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

With the introduction of nasal continuous positive airway pressure as an effective treatment of the sleep apnea syndrome, the demand for costly polysomnographic investigations has markedly increased. Hence a reliable screening method would be desirable. Patients undergoing overnight oxymetry were simultaneously examined by MESAM (n = 54) and by Apnoe-Check (n = 23) in a prospective manner. The results were compared among themselves and with the complete overnight polysomnography (MESAM n = 38, Apnoe-Check n = 20). Simple overnight oxymetry, automatically assessed oxymetry by MESAM and apnea identification by Apnoe-Check correlated well with the polysomnographic findings. On the other hand, variation of heart rate, snoring events and changes of body position as identified by MESAM did not add relevant information. Only the detection of moderate to severe sleep apnea syndrome was satisfactory, though not infallible. Thus, there is still no screening method available to identify or exclude sleep apnea syndrome, particularly the milder form, which is nevertheless a significant disease.
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PMID:[Screening for sleep apnea: clinical use of Mesam IV and Apnoe-Check]. 777 Jul 58

Diagnosis of a sleep apnoea syndrome in severely snoring patients with diurnal sleepiness is growing in importance in the consulting rooms of general practitioners, internists, ENT specialists and pneumologists. However, time and cost reasons limit the diagnostic procedures conducted by practitioners to outpatient screening. Two different systems are presently available in Germany. The MESAM system (Madaus, Freiburg) records by means of a microphone and various electrodes the oxygen saturation, heart rate, snoring and sleeping position of the patient. The Apnoe-Check System (Medanz, Starnberg) determines the nasal and oral respiratory flow by means of a mask fitted with thermistors. Evaluation is accomplished in the case of MESAM via a conventional personal computer whereas with the Apnoea Check System the apnoeas and their duration can be read off direct from a writer. The cost ratio of these systems is approximately 3:1 (MESAM:Apnoea Check). Wie compared both systems by parallel measurements on 19 female and male patients and controlled the results obtained by measurements with a CO2 infrared absorption spectrometer in our sleep lab. A total of 3201 nocturnal events were recorded via MESAM and 1488 via the Apnoe-Check System. The highest number of apneas was recorded by MESAM in a patient with severe sleep apnea syndrome, namely, 546 apnoeas in one night. The lowest number of apnea events was experienced by a healthy male with 33 apneas in a night. With the Apnoe Check the maximum of nocturnal events was 255, the minimum being 8 events in one patient. In 64.6% of all nocturnal events there was time congruence for both systems.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Efficiency of portable sleep apnea screening instruments]. 849 63

The author presents the case of a male patient with obstructive sleep apnoea syndrome, in which the use of classic CPAP therapy after performing an uvulo-pharyngoplasty (UVPP) led to very good results. The pressure levels determined initially after a polysomnography with Apnoe Check were compared with the results of the measurements with another device, AutoSet, used for the first time in our country. This allowed the tapering of pressure levels for CPAP and also revealed other advantages of the device, reviewed here.
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PMID:[Diagnosis and treatment of a case of obstructive sleep apnea syndrome with AutoSet]. 1158 68

Always take a history of snoring and sleep disturbance when reviewing children in primary care, as there is evidence that episodes of hypoxia and arousal during sleep may result in deficits in memory, attention and behaviour, in addition to the well known sequelae of growth failure, developmental delay and cor pulmonale. Check for changes in behaviour affecting school progress. To investigate for possible obstructive sleep apnoea syndrome (OSAS), clinical examination, lateral neck x-ray (adenoidal hypertrophy) and overnight oximetry (desaturation episodes) are useful screening tests, but oximetry is best used in conjunction with polysomnography. A negative oximetry test does not exclude OSAS. Polysomnography is the best method for detecting and assessing the severity of OSAS in children, and is especially helpful for prioritising treatment and evaluating the risk of perioperative complications of adenotonsillectomy. Adenotonsillectomy is thought to "cure" (ie, symptoms disappear and overnight respiratory parameters are corrected) in about 80% of children with OSAS. The remaining 20% need ongoing evaluation and treatment. Further research is needed to determine the "true" prevalence of OSAS; what degrees of severity of upper-airway obstruction lead to morbidity requiring treatment; and whether the deficits in neurocognitive function associated with sleep-disordered breathing are fully correctable.
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PMID:8. Investigation and treatment of upper-airway obstruction: childhood sleep disorders I. 1585 Apr 41

