Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was designed to test a hypothesis that patients with sleep apnea have higher blood pressure in the morning, following a night spent in apnea and hypoxemia, than in the evening. To accomplish this, we prospectively studied a set of 611 patients referred to our clinic because of suspicion of sleep apnea. All patients had full nocturnal polysomnography, including measurement of snoring. Blood pressure was measured in the evening, prior to onset of sleep, and in the morning, immediately on awakening. We found that patients without apnea and hypoxemia had lower blood pressure in the morning compared with the evening value, while patients with severe sleep apnea and hypoxemia had higher blood pressure in the morning; these evening-to-morning blood pressure differences, although statistically significant, were small, typically 1 to 4 mm Hg. Morning blood pressures were higher in patients with sleep apnea and hypoxemia than in nonapneic normoxic patients. However, this difference disappeared after the groups were matched for age and body mass index. We conclude that (1) patients with sleep apnea and nocturnal hypoxemia lose the expected morning dip in arterial blood pressure, and (2) age and body mass index are more important correlates of blood pressure than apnea and nocturnal oxygen desaturation. We speculate that the loss of evening-to-morning drop in blood pressure, if present over a long period of time, may lead to sustained elevations in arterial blood pressure frequently observed in patients with sleep apnea.
 ...
PMID:Evening-to-morning blood pressure variations in snoring patients with and without obstructive sleep apnea. 173 59

Previous studies of single families have suggested that familial factors may be important in the pathogenesis of obstructive sleep apnea. In this report, the role of inheritance in obstructive sleep apnea was assessed by quantitating the degree of familial clustering of symptoms associated with sleep-related breathing disorders. In total, 272 subjects from 29 families identified through an index case with obstructive sleep apnea and 21 control families with no relative known to have sleep apnea were studied with questionnaires that ascertained health status and symptoms. The unadjusted odds ratios of habitual or disruptive snoring, breathing pauses, and excessive day-time sleepiness in subjects with a single relative with the same symptom were 1.40 to 1.53 (p less than 0.05). Odds ratios increased progressively for subjects with increasing numbers of symptomatic relatives). Adjustment for body mass index, age, and gender modestly reduced these odds ratios to 1.33 to 1.42. These data suggest a significant familial aggregation of symptoms associated with sleep-disordered breathing that appears independent of familial similarities in weight.
 ...
PMID:Studies in the genetics of obstructive sleep apnea. Familial aggregation of symptoms associated with sleep-related breathing disturbances. 173 54

Diclofenac sodium suppositories 150-200 mg day-1 were compared with placebo in a double-blind study during the first 3 days after uvulopalatopharyngoplasty in 40 patients with habitual snoring or obstructive sleep apnoea syndrome. Consumption of rescue analgesics (paracetamol suppositories) and pain assessed by a visual analogue scale were significantly less in the diclofenac group. Bleeding time (modified Ivy's test) and reported side effects did not differ between the two groups.
 ...
PMID:Treatment of postoperative pain with diclofenac in uvulopalatopharyngoplasty. 173 73

It appears that uvulopalatopharyngoplasty (UVPP) is a reliable procedure for reducing snoring, but much less reliable when used as a treatment for OSAS. This is thought to be because of poor patient selection in that the site of the problem is not always the site of the operation. We present the technique of sleep nasendoscopy which allows direct visualization of the site or sites of obstruction in a sleeping patient. Our study has shown that there are patients with obstructive sleep apnoea syndrome (OSAS) in whom the only site of pharyngeal obstruction is at the velopharynx. These patients should do well with the relatively simple procedure of UVPP. This is not true for many other OSAS patients in whom we found that obstruction was multisegmental. This helps to explain the frequently poor results of UVPP in OSAS patients. We feel that this form of preoperative assessment will avoid unnecessary surgery.
 ...
PMID:Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea. 174 3

