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

The distribution of symptoms, physiologic responses, and upper airway structure in members of one family with three generations of subjects with sleep apnea (SA) is reported. Questionnaire data were obtained from ten family members (ages 7 to 66 years), overnight sleep studies were performed in nine subjects, and ventilatory responses to hyperoxic hypercapnia and to eucapnic hypoxia and cephalometry were obtained in five subjects. All ten family members reported habitual snoring or nighttime snorting/gasping; five of ten family members also reported excessive daytime sleepiness. All studied subjects except for a pregnant woman had greater than ten apneas/hypopneas per hour. Ventilatory responses to hypoxia were markedly reduced in all five subjects studied (less than or equal to 0.51 L/min/SaO2); hypercapnic responses were reduced in three of five subjects (less than or equal to 0.61 L/min/mm Hg CO2). No subject was morbidly obese (body mass index less than 29 kg/m2) or demonstrated retrognathia. The posterior airway space was reduced in three subjects, and the mandibular to hyoid distance was increased in four subjects. The two subjects with the longest soft palates and the most inferiorly displaced hyoids had the most severe sleep disorder. Sleep apnea was present, albeit less profound, in the one subject with normal anatomy who had an abnormal hypoxic ventilatory response. The distribution of these physiologic and anatomic measurements in this family provides further support for a genetic basis for SA, and suggests that the disorder may occur as a result of interactions between ventilatory control abnormalities and anatomic risk factors.
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PMID:A family study of sleep apnea. Anatomic and physiologic interactions. 239 35

Symptoms of excessive daytime somnolence range from mild to severe. In mild cases, there may be minimal interference with normal daytime function. The hypersomnia can be disabling. When severe the patient finds it difficult to remain awake at times when physically inactive. Excessive daytime somnolence is the chief complaint of the majority of our adult patients. In this paper, we present the findings for 1,000 consecutive patients (755 males and 245 females) who were seen at the Humana Hospital Audubon Sleep Disorders Center. Patients ranged in age from 15 to 83. All patients had a sleep history, medical history and physical, psychological evaluation, polysomnographic evaluation, and other laboratory tests as indicated. Obstructive sleep apnea syndrome was the most prevalent diagnosis for males (84.2%) and females (59.6%). It accounted for over three-fourths of all diagnoses. Hypersomnia secondary to a psychiatric disorder was the next most frequent diagnosis overall (6.1%). A psychiatric disorder was second for females and third for males. Narcolepsy was diagnosed for 5.8% of all patients. This was the second most prevalent diagnosis for males and third for females. Eighteen males (47.4% of all males with a diagnosis of narcolepsy) and 9 females (45.0%) had cataplexy. Nocturnal myoclonus was the primary diagnosis in 2.5% of all patients with excessive daytime somnolence. An additional 49 patients with sleep apnea syndrome and 18 patients with narcolepsy also had periodic leg movements during sleep. A diagnosis of obstructive sleep apnea and narcolepsy was made for 1.3% of patients. The narcolepsy component of this diagnosis was typically made only after the obstructive sleep apnea had been resolved (eg, nasal CPAP, tracheostomy).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disorder of excessive daytime somnolence: a case series of 1,000 patients. 239 10

Sleep-related motor vehicle accidents are a serious safety hazard both for the driver who falls asleep and for others on the road. Sleep disorders may be significant contributing factor in some of these accidents. We reviewed data on sleep-related accidents from 70 control subjects and 424 adults with four categories of sleep disorders: sleep apnea, narcolepsy, other disorders of excessive sleepiness, and sleep disorders without excessive sleepiness. The proportion of individuals with sleep-related accidents was 1.5-4 times greater in the hypersomnolent patient groups than in the control group. In patients with hypersomnia, the incidence of sleep-related accidents per year of excessive sleepiness was 3-7%. Although the proportion of patients with sleep-related accidents was highest in narcoleptics, apneics were involved in more sleep-related accidents because of their greater number. Apneics and nacroleptics accounted for 71% of all sleep-related accidents. The proportion of severe apneics who had sleep-related accidents was almost twice that of patients with mild or moderate apnea. Mean sleep latency by Multiple Sleep Latency Test did not differ significantly in patients with accidents and those without. Patients with a wide variety of sleep disorders appear to be at increased risk for sleep-related accidents. The severity and duration of hypersomnia are probably not the only factors that contribute to that risk. These findings have implications for the management of patients with sleep disorders.
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PMID:Automobile accidents in patients with sleep disorders. 259 72

We studied the influence of hypoxia due to sleep apnea on testosterone (T) secretion. It was conducted on the basis of an idea that sustained hypoxia may depress T secretion. The subjects consisted of 15 male patients with no drug administration whose complaints were snoring and/or obesity. The subjects participated in a sleep study on two consecutive nights. During the first night we collected blood samples starting every 4 hours from 10 PM via a catheter and measured T. From the data of the second night, we calculated total desaturation time with more than 4% from the baseline SaO2. According to the amount of this desaturation time, the subjects were divided into 2 groups; desaturation time less than 80 min in group 1 and longer in group 2, respectively. The peak value was seen at 6 AM in group 1 and at 10 AM in group 2. We investigated the correlation between the ratio of T10/T6, which is the ratio of T level at 10 AM to that at 6 AM, and parameters of sleep disorders related to oxygen desaturation. Total 4% desaturation time in total sleep period and non REM period significantly correlated with this ratio. From the diagram illustrating the correlation between the ratio and total 4% desaturation time in total sleep period, we could assume that if the ratio is beyond 1, the subject may have had more than about 80 min of total 4% desaturation time.
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PMID:[Prediction of the degree of nocturnal oxygen desaturation in sleep apnea syndrome by estimating the testosterone level]. 261 9

