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

The article reports on the results obtained by uvulopalatopharyngoplastic surgery (= UPPPS) in 31 patients suffering from obstructive sleep apnoea syndrome (= OSAS) and in 9 patients with habitual or obstructive snoring. All patients were subjected to thorough preoperative examination including rhinometry, nasopharyngeal video-endoscopy, radiocephalometry and polysomnography. In 8 out of 9 (89%) of the habitually snoring patients and in 17 of 31 (55%) of OSAS patients, surgery was successful. In these patients, a postoperative respiratory disturbance index (RDI) of less than 10 was recorded, whereas in 4 patients (13%) the postoperative RDI was between 10 and 15. Ten patients did not respond satisfactorily to UPPPS (32%). RDI was postoperatively still above 15. Analysis of patient data shows that almost all habitually snoring patients and the OSAS patients with slight overweight and low to medium apnoea index were successfully treated with UPPPS. In accordance with these results a treatment concept has been drawn up for OSAS patients that takes stock of all the possibilities and limitations of available conservative and surgical treatment methods.
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PMID:[Surgical therapy of obstructive sleep apnea syndromes: results of the Ulm treatment program]. 186 9

Sleep-related breathing disorders can strain the cardiovascular system. Link-ups with arterial hypertension have been confirmed in obstructive or mixed sleep apnoea which is characterised by discontinuous nocturnal snoring. On the other hand, it is known that arterial hypertension is very frequently seen in snorers. The present study deals with short-term, breathing-related blood pressure patterns and blood pressure changes during the snoring phase. 18 obstructive snoring phases were identified in 4 male patients aged 50 years (42-65), Broca index 136 (119-171). Polysomnographic measurements were carried out in the sleep laboratory and the blood pressure was continuously recorded via the a. brachialis. The short-term breathing-dependent blood pressure changes were systolic 10.8 (10-30) mmHg at the beginning and 17.5 (10-30) mmHg at the end of the snoring phase (P less than 0.01). Diastolically there was a difference of 9.4 (5-15) mmHg versus 13.9 (5-25) mmHg (P less than 0.01). During the snoring phases the systolic blood pressure increased from 140.3 (120-190) mmHg to 170.0 (145-235) mmHg and the diastolic pressure from 69.7 (50-110) mmHg to 93.1 (70-120) mmHg. The study proves that blood pressure increases occur not only in apnoeic snoring but also in continuous obstructive snoring. It is suspected that these changes are responsible for the high frequency of arterial hypertension among continuous snorers.
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PMID:[Increase in blood pressure due to continuous obstructive snoring]. 186 14

To determine if a history of snoring is a risk factor for brain infarction, I conducted a case-control study of risk factors for ischemic stroke using 177 consecutive male patients aged 16-60 (mean 49) years with acute brain infarction. For each patient I chose an age-matched (+/- 6 years) male control. Arterial hypertension, coronary heart disease, snoring (habitually or often), and heavy drinking (greater than 300 g/wk) were risk factors in the stepwise multiple logistic regression analysis. The odds ratio of snoring for brain infarction was 2.13. By McNemar's test this association increased strongly if a history of sleep apnea, excessive daytime sleepiness, and obesity were all present with snoring (odds ratio 8.00). My study indicates that snoring may be a risk factor for ischemic stroke, possibly because of the higher prevalence of an obstructive sleep apnea syndrome among snorers than nonsnorers.
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PMID:Snoring and the risk of ischemic brain infarction. 186 48

Intermittent snoring and cyclic oscillations of heart rate and oxyhaemoglobin saturation (Sao2) are characteristic features of the obstructive sleep apnoea syndrome (OSAS). Thus, overnight recordings of laryngeal sounds and heart rate by a portable device (MESAM) and of Sao2 by oximetry are applicable to screen outpatients for the presence of OSAS. Computerized analysis for time intervals of constant heart rate and intervals between snoring sounds is used by MESAM to quantify respiratory disturbances during sleep. Rapid increases in Sao2 during the postapnoeic hyperventilation period together with the number of desaturations are used by a new software for quantitative analysis of oximetry. To elucidate reliability of results from automatically scored MESAM and oximetry recordings, we compared the four computer calculated respiratory disturbance indices from heart rate (RDIH), snoring (RDIS), resaturations (RDIR) and desaturations (RDID) with the apnoea plus hypopnoea index (AHI) from simultaneously performed polysomnography. The study population consisted of 53 snorers with an AHI of 19.0 +/- 2.6 (median +/- SEM; range 0.7-87.8). Whereas both RDI's from MESAM correlated rather weakly with the AHI from polysomnography (RDIH: r = 0.32, p less than 0.05; RDIS: r = 0.33, p less than 0.05), this correlation was much better for the RDI's from oximetry (RDIR: r = 0.951, RDID: r = 0.93; p much less than 0.0001). Accepting a plus/minus 30 percent difference from the AHI, the RDIR classified 77% of patients correctly, the RDID 62%, the RDIS 32% and the RDIH 23%. In conclusion, results from computerized analysis of oximetry for desaturations and rapid resaturations correlate more closely with polysomnography than those from automatic scoring of MESAM recordings.
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PMID:Quantification of sleep disordered breathing by computerized analysis of oximetry, heart rate and snoring. 188 91

