Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six patients with severe sleep apnoea syndrome (SAS) were treated for one night by continuous positive pressure by the nasal route (PPC). The six patients tolerated the treatment well. During the course of the night, while receiving PPC, we noticed that in five patients there was a normalisation of the indices of apnoea, a disappearance of the episodes of desaturation and a re-organisation of sleep pattern. In one patient PPC was effective on obstructive apnoea, but did not make all mixed and central apnoea disappear. After a 4 or 5 day trial in hospital, 4 patients have now been treated at home for at least 6 months. PPC remains effective and well tolerated in the long term. As it is well tolerated and effective, PPC may be used to treat patients with SAS at an earlier stage than that at which tracheotomy is proposed.
Rev Mal Respir 1986
PMID:[Treatment of the sleep apnea syndrome by continuous positive pressure]. 352 62

Almitrine stimulates breathing by activating peripheral chemoreceptors and was given orally in a dose of 200 mg/day to nine patients with sleep apnoea syndrome, after a single blind placebo sequence. No reduction in the number of respiratory events per hour of sleep was observed. On the other hand Almitrine led to a significant fall in the mean duration of respiratory events (p less than 0.02). This fall occurred principally in the obstructive apnoea group and in those with mixed apnoea only during light slow wave sleep. These results are in agreement with the hypothesis that the arousal response to hypoxia mediated by the chemoreceptors could be responsible for the termination of sleep apneas.
Rev Fr Mal Respir 1983
PMID:[Effect of oral almitrine on the sleep apnea syndrome]. 614 8

We performed polysomnography and measured hypoxic ventilatory (HVR), hypercapnic ventilatory responses (HCVR) in 42 patients (60 +/- 11 years) with obesity and a clinical suspicion of sleep apnea syndrome (SAS) in order to determine whether an altered chemosensitivity was associated with SAS. The apnea/hypopnea index was 38 +/- 20 events per hour of sleep in 28 patients (SAS+ group) and less than 10 in the 14 others (SAS- group). The 2 groups differed only by a lower waking PaO2 in SAS+ as compared to SAS- (71.0 +/- 9 vs 77.4 +/- 8 mmHg, p < 0.05). HVR and HCVR were not significantly different in the 2 groups (0.82 +/- 0.58 vs 0.86 +/- 0.37 l.min-1.%-1; 1.41 +/- 0.81 vs 1.40 +/- 0.67 l.min-1.mmHg-1, respectively). In SAS+ group, HVR or HCVR did not change 3 or 12 months after continuous positive airway pressure (CPAP) therapy while both polysomnography and PaO2 returned to normal. We conclude that in patients with mild obesity and SAS there is no difference in chemosensitivity due to the presence of sleep apnea and that CPAP therapy does not alter these measurements. These results suggest no direct effect of SAS on chemosensitivity in the population studied.
Rev Mal Respir 1995
PMID:[Study of chemosensitivity in patients believed to have sleep apnea syndrome]. 748 Oct 48

The influence of medications and the usual taken by patients with respiratory disease on the characteristics of sleep and nocturnal respiration is complex, due to the fact of the inter-dependence which exists between these two physiological domains. Numerous medications have been evaluated for the treatment of nocturnal respiratory anomalies observed in patients suffering from chronic airflow obstruction or from a sleep apnoea or hypopnoea syndrome. For the greater part, the efficacy of these drugs remains limited and in the case of nocturnal sleep apnoea no pharmacological approach has an efficacy comparable either to mechanical or surgical treatments. It is thus important in these patients to appreciate the limits of medications prescribed for a specific purpose and the deleterious effect which may occur with certain medications employed for a symptomatic goal.
Rev Mal Respir 1995
PMID:[The effect of drugs taken by patients with respiratory pathology on the nature of sleep and on respiratory characteristics]. 763 22

