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

Attempts to elucidate the complex pathophysiology of chronic fatigue syndrome (CFS) must consider subjective and objective sleep. Several reports of CFS showed the high rate of sleep disturbance such as insomnia, hypersomnia, circadian rhythm sleep disorder, sleep apnea/hypopnea syndrome and so on. To analyze pulse wave continuously in sleep of CFS patients by laser blood flowmeter, we set base line component (0.01-0.08 Hz) and pulse wave component(0.70-1.50 Hz). Results of FFT analysis indicate that the CFS can have at least three subtypes of pulse dynamics in sleep. There probably are different types of illnesses now contained within the CFS construct, in which identifying subtypes of sleep disturbance can be one important key.
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PMID:[Sleep disturbance in chronic fatigue syndrome]. 1756 91

(1) The first-line treatment for patients with troublesome obstructive sleep apnoea syndrome is night-time nasal continuous positive airway pressure, which reduces daytime drowsiness and improves cognitive performance. (2) Modafinil, a non amphetamine psychostimulant already marketed for idiopathic narcolepsy and hypersomnia, is the first drug to be approved in France for the treatment of patients with residual daytime drowsiness despite nasal continuous positive airway pressure treatment. (3) Clinical evaluation of modafinil for this indication consists of two short-term double-blind placebo-controlled trials, lasting 4 and 12 weeks, and including a total of about 500 patients. At a dose of 400 mg/day, 68% of patients experienced an improvement in their daytime drowsiness (usually partial), compared to 37% of patients on placebo. It is not known how many patients no longer had any daytime drowsiness. A major improvement occurred in about 14% of patients (7% on placebo). (4) The main adverse effects of modafinil are neuropsychological (headache, nervousness, insomnia, anxiety, nausea). (5) In short, modafinil is an option to consider when continuous positive airway pressure is not sufficiently effective and when drowsiness continues to significantly interfere with daily activities. However, it only appears to provide a major benefit to about 10% of patients. The only important improvement is in daytime drowsiness, and this is often offset by adverse effects such as headache. Effects of long-term treatment are not known.
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PMID:Modafinil: new indication. For a minority of patients with sleep apnoea. 1758 24

Sleep disorders, mainly insomnia and daytime somnolence, can arise from very different causes. For example insomnia may be related to anxiety-depression or occur in response to a stressful lifestyle or as an element of restless leg syndrome. Subjects with hypersomnia may present episodes of sleep apnea, drug-related depression or narcolepsia. Specific management is required for each etiology. Misuse of sleep drugs generally results from an insufficient etiological diagnosis and a misunderstanding of their proper use. These drugs can be used as necessary expedients but cannot replace correct management or treatment of the cause or causes of the sleep disorder. We present here a review of the undesirable effects, particularly among the elderly population, and of the risk of addiction to the different drugs used to induce sleep in order to propose prescription guidelines.
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PMID:[Misuse of sleep and wakefulness drugs: from undesirable effects to addiction]. 1765 95

The epidemiological study of hypersomnia symptoms is still in its infancy; most epidemiological surveys on this topic were published in the last decade. More than two dozen representative community studies can be found. These studies assessed two aspects of hypersomnia: excessive quantity of sleep and sleep propensity during wakefulness excessive daytime sleepiness. The prevalence of excessive quantity of sleep when referring to the subjective evaluation of sleep duration is around 4% of the population. Excessive daytime sleepiness has been mostly investigated in terms of frequency or severity; duration of the symptom has rarely been investigated. Excessive daytime sleepiness occurring at least 3 days per week has been reported in between 4% and 20.6% of the population, while severe excessive daytime sleepiness was reported at 5%. In most studies, men and women are equally affected. In the International Classification of Sleep Disorders, hypersomnia symptoms are the essential feature of three disorders: insufficient sleep syndrome, hypersomnia (idiopathic, recurrent or posttraumatic) and narcolepsy. Insufficient sleep syndrome and hypersomnia diagnoses are poorly documented. The co-occurrence of insufficient sleep and excessive daytime sleepiness has been explored in some studies and prevalence has been found in around 8% of the general population. However, these subjects often have other conditions such as insomnia, depression or sleep apnea. Therefore, the prevalence of insufficient sleep syndrome is more likely to be between 1% and 4% of the population. Idiopathic hypersomnia would be rare in the general population with prevalence, around 0.3%. Narcolepsy has been more extensively studied, with a prevalence around 0.045% in the general population. Genetic epidemiological studies of narcolepsy have shown that between 1.5% and 20.8% of narcoleptic individuals have at least one family member with the disease. The large variation is mostly due to the method used to collect the information on the family members; systematic investigation of all family members provided higher results. There is still a lot to be done in the epidemiological field of hypersomnia. Inconsistencies in its definition and measurement limit the generalization of the results. The use of a single question fails to capture the complexity of the symptom. The natural evolution of hypersomnia remains to be documented.
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PMID:From wakefulness to excessive sleepiness: what we know and still need to know. 1834 61