Habitual heavy snoring may be considered a preliminary stage of sleep apnea syndrome. This investigation deals with the craniofacial morphology of 51 heavily snoring patients, with and without obstructive sleep apnea, and with 28 healthy control patients. The apnea group showed a reduced posterior airway and a posterior rotation of the mandible. Reduction of the anterior-posterior diameter of the cranial base, maxilla and mandible and vertical reduction of the posterior facial height appeared to be common facial characteristics in both snoring and apnea patients. These findings indicate an anatomical disposition for snoring and apnea.
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PMID:Cephalometric analysis of permanently snoring patients with and without obstructive sleep apnea syndrome. 189 Mar 23

Snoring is a common disorder, and may be associated with obstructive sleep apnoea, although there is little published information on the incidence of apnoea in snorers. This study aimed to assess the upper airway and to relate the findings to sleep study data in a population of patients referred by their general practitioners with loud snoring. Each patient had a full history, weight and height measurements, nasal examination, rhinomanometry, peroral grading of the oropharyngeal features, and fibreoptic pharyngoscopy with a modified Muller manoeuvre, followed by a sleep study. The results in our group of 35 patients demonstrate a high incidence of obstructive sleep apnoea (46%). Factors which correlated well with apnoea were excessively loud snoring, a narrow oropharynx, and marked obesity; 94% of patients with one or more of these features had evidence of sleep apnoea.
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PMID:Obstructive sleep apnoea in adults presenting with snoring. 193 59

The Prader-Willi syndrome is characterized by infantile hypotonia, early childhood obesity, mental deficiency, short stature, small hands and feet, and hypogonadism. Many patients also have hypersomnolence, experience daytime hypoventilation, and subsequently die prematurely of cardiorespiratory failure. Hypersomnolence and daytime hypoventilation are also common occurrences in the sleep apnea syndrome. For a better understanding of the relationship of sleep to the features of the Prader-Willi syndrome, we retrospectively reviewed five patients (two adults, one adolescent, and two children) with this syndrome who underwent polysomnography. All patients were obese; they had hypersomnolence and daytime hypoxemia, and they nored. In all patients, the apnea plus hypopnea index was less than 10 episodes per hour of sleep. During rapid eye movement sleep, nonapneic reductions in oxyhemoglobin saturation were detected in one adult and in one child. Despite the presence of morbid obesity and a history of snoring, patients with Prader-Willi syndrome seem to have only mild sleep-disordered breathing.
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PMID:Sleep and breathing in patients with the Prader-Willi syndrome. 194 44

We studied the long-term acceptability of nasal continuous positive airway pressure (CPAP) treatment in 168 consecutive patients, 147 with obstructive sleep apnea (OSA) and 21 with snoring. Follow-up was between 1.5 and 78 months. At latest follow-up 107 of 168 (64%) were still using CPAP. Acceptance of CPAP was least for patients with snoring alone (6 of 21 persisted) and best for patients with both excessive daytime somnolence and severe hypoxemia (minimum SaO2 less than 75%), of whom 40 of 45 (89%) persisted with treatment. Patients with excessive daytime somnolence but without severe hypoxemia were less tolerant of CPAP (39 of 71, 55%, persisted) than patients with no symptoms of excessive somnolence but with severe hypoxemia (21 of 30, 70%, persisted). The most common reasons for discontinuing CPAP were intolerance of the mask (26 of 61), the inconvenience of treatment (16 of 61), and the lack of symptomatic benefit from treatment (10 of 61). We concluded that long-term acceptance of CPAP was difficult to predict in advance but that it was most likely in patients with the most severe sleep apnea. Because intolerance of the mask and inconvenience were the most common reasons for ceasing treatment, improvements in the design of CPAP systems and careful patient training may improve the acceptability of CPAP substantially.
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PMID:Long-term acceptance of continuous positive airway pressure in obstructive sleep apnea. 195 44

Compared to uvulopalatopharyngoplasty (UPPP), maxillo-facial surgery is rarely performed in Canada for treatment of obstructive sleep apnea. However, in patients with retrolingual obstruction, UPPP cannot be expected to result in good surgical outcome. We describe a patient with retrognathia causing airway obstruction at the base of the tongue, in whom sagittal mandibular osteotomy with hyoid bone advancement resulted in resolution of snoring and sleep apnea.
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PMID:Resolution of obstructive sleep apnea following facial surgery. 196 Jul 89

61 snoring children selected for adenotonsillectomy, mainly for recurrent tonsillitis, were compared with a matched group of 31 healthy children for symptoms of sleep apnoea, extent of sleep hypoxaemia, and amount of sleep disturbance. The studies were repeated six months postoperatively, and after six months in the healthy children. Preoperatively, 61% of the children had degrees of sleep hypoxaemia above normal and 65% had abnormally disturbed sleep. A questionnaire administered to the parents about their children showed abnormal patterns of answers about sleep problems daytime sleepiness, hyperactivity, aggression, learning difficulties, restless sleep, and odd sleeping positions. After adenotonsillectomy, the abnormal hypoxaemia, excessive sleep disturbance, and multiple symptoms almost resolved; a growth spurt also occurred.
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PMID:Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. 196 19


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