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

Uvulopalatoplasty was performed (whether or not associated with tonsillectomy and/or septoplasty) in 1,222 cases of chronic rhonchopathy. Among them, 65 cases consisted of pre- and postoperatively registered sleep apnea syndrome. Clinical results were assessed on improvement of preoperative snoring, apneas, morning asthenia, daily sleepiness. Surgery was totally successful in 50% of cases, partially in 35%. Failure was encountered in 15% of cases. Failure or partial improvement are related to the preoperative presence of one or several of five particular risk factors: neck shortness, tongue hypertrophia, retrognathia, obesity and nasal pathology. Surgical complications were rare. Severe rhinolalia occurred in five cases: only three of them were sufficiently to accept plastic reconstruction which was successful.
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PMID:[Clinical results of the surgical treatment of 1222 cases of chronic snoring]. 234 21

38 patients with sleep apnea syndrome treated with uvulopalato-pharyngoplasty were interviewed 23 +/- 10.8 months after the operation (mean age 48.0 +/- 8.6 years, range 28-65). 22 were also studied in the sleep laboratory 10 +/- 10.7 months after operation. 3 months after operation 94% reported improvement in snoring and 77% improvement in excessive daytime sleepiness. 1 and 2 years after the operation snoring had decreased to 74% and 65%, respectively, and excessive sleepiness to 65%, for both periods. There was a decrease of at least 50% in the number of apneic periods per hour of sleep in 68%. Side-effects consisted of nasal regurgitation and vocal changes. Only age was of predictive value: the younger the patient the better the response.
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PMID:[Obstructive sleep apnea treated with uvulopalato-pharyngoplasty]. 234 29

Post-polio patients may develop additional neuromuscular and respiratory symptoms decades after the acute attack, the post-polio syndrome. We hypothesize some post-polio symptoms may be due to breathing disorders occurring during sleep. We performed polysomnography on 13 post-polio patients: group 1 (five patients) were those already on ventilatory assistance (rocking beds) and group 2 (eight patients), those without any assistance. Patients requiring new treatment were then evaluated on nasal CPAP or nasal mask ventilation. Group 1 patients, on rocking beds, demonstrated consistently poor sleep quality with decreased total sleep time, sleep efficiency, percentage stage 2, slow wave sleep, rapid eye movement sleep and an increase in the number of arousals and percentage stage 1 sleep. Respiratory abnormalities were also present and in all cases caused significant O2 desaturation. These patients did not respond to CPAP with the rocking bed. Repeat night-time polysomnography on nasal mask ventilation demonstrated an improvement in sleep structure and gas exchange. Three group 2 patients, (group 2a) had sleep within normal limits. The five remaining (group 2b) had poor sleep quality that was similar to but not as disrupted as group 1 patients. All but one patient demonstrated obstructive or mixed apnea and were treated effectively with nasal CPAP. One patient required nasal mask ventilation (due to mixed apnea and marked hypoventilation) to which there was a dramatic response. These patients demonstrated improved sleep quality and an improvement in daytime symptomatology. Sleep studies should be performed on post-polio patients with excessive daytime sleepiness and respiratory complaints. Those with obstructive and mixed apnea can often be treated with nasal CPAP. Those with hypoventilation syndrome and sleep apnea attributable to sleepiness and respiratory complaints. Those with obstructive and mixed apnea can often be treated with nasal CPAP. Those with hypoventilation syndrome and sleep apnea attributable to respiratory muscle weakness can be treated with nasal mask ventilation. Individuals already on respiratory assistance such as rocking beds who have features of respiratory failure can also be treated effectively with long-term nasal mechanical ventilation.
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PMID:Sleep in postpolio syndrome. 236 79

Drivers suffering from sleepiness at the wheel run the risk of being involved in car accidents. To evaluate whether objective data of driving performance can be assessed in patients with excessive tendency of falling asleep at the wheel, two test versions of a computerized driving program were created to fit an advanced driving simulator. For the evaluation 15 male drivers with habitual sleep spells whilst driving were selected among patients with the clinical features of the sleep apnoea syndrome. The brake reaction time and the deviations from straight road-line were significantly increased when compared to the performance of 10 matched controls. Irrespective of test version, the driving simulator with the program used was found to be a sensitive method to ascertain driving vigilance impairment in quantitative terms. It would also be a valuable method to evaluate the efficiency of treatment in selected patients.
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PMID:Driving vigilance simulator test. 238 28

