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)

A patient with congenital micrognathia, hypersomnia and severe pulmonary hypertension which resulted in sudden death during sleep is described. Hypersomnolence is a well-recognized manifestation of the pickwickian syndrome. A less recognized but similar disorder may affect patients with congenital or acquired micrognathia. The pathogenesis of this syndrome and obstructive sleep apnoea are reviewed. Tracheostomy timeously performed may be life-saving and the value of early resort to this apparently drastic procedure in a high-risk patient is emphasized.
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PMID:Micrognathia, obstructive sleep apnoea and cor pulmonale--a case for tracheostomy. 396 2

Four patients who were evaluated for hypersomnia-sleep apnea syndrome were found in all-night sleep studies to have obstructive or mixed apneas related to their sleeping positions. All four were available for comprehensive follow-up and were subsequently restudied while avoiding the supine position. Supine, prone, and lateral decubitus apnea indices were calculated for each patient for each night. The supine sleeping position was associated with significantly more apneas than the non-supine positions. Keeping these patients off their backs when they slept was effective treatment. Additionally, when results of surgical or pharmacologic treatments of apnea are evaluated, positional apnea indices should be considered.
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PMID:Sleeping position and sleep apnea syndrome. 407 78

Neurologists are becoming increasingly aware of the frequency and clinical importance of sleep-related respiratory impairment. Sleep-induced narrowing of the upper airways underlies the widespread and supposedly trivial complaint of snoring, which may not only constitute a risk factor for the cardiocirculatory system, but in predisposed individuals, may lead to a sleep apnea syndrome, with its array of serious disturbances, including hypersomnia, systemic and pulmonary hypertension and ultimately heart failure. Idiopathic chronic alveolar hypoventilation, or Ondine's curse, is a fairly stereotyped clinical syndrome: sleep-related respiratory insufficiency in the absence of airways stenosis. Finally, sleep, and REM sleep in particular, significantly aggravates hypoventilation in patients with chronic obstructive pulmonary disease (COPD), kyphoscoliosis or chest musculoskeletal disorders.
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PMID:Sleep-related respiratory disorders. 408 59

Persistent or periodic day-time drowsiness is an important cause of poor work, under-achievement, and social disaster. Somnolence may be associated with anxiety, ill-health, and poor or inadequate night-sleep, but also results from a group of sleep disorders including idiopathic hypersomnolence and sleep apnoea. Idiopathic hypersomnolence seems to be a genetic disorder of non-rapid-eye-movement sleep and is distinct from narcolepsy which is a disorder of rapid-eye-movement sleep. Day-time sleepiness in sleep apnoea is probably due to inadequate night sleep. The diagnosis of these disorders depends largely on the history. Treatment of hypersomnia with central stimulant drugs is often unsatisfactory, particularly in the elderly, and tracheostomy rather than medical treatment is sometimes essential in sleep apnoea.
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PMID:Day-time drowsiness. 611 40

Adenosine 3',5'-monophosphate (cyclic AMP), 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were determined in the cerebrospinal fluid of patients with respiratory disorder and hypersomnia and in control patients. Patients with the sleep apnoea syndrome confirmed polygraphically showed elevated levels of cyclic AMP and 5-HIAA. Cyclic AMP levels were inversely correlated with arterial Po(2), measured under resting conditions. The level of HVA also was raised, but the change was not statistically significant.
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PMID:Cerebrospinal fluid adenosine 3',5'-monophosphate, 5-hydroxyindoleacetic acid and homovanillic acid in patients with sleep apnoea syndrome. 617

In order to explore the efficacy of expiratory positive airway pressure (EPAP) in the prevention of sleep-induced respiratory abnormalities, we studied 9 patients with typical presentation of hypersomnia-sleep apnea syndrome 1 wk apart, without and with 10 cm water of EPAP. We found that EPAP significantly reduced apnea index (p less than 0.01), maximal and mean duration of apneas (p less than 0.01) and desaturation index (p less than 0.001), and significantly improved mean and minimal oxygen saturation (p less than 0.01) and awake supine arterial oxygen saturation (p less than 0.01) in all 9 patients. We also found that EPAP significantly decreased the relative time spent in Stages 1 and 2 NREM sleep (p less than 0.01) and increased the relative time spent in Stages 3 and 4 NREM sleep (p less than 0.01). These results indicate that EPAP reduces frequency and duration of apneas and the degree of nocturnal oxygen desaturation and improves sleep quality in patients with hypersomnia-sleep apnea syndrome.
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PMID:Effects of expiratory positive airway pressure on sleep-induced respiratory abnormalities in patients with hypersomnia-sleep apnea syndrome. 635 28

