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

Three patients with untreated sleep apnea fell asleep while driving and caused serious automobile accidents. One person died, another became permanently paraplegic, and the three patients with sleep apnea were seriously injured in these crashes. This sequela of sleep apnea is not surprising, since subjects with sleep apnea may be poor drivers with a high accident rate and a high incidence of "near-miss" vehicular incidents. Because drivers with untreated sleep apnea may cause a large number of preventable automobile accidents, physicians have specific duties involving these drivers. First, physicians must try to identify impaired drivers with sleep apnea before they have an accident; routinely asking patients about loud snoring and hypersomnolence may help identify these impaired drivers. Second, physicians must consider the diagnosis of sleep apnea when examining patients who fall asleep while driving. Next, physicians must warn their patients with sleep apnea about the risks of driving with untreated sleep apnea. Finally, physicians must treat any seriously impaired driver with sleep apnea and keep these patients from driving until they can receive successful treatment.
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PMID:Drivers with untreated sleep apnea. A cause of death and serious injury. 206 98

Knowledge of the connection between habitual snoring diseases and obstructive sleep apnoea has stimulated research into sleep disturbance in patients at high risk of cardiovascular disease. Any disturbance of nasal ventilation leads to a higher resistance to breathing and may cause cardiovascular complications in the long run. Anatomical and functional conditions that lead to intermittent incomplete blockage or complete occlusion of the upper respiratory tract must be detected and surgically eliminated, if possible. Surgical procedures for treating snoring and obstructive sleep apnoea may be successful and fill the gap between conservative treatment and continuous nasal positive airway pressure therapy. Our experience in 24 patients in presented.
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PMID:[Experience with surgical therapy in snoring and sleep apnea]. 206 69

A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its test-retest reliability and the interobserver variability of the items. The results indicate the existence of three orders of variables. The first (class A) was characterized by good intra- and inter- observer reliability. It included all interval variables (i.e. weight, height, arterial pressure) and most ordinal variables (i.e. grading of snoring, excessive daytime somnolence, morning headache, smoking, etc.). The second (class B) was characterized by good intra-observer and poor inter-observer reliability. It included snoring onset time and morning somnolence. The third class (class C) was characterized by both poor intra- and inter-observer reliability. It included sleep apnea. For large epidemiological survey purposes the authors suggest that only class A variables be used.
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PMID:[Test-retest reliability of anamnestic data on chronic obstructive apnea]. 209 68

A patient with Hunter syndrome and diffuse airway obstruction had daytime hypersomnolence, snoring, and alveolar hypoventilation. Polysomnography showed severe obstructive sleep apnea. In the past, all reported cases of sleep apnea in patients with mucopolysaccharidoses had been treated with tonsillectomy/adenoidectomy or tracheostomy. This patient, in whom tracheostomy would have been very difficult due to the diffuse nature of his airway involvement, was successfully treated with high pressure nasal CPAP and supplemental oxygen.
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PMID:Successful use of nasal-CPAP for obstructive sleep apnea in Hunter syndrome with diffuse airway involvement. 211 82

To reduce time committment and expense in the diagnosis of sleep apnea it is necessary to develop simplified monitoring techniques. The monitoring systems to detect apneas should have high sensitivity, good reproducibility, be inexpensive and practical to use. The following methods have been suggested: inductance plethysmography, capnography, flow measurements by thermistors, tracheal sound recording, static charge sensitivity bed, oximetry, activity monitoring, detection of snoring. Some devices to registrate breathing have been combined with oximetry and other methods. The results have been validated by polysomnography and show rather good correlations. However, there exists no information on the time and cost savings of a step wise diagnosis of sleep apnea.
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PMID:Monitoring at home. 211 13

Because sleep apnoea syndrome is often associated with arterial hypertension, it has been suggested that sleep apnoea might be responsible for hypertension. This hypothesis is mainly based on epidemiological studies showing a statistically significant association between snoring and arterial hypertension; this association remains true even after data correction to take into account the increased frequency of snoring with age and overweight. However, this statistical link is no evidence of a cause-effect relationship, and the mechanism through which sleep apnoea syndrome could produce arterial hypertension remains unknown. Yet treatment of sleep apnoea syndrome seems to improve arterial hypertension, and this alone would justify a search for sleep apnoea syndrome in all patients presenting with arterial hypertension.
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PMID:[Role of sleep apnea in essential arterial hypertension]. 214 5

