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

The diagnosis of obstructive sleep apnea is frequently made by taking a meticulous history coupled with a high index of suspicion. Snoring and hypersomnolence are clinical features common to individuals with sleep apnea. Since snoring is said to be a "disease of listeners," it is not uncommon that bed partners reported an increased incidence of depression and marital displeasure. It is for this reason that the spouse or bed partner should be interviewed, since the patient may not be aware of any sleeping problems. Physicians should also be alert to complaints of excessive daytime somnolence, because studies have shown that patients with obstructive sleep apnea are at increased risk for automobile crashes. It has been estimated that approx 58,000 motor vehicle accidents involving people with sleep apnea will occur in the US each yr. By proper diagnosis and treatment, the physician is in a unique position to prevent at least some of the automobile accidents that result from falling asleep while driving. Polysomnography is the only definitive way to obtain a diagnosis of sleep apnea. This allows the physician not only to diagnosis the disorder, but also helps in the evaluation of the severity of the syndrome and selection of therapy. An ENT evaluation is also important in ruling out anatomic disorders that can cause upper airway obstruction. Certain factors, such as alcohol and sedative ingestion, may aggravate the condition in a person predisposed to sleep apnea, and subtle changes, such as unexplained hypertension, polycythemia, and cor pulmonale, should lead one to investigate the possibility of sleep apnea as the etiology.
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PMID:Diagnosis of obstructive sleep apnea. 229 95

An increasing number of loud snorers seek medical attention because of the social impact of snoring as well as its association with sleep apnea. Uvulopalatopharyngoplasty is reported to reduce or eliminate snoring in the majority of patients; however, little data are available to document the procedure's success. From February 1987 through August 1988, 125 patients underwent uvulopalatopharyngoplasty for habitual snoring; many of these patients had also documented sleep apnea. Of the 74 patients who responded to a postoperative questionnaire, 64 (86.48%) indicated that their snoring was either completely eliminated or markedly reduced. Only two patients reported significant side effects.
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PMID:The surgical treatment of snoring: a patient's perspective. 229 53

Patients with clinical features of sleep apnea syndrome (SAS) and self-reported sleep spells at the wheel do poorly in simulated monotonous driving. To evaluate whether drivers with defined symptoms of SAS (heavy snoring, sleep disturbances and daytime sleepiness) compensate in real traffic by careful driving or not, the rate of car accidents over a 5-year period was investigated. A questionnaire was addressed to 140 patients with and 142 controls without symptoms associated to SAS. Seventy-three of the patients had a complete triad of SAS-associated symptoms. Fifty-two percent of these patients reported habitual sleep spells at the wheel, as opposed to less than one percent by the controls. The ratio of drivers being involved in one or more combined-car accident was similar for patients and control drivers, but for single-car accidents the ratio was about 7 times higher for patients with a complete triad of symptoms of SAS compared to controls (p less than 0.001). When corrected for mileage driven, the total number of single-car accidents was almost 12 times higher among patients with sleep spells whilst driving, compared to controls (p less than 0.001). It is concluded that drivers with the clinical features of SAS are at increased risk especially for single-car accidents and that the risk seems to vary with the severity of symptoms.
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PMID:Clinical symptoms of sleep apnea syndrome and automobile accidents. 230 60

Snoring was investigated in a survey of respiratory disease in Hispanic-Americans of a New Mexico community. A population-based sample of 1222 adults was studied with questionnaires and measurements of height, weight, and blood pressure. The age-adjusted prevalence of regular loud snoring was 27.8% in men and 15.3% in women. Snoring prevalence increased with age and obesity in both men and women. Cigarette smoking was also associated with snoring, but chronic obstructive lung disease and alcohol consumption were not. Snorers more frequently had hypertension, ischemic heart disease, and excessive daytime sleepiness. In contrast to other studies, after adjustment for confounding factors, there was no effect of snoring on hypertension (odds ratio, 1.0; 95% confidence interval, 0.7 to 1.5), but an effect on myocardial infarction was still demonstrable (odds ratio, 1.8; 95% confidence interval, 0.9 to 3.6). The association of snoring with sleepiness suggests that respiratory disturbance of sleep related to upper airway obstruction, such as sleep apnea, occurs more frequently in snorers in this population.
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PMID:Snoring in a Hispanic-American population. Risk factors and association with hypertension and other morbidity. 231 Feb 78

