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

The status of chronic fatigue syndrome (CFS) is still under debate. Mainstream views still often consider it as an undetected primary sleep disorder or as the psychosomatic expression of a related anxiety or depression syndrome. Both primary sleep disorder and CFS are often related to unrefreshing sleep and affective daytime symptoms. The present study compares nonrapid eye movement sleep distribution between patients with a primary sleep disorder and "pure" CFS patients without sleep or mood disorders. Intensity measures of affective symptoms are also analyzed. Sleep variables of 32 pure CFS (mean age, 41.9 +/- 8.7 years; 25 women), 30 Sleep Apnea Hypopnea Syndrome patients (mean age, 43.7 +/- 6.7 years; 13 women), and 14 healthy controls (mean age, 40.2 +/- 7.6 years; 9 women) were compared. Related affective symptoms were assessed using the self-reported Zung anxiety and depression scales. The study confirms previous reports on increased slow-wave sleep in CFS patients. Both patient groups showed similar sleep duration and efficiency. Sleep efficiency was lower in both patient groups compared with controls. CFS patients showed a higher microarousal index than controls. Anxiety, but not depression symptoms were more intense in the CFS group. The distribution of nonrapid eye movement sleep in CFS differs sizeably from what can be observed in a primary sleep disorder.
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PMID:High slow-wave sleep and low-light sleep: chronic fatigue syndrome is not likely to be a primary sleep disorder. 1942 87

Portable sleep studies may play an important role to take decisions on patients referred for suspicion of Sleep Apnea-Hypopnea Syndrome (SAHS). The aim of this study was to evaluate the diagnostic accuracy of automated analysis of ApneaLink in patients with suspicion of SAHS. All participants (75) performed the ApneaLink and polysomnography (PSG) simultaneously in the sleep laboratory. The two recordings were interpreted blindly. The ApneaLink software calculated: (1) risk indicator (RI)-a combination of apnea/hypopnea index (AHI) plus inspiratory flow limitation events and (2) the AHI. ApneaLink and SAHS were defined in three ways: AHI or respiratory disturbance index (RDI) >or= 5, 10 and 15 respectively. ROC curves analysis was performed. The sensitivity (S), specificity (E) and positive and negative likelihood ratio (LR+, LR-) for the different thresholds for RI or AHI were calculated; 66 patients were included (47 men, mean age 51, median RDI 10.6, mean BMI 29.3 kg/m2). The best cut off points of RI were: SAHS = RDI >or= 5: RI > 9 (S 80%, E 100%, LR- 0.20); SAHS =RDI >or= 10: RI > 13 (S 92%, E 93%, LR+ 13.7 LR- 0.089); SAHS = RDI >or= 15 =: RI > 16 (S 93.5%, E 91%, LR+10.9, LR- 0.071). The AHI had a similar diagnostic accuracy to RI for the different definitions of SAHS. The RI and AHI obtained from automated analysis of ApneaLink were highly sensitive and specific to diagnose moderate to severe SAHS.
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PMID:Utility of ApneaLink for the diagnosis of sleep apnea-hypopnea syndrome. 2022 25

We present a direct anterior sternal split expansion as a surgical option for a case of severe Thoracic Insufficiency Syndrome (TIS) in an arthrogryposis-like patient. This patient's clinical features were published as a newly described syndrome: Adam Robert Wright Syndrome. The patient born with this syndrome displays characteristic craniofacial abnormalities, severe thoracic insufficiency syndrome, cleft palate, limb contractures, arthrogryposis, pulmonary hypoplasia, cryptorchidism, ophthalmoplegia and retinopathy, with normal intelligence. His severe thoracic insufficiency necessitated an urgent life-saving surgical intervention for a progressively worsening sleep apnoea and respiratory distress. We present a review of published data of sternal expansion thoracoplasty from 1965 to 2007 found in the literature. We demonstrate that direct anterior sternal split thoracoplasty with autogenous rib grafts is an effective technique for the acute management of thoracic insufficiency syndrome in this specific case. This procedure provided our patient with symptomatic benefit. To our knowledge, this is the only reported surgical management of thoracic insufficiency syndrome demonstrating a statistical improvement in chest wall compliance and tidal volume. We show that direct anterior sternal split expansion is a surgical treatment option in some patients with thoracic insufficiency syndrome. Our surgical strategy for the management of severe thoracic insufficiency syndrome in Adam Robert Wright Syndrome provided symptomatic relief and favourable long-term results.
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PMID:Autogenous bone graft for expansion thoracoplasty in Adam Robert Wright syndrome: a case report and review. 2042 50

Commercial polysomnographs used in the test to diagnose Sleep Apnea-Hypopnea Syndrome (SAHS) usually generate a report summarizing the test. This report helps clinicians in the task of diagnosing the patient. Some of the information presented in these reports has been carefully studied and standardized -for example, the apnea-hypopnea index. Therefore, there are clear guidelines on how to interpret it. However, these reports usually contain other information that has not been carefully studied and for which no precise guidelines on how to interpret it exist. Examples include the mean values of certain descriptors of the pathological events that have occurred during the patient's sleep, such as the mean duration of apneas, hypopneas and desaturations, the mean of the minimum blood oxyhemoglobin saturation value reached in each desaturation, ecetera. The goals of this paper are to study whether this information is useful in the diagnosis of SAHS and to try to provide some insight on how to interpret it. To this end, we have analyzed the descriptors generated from 97 patients who underwent the polysomnographic test, comparing the ones arising from SAHS patients with the ones arising from healthy patients.
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PMID:The mean value of the descriptors of the pathological events recorded on the polysomnogram as a support tool in the diagnosis of SAHS. 2109 2

