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

The sleep apnea syndrome is often associated with the syndromes of daytime exhaustion and involuntary daytime sleeping fits. The cause is assumed to be fragmentary sleep resulting from night-time arousal. The central nervous activation reactions caused by apnea or hypopnea, respectively, and not the movement arousal determine the sleep structure. We have examined 10 male patients in the age range 40-55 years (48 +/- 6 SD) before and during the first 3 nights of CPAP therapy. Cardiorespiratory polysomnography was performed in all four nights. Sleep way analyzed visually and differentiation was made between respiratory (RA) and movement arousal (MA). All 10 patients had a pronounced sleep apnea syndrome. Deep and dream sleep were reduced, significantly more respiratory arousals occurred than movement arousals. The SWS latency was shortened in the first therapy night, the deep and dream sleep proportions increased and the RA decreased significantly. No further significant changes in the sleep parameters occurred during the second and third nights. We found that the number of apnea/hypopnea was not equal to the number of RA. When less arousal was recognized it was suggestive of a deficit of the diversion function while more RA was indicative of additional respiratory events, e.g. pharyngeal obstructions and hyperventilations which were not recognized as apnea or hypopnea. In addition to its role in the differential diagnosis of sleeping disorders, in particular sleep apnea, arousal differentiation is also an important criterion for estimating the efficiency of CPAP therapy.
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PMID:[Differentiation of arousal in sleep before and after CPAP therapy in patients with pronounced sleep apnea syndrome]. 761 93

In 1,150 patients with sleep apnea syndrome, the apnea number, the morning theophyllin level, the symptom of morning exhaustion were recorded for the first night of theophyllin therapy and in the follow-up period of up to 5 years; in addition, side effects were noted at the end of the observation period. Prior to start of the therapy, the average apnea number was 97 per night; this decreased to 25 per night in the initial therapy. In the observation period of between 3 and 28 months, the number of apnea phases increased slightly on average. The symptoms of morning exhaustion initially decreased to 60% but increased again by about 20% over the next five years. In responders, theophyllin reduces the number of apnea in the long term course; however, frequent therapy controls are needed to determine the optimal dosage. Longitudinally, patients with an apnea index < 20/profited most from this drug therapy.
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PMID:[Theophylline acceptance in long-term therapy of patients with obstructive sleep related respiratory disorder]. 761 12

The PPS is now a well-recognized entity encompassing the late manifestations that occur because of previous poliomyelitis. Common signs and symptoms include fatigue, cold intolerance, joint deteriorations with pain, and prominent neurologic problems that include new weakness, muscle pain, atrophy, respiratory insufficiency, dysphagia, and sleep apnea. It is estimated that there are 1.63 million polio survivors in the United States and that half of them will develop PPS. PPS and PPMA usually begin 30 to 40 years after the acute illness and are very slowly progressive. The etiology is unclear, although premature exhaustion of the new sprouts that develop after acute poliomyelitis and of their motor neurons appears most likely. Less likely is a persistent polio-virus infection or an immune-mediated problem. Treatment is primarily supportive, although nonfatiguing strengthening exercise may improve strength over the short term. The long-term effects of this type of exercise remain to be clarified.
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PMID:Post-polio syndrome: an update. 827

Chronic heart failure (CHF) is a common condition and is associated with excess morbidity and mortality, in spite of the many advances in its treatment. Chronic stable heart failure is also associated with an increased incidence of sleep-related breathing disorders, such as central sleep apnoea (CSA) and Cheyne Stokes respiration (CSR). Continuous positive airways pressure (CPAP) has been shown to alleviate the symptoms of CHF, improve left ventricular function and oxygenation. To a certain extent, CPAP also abolishes sleep-related breathing disorders in patients with chronic heart failure. In patients with acute pulmonary oedema, the use of positive pressure ventilation improves cardiac haemodynamic indices, as well as symptoms and oxygenation, and is associated with a lower need for intubation. However, some studies have cast doubts about its safety and suggest a higher rate of myocardial infarction associated with its use. In our opinion, non-invasive positive pressure ventilation and CPAP offers an adjunctive mode of therapy in patients with acute pulmonary oedema and chronic heart failure, who may not be suitable for intubation and in those not responsive to conventional therapies. Non-invasive ventilation also helps to improve oxygenation in those patients with exhaustion and respiratory acidosis. Many trials are still ongoing and the results of these studies would throw more light on the present role of non-invasive ventilation in the management of CHF.
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PMID:Positive pressure ventilation in the management of acute and chronic cardiac failure: a systematic review and meta-analysis. 1638 32

