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)

During infancy respiratory patterns change with maturation. However, there is no documentation of the development of the neurons thought to be related to respiratory control. Relevant neurons in the medulla oblongata were examined using Golgi impregnation methods. Dendritic spines increased prenatally and decreased postnatally in the medullary respiratory centers (i.e., dorsal vagal nucleus, nucleus tractus solitarii and reticular formation). The prenatal neuronal maturation is earlier in the reticular formation than the vagal nucleus. These changes in neuronal dendrites may be related to the development of central respiratory control and the occurrence of primary apnea in prematurity and sleep apnea in sudden infant death syndrome.
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PMID:Prenatal and postnatal maturation of medullary 'respiratory centers'. 369 71

The effects of intravenous injections of the opiate antagonist naloxone (0.005-0.4 mg/kg body weight) on respiratory pattern, apnoea duration and frequency were investigated in six infants with severe sleep apnoea syndrome. Since several authors found elevated plasma- and CSF-levels of endogenous opioids (endorphines) in infants with sleep apnoea syndrome, we wanted to determine whether the impairment of the control mechanisms of respiration during sleep is due to an effect of endogenous opioids. Independent of the dose, naloxone did not exert any effect on respiratory pattern and occurrence of periodic apnoea. We were unable to prove that endorphines play a major role in pathogenesis of sleep apnoea syndrome in infancy and possibly in sudden infant death syndrome (SIDS). We speculate that elevated levels of endorphines reported by some investigators rather seem to be a consequence of hypoxic stress than a cause for sleep apnoeas.
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PMID:Effects of naloxone on apnoea duration during sleep in infants at risk for SIDS. 379 80

Since 1981, 96 infants considered at increased risk of SIDS underwent home monitoring for prolonged sleep apnea: 23 infants after a near miss for SIDS event, 28 siblings of a SIDS victim and 45 infants with a variety of perinatal risk factors. For a total of 65 infants the course of home monitor surveillance was completed by September 1984 with a duration ranging from 6 to 15 month: 26% (4/15) of the near miss for SIDS group, 23% (3/13) of the SIDS siblings and 13% (5/37) of the perinatal risk cases developed more than one prolonged apneic episode with additional symptoms requiring vigorous intervention by parents. Two infants of the perinatal risk group became SIDS victims: despite an apnea alarm after 15 seconds the parents were unable to resuscitate their infant in one case, the other died from SIDS about 4 month after monitoring was discontinued because of an uneventful course and normal polygraphic sleep recordings The large number of prolonged apneas requiring intervention and the two SIDS cases (3% of the total study group) indicate a considerably increased risk of prolonged life-threatening sleep apnea and SIDS in the population monitored.
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PMID:[Home monitoring of apnea in children at increased risk for sudden infant death (SIDS)]. 395 50

By means of polygraphic sleep recording, the sleep apnea profile with respect to the number and duration of inactive, obstructive and mixed apneic episodes as well as periodic breathing has been investigated in infants born preterm at 40, 52 and 64 weeks conceptional age and compared to that of term infants. At 40 weeks preterm infants showed significantly more apnea and periodic breathing compared to term infants. The difference was essentially due to obstructive and mixed apnea in non-REM sleep. There was a sharp decrease in all apneic variables--inactive, obstructive and mixed apnea as well as of periodic breathing--at 52 weeks conceptional age in infants that were previously preterm. Both groups exhibited a rather identical sleep apnea profile at 64 weeks. Two prospectively studied infants in the preterm group later became SIDS victims. One of them might have been identified as being at risk on the basis of his apnea profile compared to the normative data now available.
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PMID:Infant sleep apnea profile: preterm vs. term infants. 398 27

Sudden infant death syndrome (SIDS) claims one in five hundred babies between 1 and 12 months of life. Since no cause of death is found at autopsy, SIDS has been and often remains a complete enigma for pediatricians, physiologists and forensic pathologists. However, there is growing evidence from careful epidemiologic, pathologic and physiologic studies that subtle changes occur in those babies for a variable period of time before death. Some of these data are reviewed and interpreted in the light of the sleep apnea-hypoventilation inducing chronic hypoxemia hypothesis. It appears that no single factor is characteristic of, or responsible for, SIDS; rather, a combination of different adverse circumstances occurring during a period of increased vulnerability may cause the fatal outcome in some infants. Some preventive aspects of SIDS in low birth weight babies, siblings of SIDS victims and near-miss SIDS are discussed.
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PMID:[Sudden infant death syndrome: respiratory causes]. 635 10

Sudden infant death syndrome (SIDS) probably represents a number of specific processes rather than one disease, the causes of which have so far eluded scientists. Various hypotheses as to cause are discussed, as is the role of the emergency physician. Also considered are apparently life-threatening events such as prolonged sleep apnea, laryngeal-induced apnea, gastroesophageal reflux-induced apnea, and seizure-associated apnea.
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PMID:Sudden infant death syndrome (SIDS), apnea, and near miss for SIDS. 639 85

