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)

This review summarizes briefly the present knowledge on sleep-related factors in ischaemic heart disease. A marked circadian rhythm in the frequency of onset of acute myocardial infarction has been found, but the exact mechanism is not known. The circadian variation is possibly explained by several mechanisms. The best documented is sleep apnoea syndrome, which seems to be a risk factor for ischaemic heart disease and stroke. Stressful REM-sleep seems to be potentially arrhythmogenic in patients with decreased cardiopulmonary function. The role of coronary spasm, increased thrombocyte aggregation and mental stress in sleep disorders is still poorly understood.
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PMID:Cardiovascular stress and sleep. 331 Aug 37

Cine CT, with its very rapid imaging capabilities, was used to evaluate eight adult patients suspected of nonfixed upper airway obstruction. A method was developed for such imaging, which provides 10 images at each of 12 contiguous levels, extending from the soft palate through the extrathoracic trachea. These give a dynamic view of the airway during at least one full respiratory cycle and take about 6 sec to obtain. Results were compared with similar studies in 10 normal volunteers. Seven of the patients showed intermittent obstruction on cine CT, while the eighth was judged normal. All results agreed with subsequent further investigations or confirmed clinical diagnoses. The pathology demonstrated included chondromalacia, laryngeal spasm, and polychondritis. Four patients were evaluated for sleep apnea. All showed dynamic abnormalities of the airway, although they were studied awake and asymptomatic, during normal quiet respiration. All were subsequently shown to have severe sleep apnea. We conclude that cine CT has the potential to provide information quickly and noninvasively on upper airway dynamics and has certain definite advantages over conventional studies.
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PMID:Cine CT demonstration of nonfixed upper airway obstruction. 348 39

A rare case of idiopathic laryngeal spasm presented itself as sleep apnea in a middle-aged man. A tracheostomy followed by the division of the recurrent laryngeal nerve relieved all of the symptoms.
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PMID:Division of the recurrent laryngeal nerve for idiopathic laryngeal spasm. 359 75

Factors precipitating nocturnal myocardial ischaemia were investigated in 10 patients with frequent daytime and nocturnal angina pectoris. Eight patients had fixed obstructive coronary artery disease or a low exercise threshold or both before the onset of ischaemia. Two patients had variant angina with normal coronary arteries and negative exercise tests. During sleep the electrocardiogram, electroencephalogram, electro-oculogram, electromyogram, chest wall movements, nasal airflow, and oxygen saturation were continuously measured. Forty two episodes of transient ST segment depression were recorded in the eight patients with coronary artery disease and 26 episodes of ST segment depression and elevation in the two patients with variant angina and normal coronary arteries. All episodes of ST segment depression in the former group of patients were preceded by an increase in heart rate as a result of arousal and lightening of sleep, bodily movements, rapid eye movement sleep, or sleep apnoea (one episode). In contrast, in the variant angina group no increase in heart rate, arousal, or apnoea preceded 23 of the 26 episodes of ST segment change. Thus increase in myocardial oxygen demand was important in precipitating nocturnal angina in patients with coronary artery disease and reduced coronary reserve. In the patients with coronary spasm these factors did not often precede the onset of nocturnal myocardial ischaemia.
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PMID:Nocturnal angina: precipitating factors in patients with coronary artery disease and those with variant angina. 376 13

Patients with sleep apnea syndrome often suffer from cardiovascular disease, but the incidence of coronary artery disease (CAD) with coronary spasm in these patients is not known. In the present study, 14 of 37 men with sleep apnea syndrome diagnosed by all-night polysomnography were suspected to also have CAD, based on the results of non-invasive clinical examinations. Coronary angiography confirmed the diagnosis of CAD either organic stenosis or coronary spasm in 8 of the 14 patients. Those 8 did not differ significantly from the 21 patients without CAD, with regard to coronary risk factors or to the severity of their sleep apnea (apnea index, 4% desaturation ratio, and nadir of SaO2). Eleven patients received intracoronary injections of acetylcholine, which induced coronary spasm in 4 (36.4%) and coronary contraction in 2 (18.2%). Coronary spasm was induced in 4 of the patients with CAD (50.0%). Although the pathophysiologic link between sleep apnea syndrome and CAD is still unclear, these results suggest that patients with this syndrome frequently suffer from CAD, particularly from coronary spasm.
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PMID:[Association between sleep apnea syndrome and coronary artery disease]. 907 Nov 51

