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

Consequences of obstructive sleep apnea syndrome in children include reduced performance during day, behaviour problems, diurmal hypersomnia, psychomotor development delay, severe forms of cor pulmonale, systemic hypertension, growing delay and death. This paper describes the clinical case of a 3-year-old girl with perennial symptoms of nasal obstruction characterized by nocturnal snoring, oral breathing, nasal voice, sleep apnea, nasal pruritus and rhinorrhea. Her treatment is also described.
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PMID:[Non-surgical treatment in case of obstructive sleep apnea syndrome in children. Report of a case]. 1496 87

Predictive factors and compliance level were evaluated in a group of patients with sleep apnea syndrome under CPAP treatment, assessing side effects and equipment condition: silicone interface (SI), mask-conectors (M-C), air tube (AT) and head strap (HS). Patients with >3mo treatment were included, clock counter reading was registered at the beginning, 2 and 4 mo. Patients were considered compliant (C+) when usage was >4h/day and >5day/week. Of 46 patients (male 34; age 62 +/- 9years; BMI 33 +/- 7kg/m2; AHI 38 +/- 18/h; time of therapy 2.1 +/- 1.7years; CPAP 9 +/- 1.4 cmH2O), 34 had a clock counter and 24 (71%) were C+. Initial symptoms included: somnolence (65%), snoring (39%), bed-partner witnessed apneas (28%). Comparing C+ and C- we didn't find significant difference in age, BMI, CPAP pressure, length of therapy, AHI and pre-treatment Epworth classification. Referred vs. measured time of use in C+ and C- were 6.6 +/- 1 vs. 6.1 +/- 1 h/d (p=0.02) and 5.6 +/- 1 vs. 2.4 +/- 1 h/d (p<0.005). Compliant patients reported more resolution of somnolence (p<0.005) and nocturia (p<0.05), lower post CPAP Epworth (p<0.05), more frequent somnolence as initial symptom (p<0.05) and a higher education level (p=0.01). Side effects (SE) (n=45): dry mouth 36%, nasal congestion 27%, sleep disruption 11%, CPAP noisy 9%, dry nose, rhinorrhea and skin irritation 7%. Twenty seven percent of patients reduced the CPAP use because of the SE. Correction strategies included: humidifier, nasal steroid, surgery or infiltration of turbinates. Comparing the condition of SI, M-C, AT and HS between < or =1 vs. >1year of use, we observed a lower percentage of fine elements (87 to 44%, 74 to 44%, 83 to 44%, 91 to 78%, respectively). Most common defects included stiffness of SI, cracks in SI, M-C and AT, loose conexions. The study confirms the importance of objective monitoring in patients with CPAP. Side effects and equipment condition require special attention because this could affect an effective treatment.
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PMID:[Compliance with continuous positive airway pressure therapy in patients with sleep apnea/hypopnea syndrome]. 1556 May 39

Patients with chronic diseases, including chronic respiratory diseases, usually have considerably impaired sleep quality that may increase the frequency of exacerbations and severity of symptoms, lead to difficulty in patient management, and reduce quality of life (QOL). During the last few decades, several studies have shown that, in addition to the classic signs of sneezing, nasal itching, rhinorrhea, and nasal obstruction, allergic rhinitis has an important impact on the QOL of adults and children. In 2001, the ARIA (Allergic Rhinitis and its Impact on Asthma) report based its new severity classification on the impact of rhinitis on QOL, with the inclusion of sleep disturbances. Thus, allergic rhinitis patients may also suffer from sleep disorders, emotional problems, as well as impairment in daily activities and social functioning. Given that sleep is fundamental for physical and mental health, the present document reviews the methods and questionnaires used to assess the quality of sleep, the importance of sleep in allergic rhinitis, impairment and improvement of sleep in allergic rhinitis by using medications (antihistamines, topical nasal corticosteroids, nasal decongestants, antileukotrienes) and, finally, the relationship between the sleep apnea syndrome with allergic rhinitis and its treatment.
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PMID:Sleep and allergic rhinitis. 1912 31

Adenoidal hypertrophy is probably the most frequent pathology in the pediatric population. This disorder manifests with several symptoms such as bilateral nasal obstruction, rhinorrhea, cough, snoring, hyponasal speech, hypopnea, and sleep apnea. When tonsillar hypertrophy is also present, obstructive sleep apnea syndrome can manifest. To date, nasal endoscopic examination is the standard technique to diagnose and estimate adenoid mass. Adenoidectomy is considered the surgical treatment of choice to resolve nasopharyngeal obstruction due to adenoidal hypertrophy. At present, several pitfalls of adenotomy (i.e., alteration of the immunological system, postoperative bleeding, and recurrence of adenoids) are object of criticism. For this reason, some researchers have tested the efficacy of topical nasal steroids in decreasing the severity of nasal symptoms and adenoidal mass. Herein, we review the literature on conservative treatments including also our personal experience.
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PMID:Can adenoidal hypertrophy be treated with intranasal steroids? 2019 84

Rhinitis is a symptomatic inflammatory disorder of the nose with different causes such as allergic, nonallergic, infectious, hormonal, drug induced, and occupational and from conditions such as sarcoidosis and necrotizing antineutrophil cytoplasmic antibodies positive (Wegener's) granulomatosis. Allergic rhinitis affects up to 40% of the population and results in nasal (ocular, soft palate, and inner ear) itching, congestion, sneezing, and clear rhinorrhea. Allergic rhinitis causes extranasal untoward effects including decreased quality of life, decreased sleep quality, obstructive sleep apnea, absenteeism from work and school, and impaired performance at work and school termed "presenteeism." The nasal mucosa is extremely vascular and changes in blood supply can lead to obstruction. Parasympathetic stimulation promotes an increase in nasal cavity resistance and nasal gland secretion. Sympathetic stimulation leads to vasoconstriction and consequent decrease in nasal cavity resistance. The nasal mucosa also contains noradrenergic noncholinergic system, but the contribution to clinical symptoms of neuropeptides such as substance P remains unclear. Management of allergic rhinitis combines allergen avoidance measures with pharmacotherapy, allergen immunotherapy, and education. Medications used for the treatment of allergic rhinitis can be administered intranasally or orally and include oral and intranasal H(1)-receptor antagonists (antihistamines), intranasal and systemic corticosteroids, intranasal anticholinergic agents, and leukotriene receptor antagonists. For intermittent mild allergic rhinitis, an oral or intranasal antihistamine is recommended. In individuals with persistent moderate/severe allergic rhinitis, an intranasal corticosteroid is preferred. When used in combination, an intranasal H(1)-receptor antagonist and a nasal steroid provide greater symptomatic relief than monotherapy. Allergen immunotherapy is the only disease-modifying intervention available.
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PMID:Chapter 5: Allergic rhinitis. 2279 78