To determine the efficacy of theophylline treatment in infants at increased risk for SIDS, we obtained 24-hour cardiorespiratory recordings (pneumograms) in 80 infants given theophylline in whom the initial pneumogram was abnormal. Fifty-three infants had a clinical diagnosis of near-SIDS, and 27 were asymptomatic siblings with a positive family history for SIDS. The initial pneumogram was obtained at a mean age of 6.9 weeks, and the repeat pneumogram 2.3 weeks later, when the mean theophylline blood concentration was 11.2 +/- 0.5 micrograms/ml. Theophylline treatment resulted in comparable and highly significant improvements in both groups. Among all 80 infants, apnea density decreased from 1.6 +/- 0.2% (SEM) to 0.3 +/- 0.1% (P less than 0.001), periodic breathing episodes/100 minutes decreased from 2.7 +/- 0.4 to 0.3 +/- 0.1 (P less than 0.001), and the longest apneic period decreased from 13.5 +/- 0.7 to 10.1 +/- 0.5 seconds (P less than 0.001). Findings on the pneumogram became completely normal with theophylline therapy in 87% of infants with near-SIDS and 81.5% of asymptomatic siblings. Pneumogram normalization was associated with absence of further symptomatic sleep apnea in the near-SIDS group and with continued absence of any clinical symptoms in the asymptomatic family history group. There were no deaths from SIDS.
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PMID:Theophylline improves pneumogram abnormalities in infants at risk for sudden infant death syndrome. 664 38

A current hypothesis that the sudden infant death syndrome (SIDS) is a sleep apnea syndrome precipitated by defective control of involuntary respiration prompted the present study in which "reactive gliosis" in sections of the medulla oblongata of 45 SIDS victims was quantitated and compared with that in 20 control infants. Six anatomic regions were studied; five are related and one is unrelated to neural control of involuntary respiration. Increased numbers of "reactive" astrocytes were found in the SIDS group when the counts for all regions were combined (P = .04). Counts were also significantly higher in the SIDS victims for each of three regions alone: (1) the hilum of the inferior olivary nucleus (P = .01); (2) a lateral region (P = .02); and (3) the nucleus of the tractus solitarius (P = .03). The region with the greatest statistical difference, the inferior olivary hilum, has no recognized role in the control of involuntary respiration. There were no consistent associations between reactive astrocyte counts and specific clinical, socioeconomic, and pathologic variables. Characterization of the SIDS group whose counts exceeded that of the highest control infant also did not uncover distinguishing features. This study reinforces previous observations that, at least statistically, an abnormality of the brainstem occurs in a group of SIDS victims in contrast to a group of control infants, but also discloses considerable overlap in the numbers of such cells between these two groups.
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PMID:'Reactive gliosis' in the medulla oblongata of victims of the sudden infant death syndrome. 686 2

Some children with "aborted" sudden infant death syndrome (SIDS) and parents of SIDS victims have abnormal control of ventilation. Because apnea during sleep occurs in some children who go on to die of SIDS, and because the abnormality in ventilatory control may be familial, we examined breathing during sleep in parents of SIDS victims to determine whether breathing pattern abnormalities were common in them. We studied 12 patients (6 couples) of SIDS victims and 12 age-matched control parents with healthy children. We failed to demonstrate significant differences in the incidence of apneas or breathing pattern irregularities between the SIDS and control parents. However, 2 SIDS parents, 1 male and 1 female, had 44 and 31 apneic episodes, respectively, exceeding the number conventionally used to document excessive apneic episodes during sleep. Neither of these parents had the hundreds of apneic episodes usually seen in the sleep apnea syndrome. Although these 2 SIDS parents support the notion that a sleep breathing abnormality may exist in SIDS parents, most of the SIDS parents had normal breathing during sleep. Because the abnormalities in the two SIDS parents were minor, and because the remainder of the subjects were normal, we conclude that polysomnographic recordings fail to reveal a "marker" that might identify potential SIDS parents.
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PMID:Breathing during sleep in parents of sudden infant death syndrome victims. 706 18

A relationship between sudden infant death syndrome (SIDS), sleep apnea, and upper airway infections has been reported. The present observation stresses the possible influence of phenothiazine-containing medications and the occurrence of SIDS. The drug is commonly used for the treatment of infants with nasopharyngitis in Belgium and in some other European countries. In a prospective study, 52 SIDS victims, 36 near miss infants, and 175 control infants were compared for the coexistence of nasopharyngitis and phenothiazine treatment in the days preceding death or hospitalization. The incidence of nasopharyngitis was comparable in the three groups (approximately 31%), but phenothiazines were used significantly more frequently in SIDS victims (23%) and near miss infants (22%) than in control subjects (2%). It is postulated that phenothiazines, as CNS depressors, may contribute to the occurrence of SIDS.
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PMID:Phenothiazines and sudden infant death syndrome. 708 37


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