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)

A case of Chiari malformation type I with orthostatic hypotension and sleep apnea leading to convulsive attacks is presented.
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PMID:Autonomic failure in a case of Chiari malformation type I. 344 75

Patients with craniocervical disorders (CCD) show a wide variety of symptoms and signs suggesting cerebellar and/or high cervical lesion. The anatomic localization of respiratory centers and their possible injury may explain the presence of respiratory disturbances in these diseases. The aim of this preliminary study was to evaluate the polysomnographic findings in a group of patients with CCD, most of them with Arnold-Chiari malformation type I, since sleep apnea has been referred to in isolated cases in the literature. Eleven patients (seven females and four males) with CCD diagnosed by magnetic resonance imaging referred from the neurosurgery unit were submitted to clinical history, physical examination with sleep questionnaires, and scored on the Epworth Sleepiness Scale. Full night polysomnography was performed in an Oxford SAC system where EEG, electro-oculography, electrocardiography, chin and leg electromyography, chest and abdominal efforts, airflow, and oximetry were recorded continuously. Nine patients presented with Arnold-Chiari type I malformation, of whom six showed associated syringomyelia. The other two had basilar invagination. Ninety percent of these patients complained of sleep problems (snoring, choking, and witnessed apneas) and 72% presented hypersomnolence (ESS >9). The polysomnographic findings showed sleep fragmentation in 81% of the patients and a reduction of rapid eye movement sleep in 63%. The apnea/hypopnea index was above 5 in 72%, with a predominance of central apnea. Patients with craniocervical disorders present a higher probability of displaying sleep respiratory disturbances. Their sleep complaints should be assessed and patients should be submitted to an overnight sleep recording in order to identify sleep apnea.
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PMID:Polysomnographic respiratory findings in patients with Arnold-Chiari type I malformation and basilar invagination, with or without syringomyelia: preliminary report of a series of cases. 1108 40

Sleep apnea syndrome (SAS) is an important cardiovascular risk factor in patients with hypertension or myocardial infarction (MI). We evaluated the influence of SAS on autonomic nervous activity and QT dispersion in patients with hypertension or coronary artery disease with old MI. A portable sleep polygraph was attached to 30 healthy volunteers (N group), 30 patients with essential hypertension (HT group), and 30 patients with old myocardial infarction (MI group) to serially record oronasal respiration, tracheal sound, thoracic respiratory movement, and percutaneous arterial oxygen saturation. In addition, a digital Holter ECG was used to examine heart rate variability during nighttime sleep. Heart rate variability was analyzed by obtaining low-frequency (LF) power, high-frequency (HF) power, the LF/HF ratio, and very low-frequency (VLF) power. Dispersion of QT intervals was obtained by CM5 and CM1 leads. VLF and LF powers were significantly higher in the HT-SAS group (hypertensive patients with SAS) than the N and HT-NSAS groups (hypertensive patients without SAS). The HF power was significantly lower in the HT-NSAS group than the N group, but the decrease in HF power in hypertension was not observed in the HT-SAS group. The LF/HF ratio was significantly higher in the HT-NSAS group than the N group, and this value was further increased in the HT-NSAS group. Percutaneous arterial oxygen saturation was decreased, and QT dispersion was significantly increased in the MI group during sleep apnea episodes. More severe autonomic nervous dysfunction and increased QTc dispersion were observed in hypertensive patients with SAS during episodes of apneas and hypopneas compared to those without SAS. These findings suggest that SAS may be associated with the future development of cardiac events.
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PMID:Influence of sleep apnea on autonomic nervous activity and QT dispersion in patients with essential hypertension and old myocardial infarction. 1513 67

Sixteen consecutive patients with Arnold-Chiari malformation type I and syringomyelia underwent full-night polysomnography (PSG). Sleep apnea syndrome (apnea-hypopnea index > 10) was diagnosed in 12 of 16 patients with 48% of central apneas. In six patients with sleep apnea syndrome, PSG was repeated an average of 203 days after decompression surgery. Postoperative PSG showed a decrease in the central apnea index from 14.9 +/- 5.5 to 1.3 +/- 0.6 (p = 0.03).
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PMID:Sleep-disordered breathing in patients with Chiari malformation: improvement after surgery. 1640 66

The Chiari malformation type I (CM-I) has been associated with sleep-disordered breathing, especially central sleep apnea syndrome. We report the case of a 44-year-old female with CM-I who was referred to our sleep laboratory for suspected sleep apnea. The patient had undergone decompressive surgery 3 years prior. An arterial blood gas analysis showed hypercapnia. Polysomnography showed a respiratory disturbance index of 108 events/h, and all were central apnea events. Treatment with adaptive servo-ventilation was initiated, and central apnea was resolved. This report demonstrates the efficacy of servo-ventilation in the treatment of central sleep apnea syndrome associated with alveolar hypoventilation in a CM-I patient with a history of decompressive surgery.
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PMID:Chiari malformation and central sleep apnea syndrome: efficacy of treatment with adaptive servo-ventilation. 2541 Aug 46

Patients with Chiari type I malformation may also present with sleep disordered breathing mainly central sleep apnea. Here, we report a patient with Chiari I malformation referred to our clinic because of snoring and sleep disordered breathing. He was a 28-year-old man referred to us for evaluation of snoring. An overnight polysomnography revealed central sleep apnea. On further evaluation of central sleep apnea, the patient found to have Chiari malformation type I on brain MRI. The patient developed obstructive sleep apnea after surgery for Chiari malformation. Accordingly, pap titration was performed for the patient's obstructive sleep apnea. In patients with central sleep apnea comprehensive evaluation of predisposing causes is required. Lesions of central nervous system including Chiari malformation should not be overlooked. Furthermore, after treatment of central sleep apnea follow up PSG is warranted to confirm newly emerged sleep breathing disorder such as obstructive sleep apnea.
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PMID:Treatment emergent obstructive sleep apnea after Chiari surgery: A case report. 3274 90