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

This overview of normal and disordered sleep introduces techniques for recording and classifying sleep stages, physiological and temporal characteristics of sleep, age-related changes in sleep, consequences of sleep deprivation, theories on the function of sleep, and neurophysiological and biochemical mechanisms regulating sleep. Various categories of sleep disorders are briefly surveyed, with special emphasis on differential diagnosis of sleep apnea syndromes and other disorders characterized by symptoms of excessive daytime somnolence.
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PMID:Sleep apnea disorders. Introduction to sleep and sleep disorders. 390 99

In a study conducted in four family practice units in Toronto, Canada, 2001 subjects reported on snoring and medical conditions in members of their households. For spouses the prevalence of snoring increased with age up to the seventh decade, with a higher prevalence of nearly 85% in husbands. For 11 medical problems an association existed between snoring, its frequency, and the presence of the condition. This association continued when the data were corrected for sex, age, and marital state. For hypertension both men and women who snored between the fifth and 10th decades had a twofold increase over non-snorers. The prevalence of heart disease and other conditions, except for diabetes and asthma, also increased in snorers in this age group. When corrected for smoking and obesity the association between snoring, hypertension, and heart disease persisted. These findings extend those of Lugaresi et al, and if they could be confirmed snoring as a risk factor for conditions other than sleep apnoea and sleep disorders might be considered. Methods of alleviating the acoustic annoyance of snoring may also provide direct medical benefits.
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PMID:Snoring as a risk factor for disease: an epidemiological survey. 392 56

Individuals 65 years of age and older were randomly selected, from a primarily white upper-class population, to participate in a study of sleep disorders in elderly adults. One hundred forty-five volunteers had a brief telephone interview, a home interview, and a portable sleep recording using the Medilog and Respitrace systems. By research classifications, we found that 18% of the elderly participants had sleep apnea (apnea index greater than 5), 34% had periodic movements in sleep (myoclonus index greater than 5) (PMS), and 10% had both sleep apnea and PMS. These were not clinical diagnoses. The home recording indicated that the individuals with PMS slept significantly less than other older adults.
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PMID:Sleep apnea and periodic movements in an aging sample. 400 77

An inability to sleep or sleep prematurely ended or interrupted by periods of wakefulness (insomnia) are some of the most frequent complaints heard from patients. Insomnia can be situationally related or persistent in nature. Persistent insomnia may be associated with biological rhythm disturbances, drug dependency, psychophysiologic abnormalities, psychiatric disturbance, sleep apnea syndrome or nocturnal myoclonus. This article describes these pathologies, gives clues toward differential diagnosis, suggests patient subgroups that would benefit from referral for specialized evaluation at a sleep disorder center and describes current treatment options.
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PMID:Sleep disorders: insomnias. 404 25

Persistent or periodic day-time drowsiness is an important cause of poor work, under-achievement, and social disaster. Somnolence may be associated with anxiety, ill-health, and poor or inadequate night-sleep, but also results from a group of sleep disorders including idiopathic hypersomnolence and sleep apnoea. Idiopathic hypersomnolence seems to be a genetic disorder of non-rapid-eye-movement sleep and is distinct from narcolepsy which is a disorder of rapid-eye-movement sleep. Day-time sleepiness in sleep apnoea is probably due to inadequate night sleep. The diagnosis of these disorders depends largely on the history. Treatment of hypersomnia with central stimulant drugs is often unsatisfactory, particularly in the elderly, and tracheostomy rather than medical treatment is sometimes essential in sleep apnoea.
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PMID:Day-time drowsiness. 611 40