A programme for the differential diagnosis of rhonchopathy is reported, based upon the MESAM system developed at the University of Marburg. With this biparametric long-term monitor the snoring noise and the heart beat frequency (a beat-by-beat analysis) were recorded in 94 patients with a history of snoring. Other investigations included tape recordings of the snoring noise, nasoendoscopy, pulsed cineradiography of the pharynx and the recording of the character of the snoring. This programme is much cheaper than a sleep laboratory, but it can distinguish between obstructive sleep apnoea syndrome, habitual rhonchopathy and non-snorers, mainly by means of the characteristic patterns of MESAM recordings. A sleep apnoea syndrome was diagnosed in 19 patients and habitual rhonchopathy in 38 patients, whereas 33 patients were regarded as non-snorers. Ten of our 19 patients with sleep apnoea were re-examined by a sleep laboratory and the diagnosis was proved in all of these cases. In the 38 patients with habitual rhonchopathy auditory analysis of the snoring noise classified 23 patients as velar and 10 as pharyngeal snorers; 5 patients showed a mixed type of rhonchopathy. The questionnaire accompanying the MESAM system, nasal endoscopy and cine films support the individual diagnosis by revealing typical complaints and characteristic organic findings and thus contribute to the differential diagnostic screening. However, the three groups do overlap quite markedly with respect to symptoms und organic findings. In summary, the MESAM system provides an economically viable examination programme that can be used routinely by the otorhinolaryngologist for the differential diagnosis of rhonchopathy.
 ...
PMID:[Differential diagnosis of rhonchopathy using the MESAM system]. 179 59

Cephalometry is often used to assess patients with sleep apnoea but whether these measurements differ from those in non-apnoeic snorers and how they are influenced by age is not clear. Cephalometric radiographs of patients with sleep apnoea were compared with those of snorers without sleep apnoea and those of non-snorers. Fifty two snorers with suspected sleep apnoea had a conventional sleep study and were divided into two groups: those with an apnoea-hypopnoea index greater than 10/h (n = 40, sleep apnoea group) and those whose apnoea-hypopnoea index was 10/h or less (n = 12, snorer group). The cephalometric measurements in these patients were compared with those of 34 non-snoring control subjects. Controls were subdivided into two groups: control group 1 included 17 subjects similar in age to the sleep apnoea and snorer groups (mean (SD) age 50.0 (10.9), 50.7 (9.4), and 50.6 (9.7) years); control group 2 included 15 young men (25.4 (2.6) years). The distance from the mandibular plane to the hyoid bone (MP-H) and the length of the soft palate were greater in the patients with sleep apnoea (28.7 (7.8) and 43.6 (5.0) mm) than in the snorers (23.7 (4.2) and 40.3 (4.9 mm). The MP-H was similar in snorers and age matched control subjects, but was significantly greater in the older than in the younger control subjects (22.1 (6.1) vs 17.0 (6.8]. The soft palate was longer in subjects who snored (both sleep apnoea patients and snorers) than in control subjects. The MP-H distance significantly correlated with age for all subjects (snorers and controls) and for the control subjects alone. This study shows that non-apnoeic snorers have cephalometric abnormalities that differ from those of patients with sleep apnoea and that cephalometric values are influenced by the subject's age.
 ...
PMID:Cephalometric measurements in snorers, non-snorers, and patients with sleep apnoea. 179 47

To determine its predictive value, polysomnography was performed on 14 snorers with sleep apnea syndrome (SAS) before and 3 months after uvulopalatopharyngoplasty (UPPP). In the 8 patients considered as cured (less than 10 apneas per hour after UPPP), total apnea index (TAI) decreased from 29.7 +/- 22.6 to 4.9 +/- 3.5. Rapid eye movement sleep (REM) increased from 10.9 +/- 3.6 to 14 +/- 5.7% of the total sleep period (TSP). In the 6 uncured patients, TAI decreased from 59.7 +/- 15.7 to 32 +/- 15.7 and REM increased from 7.7 +/- 5.6 to 15.8 +/- 7.2% of TSP. Snoring and drowsiness decreased in both cured and uncured patients. A presurgical apnea index less than 40 seems to be a reliable predictor of successful UPPP. The association of obstructive apnea with either central apnea or mixed apnea was not a factor of poor prognosis. Better sleeping could explain in part the clinical improvement in both cured and uncured patients, but postoperative polysomnography is needed to detect asymptomatic SAS.
 ...
PMID:Uvulopalatopharyngoplasty in snorers with sleep apneas: predictive value of presurgical polysomnography. 186 51