Obstructive sleep apnea/hypopnea Syndrome (OSAHS) is the most common form of Sleep Disordered Breathing (SDB) and it is estimated to affect approximately 6% of US adult population. Various methods have been proposed for the development of inexpensive screening methods to detect SDB to reduce the need for costly nocturnal polysomnography (NPSG). By using the existing air in the airway as an ultrasonic contrast agent, we propose a method to examine the narrowing or occlusion of the airway associated with OSAHS events. We describe here an in vitro study that approximates the anatomical and acoustic characteristics of the airway and neck. In this experiment, we simulate the fully open airway as well as apnea and hypopnea events. These in vitro studies results show significant differences in the ultrasonic signals acquired from the open airway model versus those from the model depicting apnea and hypopnea events. Therefore, the findings provide a foundation for development of an ultrasound system to detect SDB in vivo.
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PMID:Detection of airway occlusion in simulated obstructive sleep apnea/hypopnea using ultrasound: an in vitro study. 2109 55

Sleep Apnea-Hypopnea Syndrome (SAHS) diagnosis is still done with an overnight multi-channel polysomnography. Several efforts are being made to study profoundly the snore mechanism and discover how it can provide an opportunity to diagnose the disease. This work introduces the concept of regular snores, defined as the ones produced in consecutive respiratory cycles, since they are produced in a regular way, without interruptions. We applied 2 thresholds (TH(adaptive) and TH(median)) to the time interval between successive snores of 34 subjects in order to select regular snores from the whole all-night snore sequence. Afterwards, we studied the effectiveness that parameters, such as time interval between successive snores and the mean intensity of snores, have on distinguishing between different levels of SAHS severity (AHI (Apnea-Hypopnea Index) < 5h(-1), AHI <10 h(-1), AHI < 15 h(-1), AHI < 30 h(-1)). Results showed that TH(adaptive) outperformed TH(median) on selecting regular snores. Moreover, the outcome achieved with non-regular snores intensity features suggests that these carry key information on SAHS severity.
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PMID:Regular and non regular snore features as markers of SAHS. 2109 43

We describe the clinical characteristics of 4 singleton cases, 3 males and 1 female, with Myhre Syndrome (OMIM 139210), who were born to non-consanguineous parents. Three cases had no family history of similarly affected individuals but 1 male's mother had short stature, some facial features suggestive of Myhre syndrome and evidence of skewed X-chromosome inactivation in her blood DNA. Short stature, deafness, learning difficulties, skeletal anomalies and facial dysmorphisms were evident in all cases. Arthralgia and stiff joints with limited movement were also present. The facial appearance, thickened skin, a 'muscular' habitus are memorable features. The female patient was least affected: this patient and one affected male displayed streaky skin with areas of patchy thickening, suggestive of genetic mosaicism. One patient developed sleep apnoea, a restrictive ventilatory defect and died following a choking episode. Another affected male developed recurrent, progressive, proximal, tracheal stenosis requiring partial tracheal resection, laser treatment and eventually tracheotomy. Review of Myhre syndrome patients in the literature and syndromes in the differential diagnosis, suggests heterogeneity in Myhre syndrome and clinical overlap with Laryngotracheal stenosis, Arthropathy, Prognathism and Short stature syndrome.
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PMID:Clinical features and respiratory complications in Myhre syndrome. 2181 39

Snoring is one of the earliest and most consistent sign of upper airway obstruction leading to Sleep Apnea-Hypopnea Syndrome (SAHS). Several studies on post-apneic snores, snores that are emitted immediately after an apnea, have already proven that this type of snoring is most distinct from that of normal snoring. However, post-apneic snores are more unlikely and sometimes even inexistent in simple snorers and mild SAHS subjects. In this work we address that issue by proposing the study of normal non-regular snores. They correspond to successive snores that are separated by normal breathing cycles. The results obtained establish the feasibility of acoustic parameters of normal non-regular snores as a promising tool for a prompt screening of SAHS severity.
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PMID:Normal non-regular snores as a tool for screening SAHS severity. 2225 19

The gold standard for diagnosing Sleep Apnea Hypopnea Syndrome (SAHS) is the Polysomnography (PSG), an expensive, labor-intensive and time-consuming procedure. It would be helpful to have a simple screening method that allowed to early determining the severity of a subject prior to his/her enrolment for a PSG. Several differences have been reported in the acoustic snoring characteristics between simple snorers and SAHS patients. Previous studies usually classify snoring subjects into two groups given a threshold of Apnea-Hypoapnea Index (AHI). Recently, Bayes multi-group classification with Gaussian Probability Density Function (PDF) has been proposed, using snore features in combination with apnea-related information. In this work we show that the Bayes classifier with Kernel PDF estimation outperforms the Gaussian approach and allows the classification of SAHS subjects according to their severity, using only the information obtained from snores. This could be the base of a single channel, snore-based, screening procedure for SAHS.
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PMID:Bayes classification of snoring subjects with and without Sleep Apnea Hypopnea Syndrome, using a Kernel method. 2225 24

Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) is the most common form of Sleep Disordered Breathing (SDB) and it is estimated to affect approximately 15% of US adult population. Various methods have been proposed for the development of inexpensive screening methods to detect SDB to reduce the need for costly nocturnal polysomnography (NPSG). In this paper, a description of the ultrasonic transducer design and characterization is presented, followed by the results of a full night sleep study. The findings show a significant difference in the temporal features extracted from the received ultrasonic waveform during apneic breathing, compared to the hyperventilation that follows. Therefore, the findings indicate the feasibility of developing an ultrasonic detection device for low cost diagnosis of SDB.
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PMID:In vivo characterization of ultrasonic transducers for the detection of airway occlusion in Sleep Disordered Breathing. 2225 19


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