Vagal nerve stimulation (VNS) is a surgical option to treat drug-resistant epilepsy. A few side effects have been described, mainly as anecdotal reports. We analysed our material concerning a juvenile population to identify the most common and most important complications, discussing them with the literature. Thirty-six patients were studied (18 months-18 years old). The children were assessed before the VNS implant and 3, 6, 12, 24 and 36 months after surgery. The mean follow-up was 30 months. Four patients required a second surgery: two for changing the device 3 years after implant; one for revision of an imperfect implant; one for removing a non-functioning device. In one patient a transient vocal cord paralysis was observed. Hoarseness was the main complaint (38.8%). More infrequent was mild sleep apnoea (8.3%), sternocleidomastoid muscle spasm, drooling and snoring in one patient each. Skin scars were reported with a different frequency according to the surgical technique. At variance with the literature reports, we did not observe infections. Side effects of VNS can be minimised, but not avoided completely, with a correct technical procedure, which in turn depends upon a thorough knowledge of vagus nerve anatomy.
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PMID:Complications of vagal nerve stimulation for epilepsy in children. 1651 39

Intermittent vagus nerve stimulation can reduce the frequency of seizures in patients with refractory epilepsy. Stimulation of vagus nerve afferent fibers can also cause vocal cord dysfunction, laryngeal spasm, cough, dyspnea, nausea, and vomiting. Vagus nerve stimulation causes an increase in respiratory rate, decrease in respiratory amplitude, decrease in tidal volume, and decrease in oxygen saturation during periods of device activation. It usually does not cause an arousal, or a change in heart rate or blood pressure. Most patients have an increase in their apnea-hypopnea index (AHI). Patients with VNS can have central apneas, obstructive hypopneas, and obstructive apneas. These respiratory events can be reduced with changes in the vagus nerve stimulator operational parameters or with the use of CPAP. In summary, there are complex relationships between epilepsy and obstructive sleep apneas. In particular, patients with refractory epilepsy need assessment for undiagnosed and untreated obstructive sleep apnea before implantation of vagus nerve stimulator devices. Patients with vagus nerve stimulators often have an increase in apneic events after implantation, and these patients need screening for sleep apnea both before and after implantation.
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PMID:Obstructive sleep apnea and respiratory complications associated with vagus nerve stimulators. 2189 79

There exist a large number of drugs belonging to the benzodiazepine family. These include the 1,4-benzodiazepines such as diazepam, temazepam and oxazepam, the often more potent diazolo- and triazolo-groups represented by alprazolam, midazolam, triazolam etc. These drugs represent a large range of potencies from submilligram doses to over 100 mg and a range of polarities. Consequently, blood or plasma concentrations associated with prescribed use range from sub-nanogram per mL to near-microgram per mL. Their medical use varies, but they are predominantly used as hypnotics and sedatives. Some members are also used in the treatment of post-traumatic stress and obsessive-compulsive disorders, alcohol withdrawal, muscle spasm, and seizures. Recreationally, drug users favor these drugs to reduce the symptoms of withdrawal and unpleasant effects of heroin and cocaine. They are also commonly used as "date-rape" drugs to render a victim incapable of resisting an attack. Benzodiazepines elicit a large number of physiological and psychological responses in humans that often can lead to significant behavioral changes and adverse effects on skills required for safe driving. These include reduced lane control, increased reaction times, reduced hand-eye coordination and cognitive impairment. Impairment can exceed that seen with 0.05 g% ethanol. In high doses benzodiazepines can cause persons to exhibit classical features of CNS-depressant drugs such as nystagmus, ataxia, slurred speech, and impaired divided attention skills. As one would expect with hypnotics and sedatives, any sleep deprivation, or situations involving monotonous driving can lead to a reduced ability to concentrate and maintain vigilance. Adverse effects on REM and NREM sleep patterns will exacerbate fatigue-related components to driving. Persons with sleep abnormalities, e.g., sleep apnea, may be more likely to be affected by benzodiazepines than those with normal sleep patterns. Ethanol and narcotic analgesics also affect sleep patterns and may compound any CNS-depressant effects associated with the use of benzodiazepines.
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PMID:Benzodiazepines - Effects on Human Performance and Behavior. 2625 85