To evaluate cardiac structure and function as well as blood pressure in the obstructive sleep apnoea syndrome (OSAS), we investigated 61 male patients and 61 male controls with M-mode and two-dimensional echocardiography. All patients had a history of habitual snoring and a diagnosed light to severe OSAS by previous investigations of nocturnal oxygen saturation status. No subject in the control group had a history of OSAS or hypertension. Body weight was higher in the OSAS patients than in the controls (P less than 0.001). Fifty per cent (31 out of 61) of the OSAS patients had systemic hypertension; 17 of these 31 were on pharmacological antihypertensive treatment. Neither the systolic nor the diastolic blood pressures were found to correlate to the severity of the OSAS (desaturation index). The heart rate was higher at rest in the OSAS patients with or without systemic hypertension compared to the controls with or without a blood pressure level above 165/95 mmHg (P less than 0.05 and P less than 0.01, respectively). Left ventricular (LV) internal dimensions as assessed by echocardiography did not differ between the two groups, while the interventricular septum and the LV posterior wall were thicker in the OSAS group. Thus, the LV mass and the LV mass index were significantly higher among the OSAS patients (P less than 0.001 and P less than 0.001). The LV mass index was approximately 15% higher among the 30 normotensive OSAS patients with no history of cardiac disease compared with the normotensive controls (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnoea. 217 47

We examined flow-volume curves for their potential as screening tests for obstructive sleep apnea (OSA) in 401 patients referred for investigation of snoring. In all patients, we performed nocturnal polysomnography, maximum inspiratory and maximum expiratory flow-volume curves. The curves were examined for two features: 1) presence of flow oscillations (the "saw-tooth" sign), and 2) changes in their configuration that might suggest upper airway obstruction as documented by the expiratory/inspiratory flow ratios calculated at 50 and 75 percent of exhaled vital capacity (FR50 and FR25, respectively). Based on the results of nocturnal polysomnography, the patients were stratified according to severity into apnea groups, and the flow ratios and flow oscillations were compared among these groups. We found that neither the FR50 nor FR25 were significantly different among the groups. Inspiratory and expiratory flow oscillations were seen infrequently (32 patients) and tended to occur in patients with more severe sleep apnea. Neither the flow ratios nor the flow oscillations had good predictive values for snoring or sleep apnea. The sensitivity of the flow volume curve abnormalities ranged between 0 and 14 percent, but the specificity was high, ranging between 93 and 95 percent. We conclude that because of low sensitivity, flow-volume loops are not a useful screening test for the diagnosis of OSA in snoring patients.
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PMID:An evaluation of flow-volume curves as a screening test for obstructive sleep apnea. 219 37

The OSA syndrome, described over 100 years ago, was rediscovered in 1966. It is a common disorder, especially among fat, middle-aged men. Stentorian snoring and diurnal somnolence are the cardinal manifestations and should always lead to an examination during sleep. That examination (polysomnography) can demonstrate the pathognomonic events--repetitive apneas occurring in sleep--which signal the failure of the sleeping brain to maintain the patency of the supraglottic airway. All evidence points to the problem being an abnormal pharyngeal airway, one which has a shape or size or compliance that allows inspiratory collapse as the normal loss of pharyngeal dilator muscle tone occurs with sleep. The apneas are asphyxic events terminated by arousals which fragment sleep continuity and lead to the daytime sleepiness. Because the snoring occurs during sleep, the arousals are unremembered, and the sleepiness can develop so gradually that the patient may forget what normal alertness is like. It is important to interview the patient's spouse or partner. Besides obesity and maleness, other risk factors for OSA are diseases that have an impact on the configuration or effective compliance of the pharyngeal passageway. Recent studies support the clinical intuition that sleep apnea is undesirable. Sleepiness leads to accidents. The hypoxemia occurring during apnea can lead to potentially fatal cardiac dysrhythmias. A number of reports suggest that snoring and sleep apnea are associated with an increased risk of stroke, myocardial ischemia, and infarction. Finally, there are now two papers showing a significantly decreased probability of 5-year survival in patients with symptomatic sleep apnea. The good news is that treatment with tracheostomy or NCPAP improves mortality rates to normal. Approximately 90 per cent of patients can tolerate a night's initial trial with CPAP. Long-term acceptance of CPAP has now been reviewed in a number of studies, and it appears to be about 65 to 70 per cent.
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PMID:Sleep disorders and upper airway obstruction in adults. 219 4

It can be said that there are two methods of evaluating certain aspects of sleep. PSM is more traditional and uses older equipment to assess a full scope of sleep disorders in a rather expensive and inconvenient way. Computerized home monitoring is a more modern way of monitoring sleep using improving technology, probably most applicable to snoring with sleep apnea, in a less expensive way. A joint study group should co-ordinate and encourage progress in both traditional and computerized procedures to the greater good of all.
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PMID:Monitoring adult patients with sleep apnea. 219 5


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