During physical examination of patients with suspected obstructive sleep apnea (OSA), a comment is frequently made that they appear to have a short and fat neck. To confirm this subjective impression by objective measurements, we studied a group of 123 patients referred to us because of snoring and suspected OSA, all of whom had nocturnal polysomnography and measurements of external and internal neck circumference. The external neck circumference was measured at the level of the superior border of the cricothyroid cartilage. Internal neck circumferences were calculated from the measurements of pharyngeal, glottic, and tracheal areas obtained by the acoustic reflection technique. Internal pharyngeal circumference was further subdivided into the proximal, middle, and distal thirds. The acoustic technique also permitted us to measure the distance between the teeth and the glottic minimum, which reflects the length of the upper airway. Stepwise multiple linear regression analysis revealed that the apnea/hypopnea index (AHI) correlated only with the external neck circumference, the body mass index, and the internal circumference of the distal pharynx; these three variables accounted for 39% of the variability in AHI. We conclude that the external and internal neck circumferences and the degree of obesity are important predictors of sleep apnea; it is possible that obesity produces its effect via fat in the neck. We speculate that the static pharyngeal size modulated by the dynamic loading of the airway due to the weight of fatty tissue of the neck may contribute to the pathogenesis of OSA.
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PMID:Do patients with obstructive sleep apnea have thick necks? 198 79

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

A cephalometric study was carried out on 98 patients assigned to 3 groups including 48 patients with sleep apnea, 25 patients with chronic rhonchopathy without apnea, and 25 controls, respectively. 44 patients benefited from lateral teleroentgenographic investigations and 54 had sagittal-median NMR sections visualized. Various distance, angle and area measurements were obtained. The authors found that anomalies were the more severe that snoring was associated with sleep apnea. These arguments speak for an evolutional character of the disease. The various cephalometric anomalies were primarily related to the hyoglossal apparatus, more rarely to the maxillary-mandibular basal bones. After this analysis, the authors propose a therapeutic strategy for the management of chronic snoring associated with sleep apnea.
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PMID:[Physiopathologic value of cephalometric teleradiography study and magnetic resonance imaging in sleep apnea syndromes. Therapeutic deductions]. 234 22

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

We compared self- and spouse reports of snoring and other symptoms of sleep apnea syndrome ascertained from married couples in a community-based survey. Agreement between the two types of report varied between 70-98%, but was modest (kappa = -0.01-0.52) when adjusted for chance. For men, spouse reports yielded higher prevalence rates for snoring and for four other symptoms. For women, estimates of symptom prevalence were consistently lower by spouse report than by self-report. In multivariate analyses, the effect on snoring of gender and obesity increased and of age decreased when spouse reports were compared to self-reports. Snoring, according to spouse reports, was a significant risk factor for ischemic heart disease, but snoring according to self-reports showed a smaller effect and was not statistically significant. Snoring was not associated with hypertension when defined by either self- or spouse report. These observations suggest that questionnaire data of snoring and other symptoms of sleep apnea syndrome may be misclassified in part, and that such misclassification can affect estimates of prevalence and effects.
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PMID:Comparison of self- and spouse reports of snoring and other symptoms associated with sleep apnea syndrome. 235 96

The old Indian literature describes a technique known as Sutra-Neti. That is, passing a catheter or similar material through the nose and out of the mouth as a means of clearing the airway. One of our patients adapted this method, tying the catheter end to end, in order to control his severe snoring and obstructive sleep apnoea. This was effective for several months. He subsequently responded well to a uvulopalatopharyngoplasty.
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PMID:Simple treatment for snoring also a means of prediction of uvulopalatopharyngoplasty success? 237 Apr 74


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