A 42-year-old patient is reported who presented with marked daytime sleepiness and in whom the only major nocturnal polysomnographic abnormality was intense fragmentary (partial) myoclonus occurring with equal frequency in all stages of NREM sleep associated with some degree of sleep fragmentation. The myoclonus was very brief (less than 150 msec duration), aperiodic and recurred in asynchronous and asymmetrical fashion over the legs, arms and face. It appears unrelated to the clinically similar physiological myoclonus of REM sleep. Other main sleep disorders such as periodic movements, restless leg syndrome, sleep apnea and narcolepsy-cataplexy were excluded by history and polysomnography.
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PMID:Fragmentary pathological myoclonus in NREM sleep. 620 Feb 93

The use of tricyclic antidepressants as opposed to hypnotics in treating insomnia is reviewed. Available data indicate that TCAs alleviate sleep disturbances related to depression (often before antidepressant effects are seen) and, in selected cases, may prove effective in disturbed sleep related to sleep apnea, fibrositis, and sleep related bruxism, as well as in adults with childhood onset insomnia or a history of hyperkinesis. However, TCAs share many of the problems reported for hypnotics, as well as having some potentially serious side effects not present with benzodiazepines. The need for determination of the etiology of sleep disorders, and specific pharmacotherapy directed toward identified causes rather than the symptom of insomnia, is stressed.
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PMID:Tricyclic antidepressants in the treatment of insomnia. 635 74

A systematic review of the 19th-century literature related to sleep disorders revealed that patients with obstructive sleep apnea were vividly described in the second half of the century. Also, there were documented observations on the linkage between airway obstructions and noisy snoring, nocturnal insomnia, and excessive somnolence. The coining of the term "pickwickian" to describe an obese somnolent patient was made in 1889 during a clinical presentation of a patient with sleep apnea. Respiratory failure in sleep because of "failure of the chest and diaphragmatic movements" was defined as a specific sleep disorder by Silas Weir Mitchell in 1890. The two main reasons for overlooking the sleep apnea syndrome for so long have been misdiagnosis of patients with sleep apnea as having narcolepsy and skepticism regarding the validity of excessive somnolence as a clinical sign.
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PMID:Nothing new under the moon. Historical accounts of sleep apnea syndrome. 638 98

The authors studied a series of 10 obese patients with respiratory failure referred for treatment because of sleep disorders and diurnal, sometimes uncontrollable, episodes of somnolence. 8 parameters were recorded in the polygraphic study performed during a night of hospitalization: electroencephalogram, electrocardiogram, electro-oculogram, chin electromyogram, thoracic movements, and nasal and buccal air flows. SaO2 and transcutaneous PO2 were recorded simultaneously. A sleep apnea syndrome was diagnosed in 6 of the 10 patients, whose apnea index was markedly above the limit of 5 apneas per hour. The apnea index was below 5 in the other 4 patients. Most patients with sleep apnea syndrome suffer from obstructive apneas of varying duration taking up as much as 48% of total sleep time. The cardiorespiratory effects of these events are apparent, with a drop in PO2 and SaO2 and a decrease in heart rate at the end of apnea. Polygraphic studies seem useful in the diagnosis of the pickwickian syndrome. They allow the type of apnea and its effects to be specified and thus guide treatment.
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PMID:[Contribution of nocturnal polygraphy to the diagnosis of Pickwickian syndrome. 10 cases]. 649 22

Disturbed nocturnal sleep is considered a symptom of narcolepsy. Polysomnographic recordings of 57 consecutive narcoleptic patients were reviewed for evidence of disturbed sleep. When disrupted sleep was present, it was attributable to recognized sleep disorders: nocturnal myoclonus and sleep apnea. Comparison of standard polysomnographically derived parameters of patients who had narcolepsy without sleep apnea or nocturnal myoclonus with those of a normal control group, showed no evidence of disturbed sleep in the patient population. The narcoleptics that also had nocturnal myoclonus or upper airway sleep apnea did have disturbed sleep in comparison with the normals. Our data suggest disturbed sleep tends to develop in narcolpetic patients with age, but is not an inherent element of the narcolepsy syndrome.
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PMID:Narcolepsy and disturbed nocturnal sleep. 661 86


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