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)

Obstructive Sleep Apnea Syndrome (OSAS) is children is commonly caused by upper airway obstruction, such as that caused by adeno-tonsillar hypertrophy. We report a rare case of SAS due to a nasopharyngeal tumor. The patient was a 10-year-old boy who complained of snoring and sleep apnea. The tumor was found in the nasopharynx and mesopharyngeal space. We diagnosed this case as OSAS by overnight sleep study (Apnea Hypopnea Index: AHI = 19.67). The tumor was removed under general anesthesia. Histopathology revealed features of nasopharyngeal angiofibroma. After removal of the tumor, his symptoms resolved completely. A follow-up overnight sleep study confirmed resolution of OSAS. At the last follow up, conducted 17 months after the operation there were no signs of tumor recurrence.
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PMID:[A case of sleep apnea syndrome due to a nasopharyngeal tumor]. 882 49

The aim of the study was carried out to show the anthropometric analysis of patients with obstructive sleep apnoea syndrome and to answer the question about the relations between the degree of SAS and obesity. The research has begun since May 1993 in an interdisciplinary team. The study was carried out in a group of 40 men diagnosed as SAS in Sleep Apnoea Unit of Department of Pulmonary Diseases. The anthropometric analysis consists of basic somatometric measurements. The relations between obesity and the degree of apnoeas was determined by analysis of variance and the model of single and multiple regression. The obtained results demonstrate the dependence between the grade of apnoeas pathology during sleep and the measurements of upper body parts. The slope of the line B not equal to 0 indicates that the intensity of SAS increases in patients "commonly considered as obese". Obesity is an important factor leading to disturbances in respiratory ventilation. An important development of fatty tissue of the neck can cause pressure changes and can induce adipose degeneration. An increased fatty thickness of the thorax is a factor which can lead to the aggravation of symptoms.
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PMID:[Evaluation of the character of morphologic traits in persons with obstructive sleep apnea]. 892 81

A survey performed in 100 CPAP users indicated that irritation of the face, a painful nose and nasal obstruction were among the most frequently mentioned complaints in chronic CPAP users. In 132 normocapnic SAS patients a significant improvement of PaO2 was shown, with a decrease of the alveolo-arterial oxygen difference. This improved gas exchange was parallelled by a significant increase in the FRC and TLC. Maybe a modulation in force of the respiratory muscles may be involved. These data were more pronounced in obstructive sleep apnea than in central sleep apnea. In 50 chronic CPAP users we could show a lower AHI immediately after CPAP withdrawal after a previous prolonged treatment. These findings may support the insufflation theory as a mechanism of action of CPAP. Traditionally, mechanical splinting of the upper airway has been considered as the dominant mechanism of action. Other mechanisms like changes in regulation of breathing and decrease of the pharyngeal edema may be involved as well.
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PMID:[Nasal CPAP in sleep-related respiration disorders: patient profile, therapy compliance and influence of gas exchange and lung function pattern]. 963 49

Several epidemiological studies have suggested that sleep-disordered breathing is a risk factor for cardiovascular disease, particularly hypertension, stroke and IHD. The relative risk for IHD among obstructive SAS(OSAS) patients is 1.2 to 6.9 higher compared with the general population. The prevalence of SAS with an apnea-hypopnea index(AHI) of 10 and over was 35 to 40% in IHD, while 23.8% of SAS patients had IHD. These evidence suggests that IHD is an important prognostic factor in SAS patients. Characteristic pathophysiological conditions such as sleep apnea-induced hypoxemia and sympathetic activation may play an important role in the genesis of nocturnal angina pectoris. Most patients with OSAS are obese, and the complication of non-insulin dependent diabetes mellitus is quite a few. Insulin resistance is also attracting great attention as a cause of the cardiovascular complication of SAS.
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PMID:[Sleep apnea syndrome (SAS) and ischemic heart disease (IHD)]. 1094 39

Sleep disorders have a high prevalence in the general population: insomnia (10-20% of adults), sleep apnoea syndromes (4-6%). They are responsible for high costs of investigations and treatment modalities. The investigations are usually done in sleep laboratories at the expense of cost in personnel and long waiting lists. Remote monitoring could be an alternative to sleep laboratory studies. The first aim was to determine the need for sleep remote recording in sleep medicine in Europe, to improve health delivery and to reduce investigation costs. An enquiry was sent to 500 sleep medicine providers in Europe. Response rate was 11%. Analysis showed that the main diagnosis is obstructive sleep apnoea in adults. Currently 2/3 of sleep studies are performed in laboratory: In-lab studies: Average cost for the health care is 390 EURO/study. The range is from 700 in Finland and Germany and 180 in Greece, Belgium and Sweden are around the mean. Ambulatory studies with EEG: Average cost is around 120 EURO/study i.e. 30% of in-lab cost. The range is from 180 EURO in Portugal to 70 EURO in Germany. 50% of users are not satisfied with their current practice of ambulatory monitoring although they have a clear need for this technique to increase monitoring capacity (88%), reduce cost of investigation (85%), improve sleep quality (60%), and obtain better acceptance from the patient (76%). The expectations from ambulatory monitoring are: high diagnostic sensitivity (86%) high reliability of equipment (92%) low interference with patient's habits (94%) It is worth noting that 74% of users do not expect a fully automated interpretation of data. The indications cited are screening and follow-up of SAS, epilepsy, Periodic Leg Movements and also insomnia and narcolepsy. As a second aim, a validation study has been set-up for an ambulatory recorder. The reproducibility of the system has been evaluated in 14 patients by 2 consecutive home recordings and was satisfactory in terms of total sleep time and apnoea-hypopnea index. Nevertheless a failure rate of 7% was observed which should be improved by a better ergonomy of the system. The third aim was a socio-economical analysis in Paris, in order to define the actual standard mean cost of a polysomnography in the lab (500 EURO) and in ambulatory (238 EURO) i.e. less than one half of the laboratory cost. The monography of the health care process for sleep medicine in Paris showed a delay of more than 10 years for diagnosis of SAS in 25% of the patients and up to 5 physicians visited before referral to the sleep lab. In 48% of the cases the primary physician visited is a GP. In conclusion, there is a clear need for ambulatory monitoring of sleep disorders to decrease the burden of cost and long waiting lists which is not well satisfied with the current health care system and commercially available equipment.
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PMID:Needs and costs of sleep monitoring. 1115 8

