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)

Obstructive sleep apnea syndrome is the most common cause of hypersomnolence in patients referred to sleep disorders centers. This type of sleep apnea is characterized by loud snoring, nocturnal oxyhemoglobin desaturation, and disrupted sleep that leads to daytime hypersomnolence. The anatomic configuration of the pharynx and the physiologic responses to occlusion of the upper airway play a major role in the pathogenesis of this disorder. Polysomnography can accurately identify obstructive sleep apnea, and the multiple sleep latency test allows an objective measurement of daytime alertness. Weight loss and training the patient to sleep in a lateral position are frequently used to alleviate mild cases. Nasally applied continuous positive airway pressure is an extremely effective modality for treating moderate and severe obstructive sleep apnea. Surgical correction of obvious anatomic defects has a role in diminishing obstructive sleep apnea, but the exact role of surgical intervention in patients without obvious anatomic defects remains unknown. The choice of therapy should be tailored to the individual patient with sleep apnea, and careful follow-up is essential to ensure a positive response to therapy.
 ...
PMID:Obstructive sleep apnea syndrome. 220 37

The experience of the uvulopalatopharyngoplasty operation, performed on 24 patients for the relief of loud or heroic snoring, is presented. The operation successfully reduced the severity of snoring in 96% of patients. Postoperative complications were uncommon but included nasal regurgitation and intrapharyngeal adhesions in one patient. The role of the uvulopalatopharyngoplasty operation in the treatment of obstructive sleep apnoea is undecided but the authors do not perform this operation on such patients.
 ...
PMID:The uvulopalatopharyngoplasty operation: the Edinburgh experience. 202 59

Sleep screening was used to discover the incidence of sleep apnoea in 50 children undergoing routine adenotonsillectomy for recurrent upper respiratory tract infections, randomly selected from the waiting list. Preoperative assessment included a detailed parental history, physical examination, and lateral cephalometry, in order to identify factors that might alert the clinician to a diagnosis of obstructive sleep apnoea. There were 2 equal groups of snorers and non-snorers (grade 0); 1 patient was found to have the sleep apnoea syndrome (IV), 9 patients had obstructive snoring with apnoeic episodes (III), 3 patients had snoring with a disrupted sleep pattern (II), and 12 patients snored with no disruption of sleep (I). In identifying patients with apnoea, a history of snoring was unhelpful, whereas one of breathing irregularities was found to be highly specific. Nasal obstruction correlated poorly; however, there was a significant relationship between tonsillar position and size and sleep grade (Chi-squared P less than 0.01). Stepwise regression analysis showed a large contribution to the grading was made by the size of the oropharyngeal airway measured by lateral cephalometry. The children in grade II-IV were re-studied 3 months post-operatively and all reverted to grades 0 or I.
 ...
PMID:Obstructive sleep apnoea in children undergoing routine tonsillectomy and adenoidectomy. 222 98

A cardiac pacemaker was implanted because of nocturnal sinus arrhythmia into a 53-year-old man with hypersomnia. After other patients had reported loud snoring and breathing pauses, which appeared to be dangerously long, polysomnography was performed. It indicated a marked obstructive sleep apnoea syndrome with an apnoea index of 55 and an average apnoea duration of 35 seconds. The nocturnal cardiac arrhythmias disappeared under continuous nasal raised pressure ventilation.
 ...
PMID:[Cardiac pacemaker implantation in unrecognized obstructive sleep apnea syndrome]. 222 64

To characterise the relation between pharyngeal anatomy and sleep related disordered breathing, 17 men with complaints of snoring were studied by all night polysomnography. Ten of them had obstructive sleep apnoea (mean (SD) apnoea-hypopnoea index 56.3 (41.7), age 52 (10) years, body mass index 31.4 (5.3) kg/m2); whereas seven were simple snorers (apnoea-hypopnoea index 6.7 (4.6), age 40 (17) years, body mass index 25.9 (4.3) kg/m2). The pharynx was studied by magnetic resonance imaging in all patients and in a group of eight healthy subjects (age 27 (6) years, body mass index 21.8 (2.2) kg/m2, both significantly lower than in the patients; p less than 0.05). On the midsagittal section and six transverse sections equally spaced between the nasopharynx and the hypopharynx several anatomical measurements were performed. Results showed that there was no difference between groups in most magnetic resonance imaging measurements, but that on transverse sections the pharyngeal cross section had an elliptic shape with the long axis oriented in the coronal plane in normal subjects, whereas in apnoeic and snoring patients the pharynx was circular or had an elliptic shape but with the long axis oriented in the sagittal plane. It is suggested that the change in pharyngeal cross sectional shape, secondary to a reduction in pharyngeal transverse diameter, may be related to the risk of developing sleep related disordered breathing.
 ...
PMID:Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. 224 61

