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

A new wrist actometer was used to obtain ambulatory activity-rest recordings in 18 patients with sleep apnea syndrome (SAS) and in 22 control subjects. A movement index (MI) and a fragmentation index (FI) during sleep time were computed, giving an estimate of the stability of sleep. In control subjects, we observed a clear differentiation between night and day activity levels. The distribution of MI and FI was very narrow, with a mean +/- SD of 13.9 +/- 5.4 and 16.1 +/- 5.8%. No correlation of MI and FI with body mass index, even in heavily obese subjects, was found; MI and FI decrease significantly with age. A diagnosis of SAS was made by standard all-night polysomnography. Patients with SAS had a significantly higher MI and FI than did control subjects (p less than 0.001). With respect to polysomnographic diagnosis of SAS, the sensitivity of activity recordings was 89%, whereas the specificity was 95%. Five patients were studied after treatment, and decreases in MI and FI at home were in good agreement with the improvement in their sleep as assessed clinically and by polysomnography. We conclude that this technique is useful for an objective measurement of sleep restlessness and fragmentation, and for a simple evaluation of therapeutic effects under real life conditions in SAS.
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PMID:Ambulatory evaluation of sleep disturbance and therapeutic effects in sleep apnea syndrome by wrist activity monitoring. 366 39

Hypoxaemia during the rapid eye movement phase of sleep is common in older healthy normal subjects over 55 years of age; the sleep apnoea syndromes--such as obstructive sleep apnoea, where oro-nasal airflow ceases for more than 10 seconds on many separate occasions throughout the night, due to failure of contraction of the genio-glossus muscle; "blue and bloated" patients with chronic bronchitis and emphysema, where profound nocturnal hypoxaemia is common in REM sleep, and is associated with further elevation of pulmonary arterial pressure; the overlap syndrome--where "blue and bloated" chronic bronchitis is associated with an obstructive sleep apnoea syndrome; and bronchial asthma, where hypoxaemia is associated with irregular breathing and possibly nocturnal bronchoconstriction. Although absolute recognition depends upon all night sleep studies, monitoring of ear oxygen saturation, breathing patterns, and EEG, the clinical features when awake can lead to suspicion of sleep hypoxaemia--as, for example, obesity and obstructive sleep apnoea with loud snoring and restlessness in sleep, hypoxaemia during wakefulness in the overlap syndrome, and nocturnal awakening with wheeze in bronchial asthma. Treatment depends on the cause, and may vary from weight loss and nasal continuous positive airway pressure in obstructive sleep apnoea, to nocturnal oxygen in "blue bloaters", a combination of these two in the overlap syndrome, and long acting bronchodilators such as slow release theophyllines in nocturnal asthma. Recognition and appropriate treatment of nocturnal hypoxaemia is an important new development in respiratory medicine.
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PMID:Breathing during sleep. 390 86

An obese patient with sleep apnea and chronic obstructive pulmonary disease was difficult to sedate and ventilate after tracheostomy. High peak inspiratory pressures and severe patient agitation persisted despite sedation with lorazepam, and threatened security of the tracheostomy. The use of a ketamine infusion sedated the patient and allowed weaning to progress uneventfully.
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PMID:Use of ketamine to wean a patient with sleep apnea. 394 24

The presenting symptom complex, diagnostic features, and therapeutic alternatives for obstructive and central sleep apnea are discussed in relation to two illustrative patients. Heavy snoring and restlessness during sleep in an obese individual, usually a male, may indicate obstructive apnea. Daytime hypersomnolence, intellectual deterioration, mental depression, impotence, cardiac arrhythmias, cor pulmonale, systemic hypertension, and erythrocytosis are the most common complications. Tracheostomy, the classic form of therapy, can be replaced by pharmacologic intervention in most patients. The clinical presentation of central apnea is less dramatic, but neurological and cardiac complications can occur. Therapy is less well established for this entity. Knowledge of the increased incidence of these disorders and awareness of more subtle complications indicate that sleep apnea should be placed in the differential diagnosis of pulmonary and systemic hypertension, hypersomnolence states, mental deterioration, psychiatric illness, and even insomnia.
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PMID:Diagnosis and therapy of sleep apnea. 722 83