In this paper the use of an accelerometer to measure cardio-respiratory activity is presented. Movement of the chest was recorded by an accelerometer attached to a belt around the chest. The acquisition is realized in different status: normal, apnea, deep breathing or after exhaustion and also in different postures: vertical (sitting, standing) or horizontal (lying down). The resulting signal was compared with reference measurements. The results of experimental evaluation indicate that using a chest-accelerometer can correctly detect the respiratory waveform and heart rate (HR) signal. This method is therefore suitable for automatic identification some disease, for example arrhythmia or sleep apnea.
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PMID:Estimation of respiratory waveform and heart rate using an accelerometer. 1916 19

The strongly pronounced obstructive sleep apnoea syndrome can lead to serious traffic accidents if the driver falls asleep at the wheel. This article deals with the insurance law consequences, especially with the problem if the insurer raises the objection that the sleep apnoea sufferer acted grossly negligent. Since the new German Insurance Contract Act of 1 (st) January 2008 paragraph 81 regulates a benefit reduction in cases of gross negligence by the insurant. The insurer can shorten assurance benefit according to the degree of fault. In the literature it is proposed to grade the level of grossly negligence into low, middle and serious forms of default. Usually the driver notices clear signs of exhaustion in the current state of medical science. If he ignores obvious facts of exhaustion the insurer can shorten assurance benefits percentual. When the driver dozes off after a long trip although he has noticed his exhaustion, a case of gross negligence exists. Here the insurer can reduce the assurance benefit by about 50 %. Does the sleep apnoea sufferer always act in a grossly negligent manner in cases of microsleep? This point has not yet been decided by the German jurisdiction in favour of the policyholder. The jurisdiction is aware of the fact that in the case of sleep apnoea fatigue does not necessarily need to precede the act of falling asleep. In the opinion of the author it has to be distinguished between medicated and not medicated sleep apnoea and further if the sufferer knows about his disease. If the sleep apnoea sufferer has known of the risk of sudden microsleep, for example, after being warned by his doctor who discovered the disease, gross negligence cannot be dismissed and assurance benefit has to be reduced by about 65 %.
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PMID:[Does the sleep apnoea sufferer act grossly negligent according to paragraph 81 of the new German Insurance Contract Act (VVG) when he causes a traffic accident through microsleep?]. 1925 15

The effect of sleep on work is now receiving appropriate research attention, yet most results have been based on community (i.e., nonclinical) populations. Based on previous findings that clinical treatment for diagnosed obstructive sleep apnea benefits sleep quality, we hypothesized that sleep quality would mediate the effects of such treatment on work withdrawal behaviors (i.e., emotional exhaustion, cognitive distraction, work neglect, and partial absenteeism). A total of 125 adults with potential sleep apnea, who were referred to a midsized hospital's sleep disorders laboratory, participated in this 3-wave (pretest, posttest 1 month following initial treatment, and a follow-up 3 months later), quasi-experimental study. Clinical assessment using pretest data resulted in 83 participants being diagnosed with sleep apnea and receiving treatment (i.e., continuous positive airway pressure, n = 62; or positional therapy, n = 21); 42 patients who were not diagnosed with sleep apnea comprised the control group. Consistent with our hypotheses, treatment positively affected sleep quality, which in turn decreased emotional exhaustion, cognitive distraction, and partial absenteeism (but not work neglect). We discuss the implications of these findings for future research on sleep and its work-related consequences and organizational practice. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Indirect effects of obstructive sleep apnea treatments on work withdrawal: A quasi-experimental treatment outcome study. 3235 18