementia and Parkinson's disease are usually problematic for the patient as well as the caregiver, whether in the home or in the nursing home. Proper management of these disturbances is beneficial in terms of delaying institutionalization and reducing nursing care costs, as well as improving the quality of life for both patient and caregiver.
 ...
PMID:Sleep Disorders in the Elderly. 1112 56

Respiratory disturbances in patients with the sleep apnea-hypopnea syndrome (SAHS) may be detected by means of nasal prongs (NP) pressure (PNP). Nevertheless, PNP is nonlinearly related to flow (V). Our aim was to demonstrate the relevance of linearizing P NP for assessing hypopneas and flow limitation in SAHS. V was measured with a pneumotachograph during the hypopneas and flow limitation events in a continuous positive airway pressure (CPAP) titration in six patients with severe SAHS. These flow patterns were reproduced by a flow generator through an analog of the nares and recorded by NP. PNP was linearized [V NP = (PNP)1/2] by a specially designed analog circuit. For each event we used V, P NP, and V NP to compute the hypopnea flow amplitude (HFA) and a flow limitation index (FLI). Owing to NP nonlinearity, PNP considerably misestimated HFA and FLI. By contrast, V NP provided HFA and FLI values that were very close to those obtained from V: HFA (V NP) = 1.098. HFA(V) - 0.063 (r2 = 0.98) and FLI(V NP) = 1.044. FLI(V) + 0.004 (r2 = 0.99). Square-root linearization of NP greatly increases the accuracy of quantifying hypopneas and flow limitation. This procedure, which could be readily carried out in routine practice by means of the analog circuit we developed, is of interest in optimizing the assessment of respiratory sleep disturbances in SAHS.
 ...
PMID:Relevance of linearizing nasal prongs for assessing hypopneas and flow limitation during sleep. 1117 29

When sleep was recognized as an active process which is regulated by the interaction of homeostatic and circadian systems a new understanding of sleep disturbances set in, and sleep medicine developed as a new medical speciality. An internationally recognized classification system was developed which allows to diagnose the different sleep disturbances reliably. Sleep disorders comprise (a) dysregulations of the sleep-wake system (insomnias, hypersomnias, narcolepsy, parasomnias), (b) sleep associated disturbances of functional systems (for example sleep apnea, restless legs syndrome), (c) disturbances of the circadian sleep-wake rhythm, and (d) sleep disturbances in association with other organic or psychiatric illnesses. The present contribution shows the diagnostic procedures for four main sleep disorders, namely insomnia, obstructive sleep apnea (OSAS), restless legs syndrome (RLS), and narcolepsy.
 ...
PMID:[Diagnosis and classification of sleep disorders]. 1123 95

Fibromyalgia syndrome is a common chronic pain syndrome that is often associated with sleep disturbances characterized by subjective experience of non-restorative sleep. The complaints of sleep disturbances are correlated with polysomnographic features showing clear abnormalities in the continuity of sleep as well as in the sleep architecture. Sleep-recording abnormalities are characterized by a reduced sleep efficiency with increased number of awakenings, a reduced amount of slow wave sleep and an abnormal alpha wave intrusion in non rapid eye movement, termed alpha-delta sleep. These data were confirmed by spectral analysis of sleep showing an increased EEG power density in the higher frequency band and a reduced EEG power density in the lower frequency bands. Moreover, other microstructural aspects of sleep were modified with high frequency of arousals and alpha-K complex reported, both indicators of fragmented sleep. The fibromyalgia symptoms may relate to a non-restorative sleep disorder associated with the alpha-EEG sleep anomalies. However, alpha-EEG sleep anomaly is non-specific for fibrositis, also seen in normal controls during stage 4 sleep deprivation. Moreover, fibromyalgia patients may also experience primary sleep disorder such as sleep apnea or periodic leg movements. The etiology of this common condition is incompletely understood and the existence of a specific entity of fibromyalgia is still a matter of debate. However, several studies have found abnormal brain metabolism of substances such as serotonin implicated in sleep arousal and pain mechanisms and administration of tricyclic antidepressants and selective serotonin reuptake inhibitors may be useful in fibromyalgia. Pain, poor sleep quality and anxiety may contribute to the clinical picture. Several factors such as psychological, environmental, genetic factor, altered serotonin metabolism and altered sleep physiology are involved in the pathogenesis of fibromyalgia.
 ...
PMID:[Sleep in fibromyalgia: review of clinical and polysomnographic data]. 1128 Oct 66

Sleep apnoea syndromes have been known since long, and frequently the presenting symptoms are neurological in nature. However, these disorders have not been systematically studied and reported in the Indian literature. Out of 12,000 neurology outpatients seen by authors in 2 years, 60 had primary sleep disturbances. All these 60 patients underwent clinical evaluation and video EEG polysomnography. In 8 out of 60 (13%) patients, sleep apnoea was documented. Five patients had obstructive sleep apnoea, 3 had mixed sleep apnoea and none had pure central sleep apnoea syndrome. Three-fourths of the patients were obese (mean weight 82kg) middle aged males (mean age 46.3 years). The main symptoms encountered were excessive daytime somnolence and snoring. The symptom severity was found to correspond directly with the duration of symptoms as well as obesity. Sleep apnoea syndromes must be seriously considered and documented in all patients complaining of excessive daytime somnolence.
 ...
PMID:Sleep apnoea syndromes : clinical and polysomnographic study. 1130 41

Recently there has been a sizeable increase in research on fatigue and accidents in transportation. Therefore a meeting was convened last year to discuss prevalence, mechanisms and countermeasures, with the intention to produce an international consensus document. It was concluded that official statistics strongly underestimate prevalence, and that a reasonable estimate, based on research, lies between 10 and 20% for accidents on the road, in the air and at sea. The main causes are disturbed sleep and work at the circadian low, caused by night work, morning work, sleep/wake disorders (including sleep apnea) or social obstacles to sleep. Suggested countermeasures include information/education of the public and of transportation companies, as well as enforcement of existing work hour regulation. Additional countermeasures include strategic use of napping and caffeine, as well as implementation of rumble strips and--possibly--electronic devices for drowsiness detection.
 ...
PMID:[International consensus meeting on fatigue and the risk of traffic accidents. The significance of fatigue for transportation safety is underestimated]. 1146 74


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