We report the case of a 46-year-old male with myotonic dystrophy who developed daytime hypersomnia and dyspnoea. After a therapeutic tracheostomy, overnight polysomnographic studies were performed under three different ventilatory conditions. When the patient breathed spontaneously through a tracheal cannula, abnormal cyclical sleep increased and rapid eye movement (REM) sleep decreased markedly. The apnoea and hypopnoea index (AH index) was 35.1. When breathing spontaneously through his normal airway, there were many instances of cyclical sleep, but few instances of deep sleep and no episodes of REM sleep. The AH index was 58. Under assisted ventilation the patient's sleep pattern was normal. Our conclusion, therefore, is that these studies demonstrate the patient had sleep apnoea of central origin.
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PMID:Sleep apnoea of central origin in a case of myotonic dystrophy. 1864 6

Sleep is a physiologic state that performs an essential restorative function and facilitates learning and memory consolidation. When sleep is disrupted for more than a short time, normal daily functions decline. Mood, attention, and behavior deteriorate. Sleepiness and disrupted sleep can result from a large number of pathological disorders. Currently, 88 sleep disorders are listed in the International Classification of Sleep Disorders, as established by the American Academy of Sleep Medicine, and sleep disorders adversely affect more than an estimated 70 million Americans. Most of these disorders can be classified as causing insomnia and/or hypersomnia. Insomnia results from disorders that cause difficulty with falling asleep and staying asleep; examples are hyperarousal, circadian dysrhythmia, and homeostatic dysregulation. In contrast, hypersomnia refers to difficulty in staying awake and is characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep. Hypersomnia can result from several primary sleep disorders, including narcolepsy, sleep apnea, restless legs syndrome, idiopathic hypersomnia, and periodic limb movement disorder. The effects of some of these sleep disorders and other chronic illnesses on daytime sleepiness are measured using the Epworth Sleepiness Scale. Narcolepsy was found to cause some of the highest measures of excessive sleepiness. This supplement uses a case-based approach to describe the underlying pathology and symptoms of narcolepsy. Differential diagnosis of narcolepsy and current treatment options will be discussed.
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PMID:Stay awake! Understanding, diagnosing, and successfully managing narcolepsy. 1868 53

Sleep apnea and hypopnea syndrome (SAHS) is a disorder characterized by intermittent and repetitive obstruction of the upper airway provoking pharyngeal collapse. It is characterized clinically by a triad of daytime hypersomnia, snoring and pauses in breathing during sleep that are normally reported by the partner. Polysomnography is the chosen method for diagnosing this pathology. Patients with this disorder tend to have the following dental and orofacial signs: a retrognathic jaw, a narrow palate, a wide neck, deviation of the nasal septum and relative macroglossia, among others. Dentists should be ready to evaluate the risk-benefit of certain dental treatment options for this public health problem. The treatment of this problem will depend on its severity, with one of the options being the Mandibular Advancement Device (MAD) that is used especially in the treatment of slight or moderate SAHS and in the treatment of snoring, with results that are occasionally very successful. The objective of this study is to carry out an up-to-date literature review of SAHS and to evaluate the role of the dentist when faced with this pathology.
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PMID:Sleep apnea and mandibular advancement device. Revision of the literature. 1875 97

Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert- based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder.
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PMID:Evidence-based recommendations for the assessment and management of sleep disorders in older persons. 2012 76

Sleep apnoea and related sleep breathing disorders are a major cause of medical, social and occupational disability. Excessive sleepiness may be associated with respiratory failure, obesity, hypertension and insulin resistance in the cardiometabolic syndrome. This article reviews practical assessment and management.
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PMID:Sleep apnoea and sleep breathing disorders. 1951 7

There is a 10 -36% rate of obstructive sleep apnoea syndrome (OSAS) associated with rapid eye movement (REM) in the OSAS population. Prior studies have suggested an increased prevalence of psychiatric disorders and an effect of gender and age on these patients. Our aim was to study the clinical and polysomnograph (PSG) characteristics of our patients with REM- -related sleep disordered breathing (REM SDB). Inclusion criteria was the identification of REM SDB detected by PSG defined as apnea -hypopnea index (AHI) in REM sleep > or = 5h, AHI in non -REM sleep (NREM) < or = 15h and REM/NREM AHI > or = 2. Several Sleep Disorders Questionnaire (SDQ) version 1.02 parameters were analysed. The study comprised 19 patients with a mean age of 54.0 (SD+/-13.97), a mean BMI of 29.01 (SD +/- 4.10) and a 0.58 female / male ratio. The mean Epworth Sleepiness Scale score was 12.74 (SD +/-4.86). Mean AHI was 9.16/h (SD 4.09); mean AHI in REM sleep 37.08/h (SD 25.87) and mean REM -AHI/NREM- -AHI 8.86 (SD 8.63). The anxiety disorder rate was 33.3%; 44.4% in females, 16.7% in males. The average deep sleep was 20.7% (SD 10.42) and REM sleep 15.45% (SD 9.96), with a sleep efficiency of 85.3 (SD 8.70). No significant statistical correlation was found between the REM/NREM AHI index and anxiety symptoms, daytime sleepiness and sleep quality (REM and deep sleep percentages). These patients differ from the general OSAS population: on average, they are not obese, there are a greater number of females affected and they do not present a very significant diurnal hypersomnia. Reduced deep sleep and increased REM sleep were also present versus general population data, and sleep efficiency was just below the normal limit. Anxiety disorders were more prevalent in this group than described for the general population (3%) and OSAS patients.
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PMID:Clinical and polysomnographic characteristics of patients with REM sleep disordered breathing. 1964 43


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