A 39-year old Chinese man presented with an acute onset of severe headache, accelerated hypertension and subsequently an unexpected extensive right occipital haemorrhage. These were found to be related to a sleep apnoea syndrome which had been unrecognized for many years despite its typical symptoms of loud snoring and excessive daytime sleepiness. Weight reduction led to significant clinical but not polysomnographic improvement of the sleep apnoea syndrome.
 ...
PMID:Sleep apnoea presenting as severe hypertension and silent occipital haemorrhage. 225 42

Uvulopalatopharygoplasty has become widely performed for chronic snoring and for cases of obstructive sleep apnoea. Unfortunately this operation is not without morbidity and complications. We report our results of a prospective series of 50 patients undergoing uvulopalatopharyngoplasty with a minimum follow-up of one year. Snoring was abolished in 18 (36 per cent) and substantially reduced in the remainder. Obstructive sleep apnoea syndrome, identified in 11 patients pre-operatively, was reduced in severity in all but three. Troublesome complications were seen in 18 (36 per cent) patients, namely intermittent velopharyngeal incompetence in five (10 per cent), pharyngeal dryness in 11 (22 per cent) and loss of taste in five (10 per cent). One patient had nasopharyngeal stenosis requiring correction. A cautious approach to this operation is required with rigorous case selection. The importance of full assessment and careful follow-up should not be underestimated.
 ...
PMID:Uses and complications of uvulopalatopharyngoplasty. 226 10

Arterial hypertension was found in 78 of 224 consecutive patients operated for nasal polyposis. An exacerbated degree of hypertension was significant in groups aged above 50 years. In total, 46% of patients whose nasal polyposis was of a duration of more than 10 years suffered from hypertension. Fifty of 78 patients developed hypertension after nasal polyposis was established and the mean duration time from polyposis to hypertension was 11.1 years. Hypertension was established in 50% of patients suffering from the triad asthma, intolerance to acetylsalicylic acid and nasal polyposis. In analogy with knowledge that sleep apnoea and snoring are aetiological factors for arterial hypertension, we propose that long-standing nasal obstruction by nasal polyposis be a risk factor for arterial hypertension.
 ...
PMID:Nasal polyposis as a risk factor for hypertension. 227 22

We describe in six men, recurrent episodes recurring over months or years, of sudden, brief complete obstruction to respiration followed by dyspnoea with loud inspiratory stridor lasting two to five minutes. Attacks occurred during wakefulness and/or sleep. In one patient an episode was witnessed endoscopically: the initial obstruction was seen to be caused by complete laryngeal closure. The false vocal cords then opened, but the vocal cords remained adducted and caused inspiratory stridor. The similarity of the attacks described by the other patients suggests that they were all caused by laryngeal closure. Furthermore, they could simulate the episodes by voluntarily adducting their vocal cords. The symptoms were usually preceded by a sensation of throat irritation and in four cases symptoms of upper respiratory infection were present. Associated features present in some of the patients included post-nasal discharge, snoring, sleep apnoea and gastro-oesophageal reflux. None was hypocalcaemic. Although stimulation of laryngeal receptors is known to produce reflex laryngeal closure, cough is the usual response during wakefulness. Treatment aimed at reducing upper airway irritation and voluntary inhibition of coughing appeared successful in reducing the incidence and severity of the episodes. Recognition of the condition is important as it may be confused with other causes of acute dyspnoea and it appears to respond to specific management.
 ...
PMID:Brief upper airway (laryngeal) dysfunction. 228 83

Sleep apnoea syndrome, consisting of daytime sleepiness and loud snoring, is caused by obstruction of the upper airways. This paper reviews the techniques which could be used for localising and quantifying the degree of obstruction while the patient is sleeping. Each has specific limitations and it is concluded that while none is ideal, magnetic resonance imaging and ultrasound show the greatest promise.
 ...
PMID:Upper airway imaging. 228 39


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