Sleep disturbance among uremic patients is reported to be high, but data on the actual prevalence, clinical significance, and causative factors is limited. A sleep questionnaire was distributed to an entire hemodialysis unit of 64 patients. Of the 54 patients who completed the survey, 83.3% had sleep-wake complaints. Disturbed sleep was reported by 28 patients (51.8%), and causes were secondary to delayed sleep onset in 25 patients (46.3%), frequent awakening in 19 patients (35.2%), restless legs syndrome (RLS) in 18 patients (33.3%), and generalized restlessness in six patients (11.1%). Daytime sleepiness was the most frequent complaint, reported by 36 patients (66.7%), and RLS was the second most frequent specific complaint, reported by 31 patients (57.4%). Symptoms of sleep apnea were described by seven patients (13.0%). Male gender, age more than 60 years, RLS, and caffeine intake were associated with more sleep-wake complaints (P = 0.009, P = 0.002, P = 0.028, and P = 0.008, respectively). Urea and creatinine levels were higher in patients with RLS (P = 0.04 and P = 0.08, respectively); otherwise, no other metabolic or demographic variable was associated with specific sleep disorders or disturbance. Sleep problems are very common in dialysis patients and likely contribute to the impaired quality of life experienced by many of these patients.
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PMID:Sleep complaints are common in a dialysis unit. 748 27

Insomnia dominates the sleep disorders of the elderly. Sleep apnea, the restless legs syndrome and nocturnal agitation represent other facets. After eliminating the possibility of painful or degenerative organic disease, iatrogenic cause and mode of life, other symptoms should be sought, namely mental and personality-related. Investigation requires polysomnogram recording, supported by careful history-taking, including objective and subjective factors. Treatment includes notions of diet, biological rhythm and desynchronisation. It should take into consideration the deleterious effects of prolonged use of certain psychotherapeutic agents.
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PMID:[Sleep disorders in the elderly]. 793 8

1. Although no clear definition of "sundowning" or "sundown syndrome" exists in the literature, most health care professionals affix either of these terms to the behavior observed in patients with dementia associated with increased agitation and confusion that occurs in the late afternoon. 2. Specific etiologic hypotheses that relate to sundowning behavior include disturbance in Rapid Eye Movement (REM) sleep, episodes of sleep apnea, and a deterioration of the suprachiasmatic nucleus of the hypothalamus. 3. Management of sundowning behavior includes the identification and treatment of any physiologic factors, low doses of specific neuroleptics, and nonpharmacological interventions such as restriction of daytime sleep, exposure to bright lights during the day, and mild activity schedules.
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PMID:Sundown syndrome: etiology and management. 873 82

Recognizing the signs and effects of pediatric apnea is essential for accurate diagnosis and treatment of children with psychological difficulties. Sleep apnea can have serious deleterious effects on children's cognitive, behavioral, and physiological functioning. Diurnal effects include inattention, decreased academic performance, oppositionality, and restlessness, stemming from frequent nocturnal arousals, excessive daytime sleepiness, and hypoxia. Clinically, the effects of pediatric apnea appear similar to characteristics of other childhood disorders, most notably attention deficit hyperactivity disorder. Efforts to screen for sleep apnea should be regularly employed, especially for children who present with the symptoms discussed. Additional study of pediatric apnea is needed to heighten clinicians' awareness and improve diagnostic accuracy.
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PMID:Neuropsychological features and differential diagnosis of sleep apnea syndrome in children. 929 88

Restless-legs syndrome and periodic movements during sleep are associated with sleep apnoea syndrome. Similar to sleep apnoea syndrome, restless-legs syndrome and periodic movements during sleep may cause severe hyposomnia and hypersomnia. Exact diagnosis may partly fail in severe obstructive sleep apnoea syndrome if only cardiorespiratory polygraphy is performed. Simultaneous videorecordings and EMG of mm. tibialis ant. ensure diagnosis. Therapeutic regime may be difficult due to failure or side effects, however. We report on our experience in an one-year follow-up of 12 patients with sleep apnoea syndrome and restless-legs syndrome and/or periodic movements during sleep. Despite adequate interdisciplinary initiation of therapy and monitoring, these patients are often subject to therapy changes, failures or side effects. There was no correlation between jerks and the complaints of the patients.
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PMID:[Restless legs syndrome and periodic leg movements during sleep in patients with sleep apnea--a therapeutic problem?]. 934 Jun 24

A 52-yr-old man with a residual phase of schizophrenia developed sleep apnoea-hypopnoea syndrome (SAHS). After five days of continuous positive airway pressure (CPAP) treatment, the patient developed an aggressive mood with incoherence, prominent hallucinations and agitation, and attempted to hit his relatives. He was finally admitted to the hospital with an acute psychotic episode. Withdrawal of CPAP, and neuroleptic treatment controlled the episode, and clinical symptoms of SAHS reappeared 10 days later. Schizophrenia associated to sleep apnoea-hypopnoea syndrome has rarely been reported, but, to the authors' knowledge, the induction of a psychotic episode by continuous positive airway pressure treatment in a patient with sleep apnoea-hypopnoea syndrome and coexisting schizophrenia has never been previously reported.
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PMID:Acute psychosis after CPAP treatment in a schizophrenic patient with sleep apnoea-hypopnoea syndrome. 1133 36


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