Patients afflicted with obstructive hypersomnia sleep apnea (HSA) have been treated traditionally with permanent tracheostomy. More recently, an association between HSA and mandibular retrognathism has been noted. Several centers have reported rapid reversal of HSA symptoms in retrognathic patients after mandibular advancement. Their experiences are outlined; the anatomy and pathophysiology leading to obstructive HSA are reviewed, and the recommendations for evaluation and patient management are discussed.
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PMID:Maxillo-facial surgical approach: an introduction and review of mandibular advancement. 636 Feb 55

A patient was seen for evaluation of excessive daytime sleepiness, which was exacerbated following complications secondary to surgical reconstruction of the pharynx for a submucous cleft palate. She underwent recordings in the sleep laboratory and was found to have sleep apnea. Also, a thorough clinical and laboratory assessment established the diagnosis of myotonic dystrophy. Following tracheostomy, both the patient's sleep apnea and daytime hypersomnia were eliminated. Our case demonstrates that surgical procedures involving the upper airway should be approached with considerable caution in patients with myotonic dystrophy and only after the presence of associated sleep apnea has been carefully excluded. An original finding is the suggestion of a decrease in the number of T-cell lymphocytes in a patient with myotonic dystrophy.
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PMID:Sleep apnea precipitated by pharyngeal surgery in a patient with myotonic dystrophy. 647 82

Observations are described in 12 massively obese patients (5 women, 7 men), aged 25 to 59 years (mean 37), who weighed 312 to more than 500 pounds (mean 381). Seven patients had had systemic hypertension, 4 hypersomnia or sleep apnea, 2 diabetes mellitus, and 1 patient symptomatic coronary artery disease. Five patients died suddenly from undetermined causes, 2 from right-sided congestive heart failure, 1 patient from acute myocardial infarction; 1 from aortic dissection; 1 from intracerebral hemorrhage; 1 from a drug overdose, and 1 soon after an ileal bypass. The heart weight was increased in all 12 patients. The heart weight to body weight ratio expressed as a percent ranged from 0.22 to 0.61 (mean 0.37) (normal for men 0.42 to 0.46 [mean 0.43], normal for women 0.38 to 0.46 [mean 0.40]). The left ventricular cavity was dilated in 11 patients and the right ventricular cavity in all 12. Only 2 patients (aged 42 and 59 years) had 1 or more major epicardial coronary arteries narrowed greater than 75% in cross-sectional area by atherosclerotic plaque, 1 of whom had no symptoms of myocardial ischemia. Of 664 five-millimeter segments from the 4 major epicardial coronary arteries from 11 patients (mean 60 per patient), 431 (65%) were narrowed 0 to 25% in XSA, 143 (21%) were narrowed 26 to 50%, 73 (11%) were narrowed 51 to 75%, and 17 (3%) were narrowed 76 to 100%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The heart in massive (more than 300 pounds or 136 kilograms) obesity: analysis of 12 patients studied at necropsy. 649 30

The authors propose a method of quantitative evaluation of excessive diurnal sleepiness intensity. They perform in each patient a 45-minute polygraphic examination to evaluate the occurrence of manifestations of wakefulness as well as all forms and stages of sleep, together with their latencies and total durations. In this way it is possible to describe the patients' sleepiness both quantitatively and qualitatively. The above test was used in the study of 8 healthy controls, 8 patients with narcolepsy-cataplexy, 8 patients with idiopathic hypersomnia and 8 patients suffering from the syndrome of hypersomnia with sleep apnea. All three groups of patients differed significantly from the control group showing deeper sleep stages of shorter latency and longer total duration. The three groups of patients differed also in some aspects from each other.
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PMID:A quantitative polygraphic study of daytime somnolence and sleep in patients with excessive diurnal sleepiness. 654 28


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