From 1958 to 1986, 27 crewmembers with suspected sleep disorders were referred to the USAF School of Aerospace Medicine. The presenting complaint in most cases was excessive daytime sleepiness (EDS). Prior to 1984, evaluations included neurologic and psychiatric testing, screening laboratory studies, and awake and asleep electroencephalography. Polysomnography and sleep latency studies were included after 1984. In the majority of cases, the etiology of the complaint could not be determined. The prevalence of EDS is estimated to be between 0.3% and 4.0% of the adult population. Major causes cited in the world literature include the sleep apnea syndromes, narcolepsy, parasomnias interrupting sleep, hypersomnia secondary to systemic or affective disorders, and essential hypersomnia. Current sleep lab techniques and human leukocyte antigen (HLA) typing are reported to make the diagnosis in up to 90% of sleep disorders. Evaluation of EDS should begin with a history emphasizing sleep habits, work schedules, daytime naps, and presence of vegetative signs. A sleep diary will allow a more accurate estimate of the quantity of nocturnal sleep. This diary may reveal poor sleep hygiene or insomnia. Polysomnography and/or multiple sleep latency determination can then be used to diagnose sleep apnea, parasomnias, and narcolepsy.
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PMID:Evaluation of the sleepy crewmember: USAFSAM experience and a suggested clinical approach. 265 2

Sleep disorders are so common that approximately 38% of the general population complains about a current sleep problem and 52% complains about a current or past sleep problem. Psychiatric factors are prominent in virtually all sleep disorders, either as primary factors (insomnia and adult parasomnias) or as significant secondary consequences (sleep apnea and narcolepsy). The authors describe normal sleep; delineate the prevalence of sleep disorders, both those associated with psychiatric disturbance and those of organic etiology; and outline procedures for evaluation and treatment, which is multidimensional and comprises general measures, psychotherapy, and, when indicated, pharmacotherapy.
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PMID:An update on sleep disorders. 265 90

Sleep apnea and PLMS are extremely prevalent in the elderly. The subjective reports of poor sleep, insomnia, snoring, and excessive daytime sleepiness should not be taken lightly and should not be assumed to be a normal sign of aging. These problems may be interrelated and may be symptoms of the sleep disorders discussed above. Physicians and gerontologists need to become more sensitive to the special problems and needs related to sleep disorders in the geriatric population.
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PMID:Epidemiology of sleep disorders. 266 16

This investigation examined the diagnostic value of polysomnography (PSG) for evaluating disorders of initiating and maintaining sleep (DIMS). The sample consisted of 100 outpatients who presented to the Duke Sleep Disorders Center with a complaint of chronic insomnia. All patients were given comprehensive medical, psychiatric, behavioral, and ambulatory PSG evaluations. Sleep disorder diagnoses were assigned using the criteria of the Association of Sleep Disorders Centers. Overall, PSG yielded important diagnostic information in 65% of the sample: 34% were given a primary sleep disorder diagnosis that was heavily dependent on PSG data [periodic movements of sleep (PMS) = 25%, apnea = 3%, and subjective insomnia = 6%]; 15% were given a secondary diagnosis of one of these three disorders; and PSG ruled out suspected PMS in 9% and sleep apnea in 7% of the sample. Patients greater than 40 years of age had a significantly higher rate of positive PSG findings than younger patients. Using only the clinical exam, two experienced sleep clinicians were able to predict only 14 of 25 PMS cases and one of three cases of sleep apnea. Based on these data, we suggest using PSG routinely with older insomniacs and with younger patients who fail initial treatment.
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PMID:Polysomnographic assessment of DIMS: empirical evaluation of its diagnostic value. 276 87

The symptoms of hypothyroidism are protean and include apathy, somnolence, lethargy, personality change, and intellectual deterioration. Many of these symptoms may be related to hypothyroid-induced sleep disorders. Hypothyroidism is associated with abnormal ventilatory drive, abnormal sleep architecture, and sleep apnea. Central, obstructive, and mixed patterns of sleep apnea are commonly observed in hypothyroidism. A case of severe sleep apnea in a grossly myxedematous patient who improved dramatically following thyroid replacement alone is presented. Myxedema is a reversible cause of sleep apnea, and thyroid function testing should be considered in its diagnostic work-up.
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PMID:Sleep apnea, sleep disorders, and hypothyroidism. 276 18

In 100 consecutive adults who came to a sleep disorders center complaining of repeated nocturnal injury, polysomnographic study identified five disorders: night terrors/sleepwalking (N = 54), REM sleep behavior disorder (N = 36), dissociative disorders (N = 7), nocturnal seizures (N = 2), and sleep apnea (N = 1). Ninety-five patients sustained ecchymoses, 30 had lacerations, and nine had fractures. DSM-III axis I disorders (past or current) were found in 48.1% of the group with night terrors/sleepwalking and in 30.6% of the group with REM sleep behavior disorder; these were mainly affective disorders. In these two groups, clonazepam controlled the symptoms of 51 of the 61 patients to whom it was given.
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PMID:A polysomnographic and clinical report on sleep-related injury in 100 adult patients. 276 74


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