A total of 34 severely obese men with a history of heavy snoring and excessive daytime sleepiness indicative of obstructive sleep apnoea syndrome (OSAS) were studied prospectively. Their mean age was 46 years, and mean body mass index was 41.6 kg m-2. During a 4-year follow-up, 15% (5/34) of these subjects died (three cases of acute myocardial infarction and two cases of pulmonary oedema), all of them suddenly and unexpectedly, outside hospital. On autopsy the degree of atherosclerosis was found to be moderate in all cases. In 68% (15/22) of the men a pathological apnoea index (mean value 46 +/- 20) confirmed the OSAS diagnosis. Exercise tests and neurological examinations did not reveal any other causes of daytime sleepiness. Mean blood pressure at rest and during exercise was normal, and mean serum lipid and blood glucose levels were normal. Spirometry revealed intrapulmonary restrictive changes that could not be attributed to the heavy thoracic wall. Compliance was reduced to about 50% of reference values, and the mean pCO2 level (5.8 kPa) was close to the upper reference limit. Blood tests suggested that high alcohol consumption may be an important factor contributing to OSAS. These results demonstrate that morbidly obese men with a history of OSAS have a high risk of sudden cardiovascular death, despite the absence of other conventional risk factors.
 ...
PMID:The sleep apnoea syndrome in obesity: risk of sudden death. 186 65

In a Rehabilitation Clinic for Diseases of the Respiratory Organs we examined 497 male patients aged 45.9 +/- 11.1 years with a relative weight of 109 +/- 16.7% who were suffering from chronic diseases of the respiratory tract (66.2% chronic bronchitis, 33.8% asthma bronchiale, 49.6% obstruction of the respiratory tract). They were subjected to a detailed physical examination and were given an anamnestic questionnaire for the purpose of diagnosing sleep-related respiratory disturbances (Siegrist et al., 1987). In addition, whole body plethysmography was performed in all patients as well as a pulse-oximetric examination during night sleep. Using factor analysis, it was possible to extract 5 factors from the 23 items of the anamnesis questionnaire. With these 5 factors, 60.5% of the total variance could be explained. These factors describe: 1. Dyspnoea (35.3%); 2. Vigilance (8.5%); 3. Sleep disturbances (6.3%); 4. Headache (5.8%) and 5. Snoring (4.7%). Different factor patterns are seen for different groups of patients. In patients suspected of an obstructive sleep apnoea syndrome, however, it will always be necessary to perform further stage-wise diagnosis to safeguard the diagnosis.
 ...
PMID:[Evaluation of an anamnesis questionnaire for the diagnosis of sleep apnea in patients with chronic diseases of the respiratory organs]. 186 94

At the moment diagnosis of sleep related breathing disorders (SRBD) is carried out in specialised clinical centres with well-equipped sleep laboratories. Since there are only few of these in Germany, medical care in this field is not sufficient at all even if applied only to high-risk patients. To cope with the large number of patients with severe SRBD we developed a mobile 10-channel unit (SIDAS 2010) designed for diagnosing SRBD even outside the conventional sleep laboratories. In this study we investigated 108 patients who after using the 4-channel recorder presented signs and symptoms suggesting SRBD. After evaluating the tracings in 53 patients a distinct obstructive sleep apnoea (OSA) (AI 10) could be diagnosed; in 55 patients the signs remained indistinguishable. In 2 recordings with SIDAS in 74 patients, a distinct OSA was diagnosed, 34 patients had an AI less than 10; these patients underwent renewed polysomnographic recordings with EEG in addition. The polysomnographic recordings revealed 5 patients with an AI between 5 and 10.3 with primary and secondary alveolar obstructive hypoventilation due to excessive snoring. The comparison of SIDAS recordings with recordings made by polysomnography proved SIDAS to be valuable in respect of diagnosing type of SRBD (obstructive/central) and amount of respiratory events (apneas/hypopnoeas). In this study only 13 patients with SRBD (14.9%) need further diagnostic procedures. We conclude that with SIDAS most of the SRBD can be diagnosed sufficiently even outside conventional sleep laboratories.
 ...
PMID:[SIDAS 2010: mobile 10-channel unit for the diagnosis of sleep-related respiratory disorders]. 186 98


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>