Non-alcoholic steatohepatitis (NASH) is one of the most common liver disorders. This is highly prevalent in obese and diabetic subjects. Persons with central obesity are at particular risk. Other clinical predictors are age more than 40-50 years and hyperlipidemias, but none of these factors is invariable for causation of NASH. Other reported associations are, celiac disease, Wilson's Disease and few other metabolic diseases. Drugs, particularly amiodarone, tamoxifen, nucleoside analogues and methotrxate have also been linked to NASH. The disease is evenly distributed in both sexes but advanced disease is more common in women. Ethnic variation exists and African Americans are less affected than Hispanic Americans. Specific clinical features of NASH are infrequent. Patients usually come to clinical attention by elevated liver enzymes found on routine evaluation but on history, about two third of patients will admit to have mild fatigue and about half will report right upper quadrant pain. Rarely, patient may present with a complication of cirrhosis. Physical examination may reveal hepatomegaly and splenomegaly. Research in last few years has stressed that development of steatosis, stetohepatitis, fibrosis with subsequent cirrhosis are most probably the result of insulin resistance. Therefore, clinical features may reflect existence of insulin resistance. Obesity, particularly central obesity is most important of these. Patients may have sleep apnea syndrome. Hypertension and manifestations of diabetes mellitus like polyuria, polydypsia, and neurological deficits may occur. Patients may have varying combination of obesity, diabetes, hyperlipidemia, hypertension and impaired fibrinolysis (syndrome X). Children with insulin resistance may show acanthosis nigricance. Patients with polycystic ovary syndrome, which consists of insulin resistance, diabetes, obesity, hirsutism, oligo or polymenorrha and hyperlipidemia may have NASH. Other rare manifestations of insulin resistance, which can be seen in patients of NASH are lipomatosis, lipoatrophy/lipodystrophy and panniculitis. Most other rare conditions known to cause NASH like peroxisomal diseases, mitochondialpathies, Weber-Christian disease, Mauriac syndrome, Madelung's lipomatosis and abetaliopprotenemia also have insulin resistance. This is believed that primary defect underlying insulin resistance is impairment in postreceptor pathways (through tyrosine kinase activity) of insulin action. Primary defect in insulin receptors appear uncommon. This results in down regulation of insulin receptor substance 1 (IRS-1) signaling by excess free fatty acids. In muscle, activated IRS-1 promotes translocation of glucose transporter protein 4 (GLUT4) to cell membrane. As a result, monocyte glucose uptake by GLUT4 increases glucose disposal from blood and reduced need for insulin. PKC-0 is a likely candidate as serine kinase in muscle regulated by fatty acids that can impair the activation of IRS-1. Insulin resistance is usually evaluated by fasting insulin levels, Quantitative Insulin Check Index (QUICKI) and Homeostasis Model Assessment of Insulin Resistance (HOMA), C-peptid/insulin ratio oral glucose tolerance test and hyper insulinemic euglycemic clamp. The clamp technique is considered the gold standard.
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PMID:Insulin resistance and clinical aspects of non-alcoholic steatohepatitis (NASH). 1619 20

The future of solving the problem of sleep apnea necessitates the systematic organization of activities that would include: 1) increase in the awareness of the significant prevalence of sleep apnea and its influence on health and economic burden in the population via media and educational campaign; 2) establishment of the work groups that will find the answers and set the scientific research according to the needs posed by the sleep diseases; 3) Check the existing and develop new diagnostic and therapeutic methods with special reference to home monitoring with the creation of the national research network which will connect researchers and their programs and research centers; 4) Organization at the national level of educational centers and laboratories that will adequately respond to the needs of the pathology present in the population.
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PMID:[How to solve the problem of sleep apnea?]. 1806 55

This study explores the psychological wellbeing of twenty-two (n = 22) adults with achondroplasia. The sample was composed of seven (n = 7) males and fifteen (n = 15) females between the ages of 21 and 75 (mean age = 39.6). Each individual completed four self-administered questionnaires: the Beck Depression Inventory (BDI-l), the Beck Anxiety Inventory (BAI), the Beck Hopelessness Scale (BHS), and Derogatis Symptom Check-list-90-Revisited (SCL-90-R). They also filled out a socio-demographic questionnaire. We found that 31.8% of the sample reported at least one comorbid condition such as, hypertension, diabetes, rheumatoid arthritis, asthma, scoliosis, thyroid problems, neuropathy, psoriasis, gastritis and/or sleep apnea; 32% reported mild to severe depressive symp- toms; 55% reported mild to severe symptoms associated to anxiety and 18% reported mild to severe symptoms associated with hopelessness; 22.7% reported mild to severe symptoms in at least one of the sub-scales in Derogatis Symptom Checklist-90-Revisited (SCL-90-R) particularly the obsessive-compulsive, paranoid and depressive subscales. Chi Square correlations (X2) were made to observe if there was interdependence between the socio-demographic variables and the administered tests. In general, no significant correlations were found between BDI-Il, BAI, BHS, SCL-90-R and civil status, gender, income and age. However, a significant correlation was found between age and the somatization sub-scale of the SCL-90-R (rs = 0.510, p < 0.05). Our findings suggest that this particular sample is at risk for developing psycho-medical conditions. There is a marked lack of research in Puerto Rico associated to achondroplasia. The development of preventive and cultural sensitive interventions is suggested in order to protect and treat individuals with the condition.
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PMID:[Achondroplasia: a pilot study on the psychosocial and medical features of a sample in Puerto Rico]. 2674 98