Four of the 708 snorers (0.56%), referred to our sleep breathing disorders clinic for the past 2 years were diagnosed as having narcolepsy-cataplexy. Detecting HLA DRB1*1501/DQB1*0602 positive was informative for differentiating genuine narcolepsy from non-sleep apnea syndrome (non-SAS) hypersomnia in our clinic. A non-SAS obese boy, diagnosed as having essential hypersomnia syndrome, was found to be HLA DRB1*1502/DQB1*0601 positive. His hypocretin concentration was 206 pg/mL in the cerebrospinal fluid.
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PMID:Narcolepsy and other non-SAS hypersomnia in sleep breathing disorders clinic. 1142 42

The first generation of Auto CPAP devices caused respiratory arousal by apnoes, hypopnoeas, incomplete obstructions and pressurechanges. The new, second generation of CPAP devices which is based on forced oscillation technique will change the pressure with slower velocity and before the respiratory arousal reaction will occur (1, 9, 10). Fifty patients with severe sleep apnoea (AHI 66+/-26 /h) were treated with both, constant- CPAP (continous positive airway pressure) or Auto CPAP under polysomnographic control in a randomised order. The Auto CPAP based on forced oscillation technique reduced the number of apnoeas and hypopnoeas as did most of the other Auto CPAP systems to AHI 2.5+/-5.9 /h (p<0.05). In comparison to Auto CPAP of the first generation it also decreased the number of respiratory arousal reactions caused by apnoeas and hypopnoeas. However there is still a significant difference to number of arousal detected with constant CPAP (p<0.01). In conclusion although the new generation of Auto CPAP reduced the number of respiratory arousals compared to first generation, we did not find a therapeutical benefit for patients with severe SAS.
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PMID:Improvement of CPAP Therapy by a Self-Adjusting System. 1189 3

Seventeen patients with sleep apnea syndrome [SAS, Respiratory Disturbance Index (RDI) = 12-85] were compared with 16 normal controls (RDI < 7) on neuropsychological tests of executive functions, a domain in which SAS patients have been suggested to have deficits. SAS patients demonstrated greater deficits in the retrieval of information from semantic memory (Controlled Oral Word Association task) and in shifting responses in the face of error (Wisconsin Card Sort Test), but differences in working memory were not observed. Eliciting deficits in cognitive executive functions in SAS may require more sensitive measures than are typically used in neuropsychiatric research.
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PMID:Executive Functions in Persons with Sleep Apnea. 1189 98

In patients with sleep apnea syndrome a high night by night variability of the respiratory breathing disturbance was reported in some studies. In the following study the variability of the apnoe-/hypopnoeindex (AHI) was prospectively determined with an ambulant monitoring system. Outpatients were instructed to perform three measurement at home independently. The influence of the variability was determined with respect to a first night effect (FNE), body position, severity of SAS, age and sex of the patients. 19 patients (12 men and 7 women, mean age 51.6 +/- 12.4 years) were investigated. The measurements were done with the ambulatory device Jaeger pro (ViaSys Comp., Wuerzburg). No statistically significant differences of the AHI and the cardiorespiratory parameters between the 3 nights were found (AHI 9.8 +/- 11.7/h, 10.1 +/- 9.6/h vs. 8.5 +/- 9.0/h). However the individual AHI difference was 5,6 +/- 5,0/h. In 15 % of the patients the AHI varied even by more than 10 per h. The variability of the AHI was associated with the severity. No FNE, dependency of body position, sex or age was found. Due to the individual variability of the AHI severity in patients with sleep apnoe syndrome, the severity is underestimated in a considerable number of patients. Repetitive measurements improve the diagnostic power.
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PMID:[Screening measurements for sleep apnea: is a single measurement enough?]. 1244 7

Sleep related breathing disorders (especially sleep apnea syndrome--SAS) limit the patient through deteriorated nocturnal sleep, insufficient wakefulness, daytime inefficiency and tiredness including a cognitive impairment, through higher rate of road accidents, higher co morbidity, through impaired quality of life and higher mortality. The society pays for the SAS patient higher medical costs and other expenses related to the accidents, co morbidity and lower professional productivity.
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PMID:[Socioeconomic aspects of sleep-related breathing disorders]. 1244 38


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