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

In an attempt to identify predictors of long-term compliance with nasal continuous positive airway pressure (CPAP), we reviewed the records of 125 patients with obstructive sleep apnea (OSA) referred to our center for nasal CPAP trials. Severity of sleep apnea, sleep staging, daytime hypersomnolence, effectiveness of nasal CPAP, previous palatal surgery, and adverse reactions were compared in compliant and noncompliant patients. Nineteen patients did not tolerate a nasal CPAP trial in the laboratory or refused home nasal CPAP therapy. Ten patients were unavailable for follow-up. Of the remaining 96 patients, 23 (24 percent) had discontinued therapy, while 73 (76 percent) were still using nasal CPAP at 14.5 +/- 10.7 months (mean +/- SD). There were no statistically significant differences between the compliant and noncompliant patients in baseline apnea plus hypopnea index (AHI), baseline sleep staging, AHI while receiving nasal CPAP, sleep staging while receiving nasal CPAP, or frequency of adverse reactions during therapy. Severe daytime sleepiness was present in 65 of the 73 compliant patients and in 12 of the 23 noncompliant patients (p less than 0.05). Ten of 43 in the compliant group had previous palatal surgery compared with ten of 23 noncompliant patients (p less than 0.05). Our data confirm earlier observations in smaller samples that compliant and noncompliant patients have equally severe sleep apnea and good initial responses to nasal CPAP. Long-term compliance with nasal CPAP may be associated with the severity of daytime hypersomnolence on presentation. Previous palatal surgery was more frequent in patients who did not tolerate long-term nasal CPAP therapy.
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PMID:Long-term compliance with nasal continuous positive airway pressure therapy of obstructive sleep apnea. 240 99

Two obese patients with sleep apnea syndrome were administered chlormadinone acetate (CMA), a synthetic progesterone, known as a potent respiratory stimulant to augment load compensation response as well as CO2 chemosensitivity. Before CMA administration, both cases showed normal chemosensitivity of hypoxic and hypercapnic ventilatory responses (HVR and HCVR) at daytime, although marked oxygen desaturation with sleep apnea was observed. During CMA administration for 7 days, HVR, HCVR and occlusion pressure response to flow-resistive loading were altogether augmented. In one case obstructive sleep apnea (OSA) was altered to obstructive hypopnea, and in the other case central apnea disappeared completely, resulting in remarkable improvement of oxygen desaturation at sleep and daytime somnolence in both cases. We conclude that CMA might be useful in the treatment of sleep apnea syndrome.
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PMID:Obese patients with sleep apnea syndrome treated by progesterone. 247 20

Sleep apnea syndromes have been identified only relatively recently. Their most frequent form is characterized by a sleep-related upper airway obstruction resulting in apneas which may repeat themselves up to several hundred times during a night's sleep. Their mean duration is about 30 to 40 seconds, but some apneas last over one minute. Breathing resumption requires an arousal, which may be clearly identified on the EEG but usually goes unnoticed by the patient. The most immediate consequence are hypoxemia and sleep fragmentation. There may be associated arrhythmias and hemodynamic changes, especially in the pulmonary circulation. The predominant clinical signs are snoring (during the breathing resumption between the apneas) and daytime somnolence due to sleep fragmentation. In addition to the risks of work and traffic accidents, these patients run a long-term risk of cardiovascular accidents. About 20% develop pulmonary hypertension, a contributing factor to right heart failure. About 50% are hypertensive, which combined with a frequently observed polycythemia, makes them vulnerable to ischemic accidents. The treatment is based upon the use of continuous positive airway pressure (CPAP) during sleep. In case of failure, surgical alternatives may be considered.
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PMID:[Sleep apnea syndromes]. 253 41

Excessive daily sleepiness attribute to sleep disturbances can be a problem for occupational physician concerning the work ability to security works, night shift work and vehicle driving. It's difficult to detect those pathologies because the workers don't identify their symptoms as serious diseases or because they mask these symptoms for fear of the loose of their job. We've studied one case of SAS (sleep apnea syndrome) and one case of narcolepsy to demonstrate: 1) the criterions of the occupational forecast; 2) the sometimes serious social and occupational consequences of a medical inaptitude sanction. We insist on the necessity of a good collaboration between general practitioner and occupational physician.
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PMID:[Sleep disorders and medical work capacity]. 253 45

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


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