Diurnal hypersomnia was studied in sixteen patients suffering from the sleep apnoea/hypopnoea syndrome (SHAS) Group I, and seventeen snorers Group II. The groups were studied in their basal state then after 51 +/- 14 days of continuous positive pressure (CPP) in Group I with the aid of clinical scores and of multiple latency tests of sleeping episodes (TLME). The patients in Group I presented with increased and pathological diurnal somnolence (TLME = 3.9 +/- 2.45 min) associated with disturbances of oxygen saturation during the course of sleep (a significant reduction of the mean SaO2) and of the pattern of sleep (significant reduction in light slow sleep at the expense of deep slow sleep, with a significant increase in the index of brief arousals). We have found a positive correlation between the initial TLME and the mean SaO2 during the course of sleep (p < 0.05; R = 0.51) without any correlation with other polysomnographic parameters. At the time of the final assessment, the improvement in TLME in the patients of Group I was significant (p < 0.001). However, in a sub-group of patients (BR: n = 7) the TLME were returned to normal using CPP (16.4 +/- 2.21 min) while those in patients in the second sub-group (MR: n = 9) the TLME remained below ten minutes on CPP (6.18 +/- 1.88 min). In the BR subgroup which presented with the most elevated mean initial TLME levels the amplitude of the rise of TLME between the two groups was significantly larger. No initial polysomnographic difference existed between the two sub-groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1995
PMID:[Differences in efficiency of continuous positive pressure respiration on the diurnal somnolence of patients with sleep apnea/hypoapnea syndrome]. 763 25

Many nocturnal cardiac arrhythmias and conduction defects have been reported in the adult sleep apnoea syndrome. The most original is the great variability of the heart rate which is cyclical and related to the apnoeic episodes, and easily differentiated from simple respiratory sinus arrhythmia. It is characterised by an initial bradycardia followed by rebound tachycardia. The bradycardia is vagally dependent (inhibited by atropine) probably secondary to carotid chemoreceptor stimulation by the hypoxaemia. The tachycardia is mainly attributed to the cessation of vagal hypertonicity although catecholamine stimulation has been suggested. The origin of these changes is purely functional, regressing with treatment of apnoea (waking, tracheotomy), the maintenance of arterial oxygen concentrations with oxygen therapy and parasympathetic blockade (atropine). The intensity of the phenomenon is related to the degree of arterial desaturation, which is itself related to basal arterial saturation (SaO2) and the duration of the apnoeas. Prolonged systole due to paroxysmal sino-atrial or atrioventricular block may be observed at night in these patients. The influence of vagal overactivity is confirmed (suppression of vagotomy) with no organic pathology (diurnal absence, tracheotomy, normal electrophysiological testing) in favour of a relationship with apnoea. Though less common than conduction abnormalities, atrial arrhythmias (extrasystoles, flutter, fibrillation) are also possible complications of sleep apnoea. The absence of an organic substrate is indicated by their regression post-tracheotomy and the efficacy of atropine (again in favour of a vagally-induced mechanism). Finally, nocturnal ventricular hyper-excitabilty is sometimes observed, the probable mechanism being the association of severe hypoxaemias (SaO2 < 60%) and the increased sympathetic tone at the end of the apnoea.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1993 Dec
PMID:[Arrhythmia and syndrome of obstructive sleep apnea in adults]. 802 77

A retrospective study was carried out on 347 case notes involving 303 men and 44 women who were suffering from a sleep apnea syndrome (SAS). The mean age was 57 plus or minus 10 years, and the diagnosis was made between 1982 and 1992. We have carried out the research to examine if there were clinical factors or factors related to respiratory function which would predict the acceptance in the short or long term and the correct observation in a daily time-table of nocturnal continuous positive pressure (PPC). The diagnosis of SAS was made using conventional polygraphy (35%), computerised cardiorespiratory recording 38%, or limited to transcutaneous saturation 27%. The mean number of respiratory nocturnal events in the three groups were respectively 48 plus or minus 25 per hour during sleep, and 45 plus or minus 23 and 51 plus or minus 20 per hour by the recording techniques. We have suggested a treatment by PPC in 235 patients: 86 patients refused at the outset (37%), 26 stopped secondarily (11%), and 108 (46%) continued until the end point 1992 with a mean duration of treatment of 24 (plus or minus 17), months and a mean duration of nocturnal usage of 6.2 (plus or minus 2.5) hours a mean level of positive pressure of 11 (plus or minus) 2) centimetres. The primary acceptance of PPC is significantly linked to the understanding of the patient of the functional signs (p less than 0.001) and of the severity of diurnal hypersomnolence (p less than 0.001). The acceptance in the long-term is linked in a weakly significant manner to the recognition by the patient of functional signs (p less than 0.04). None of the other 68 criteria used for assessing the severity of the patient and the SAS had any influence on the acceptance of PPC in short or long term. The compliance with a daily time-table is a weakly significant factor to the severity of the SAS judged by the number of nocturnal respiratory events (p less than 0.03).
Rev Mal Respir 1993
PMID:[Predictive factors in maintaining nocturnal continuous positive pressure in patients with sleep apnea syndrome]. 812 17

The aim of this work was to study the existence of special characteristics in the sleep apnoea syndrome (SAS) discovered following a stay on the Intensive Care Unit. This retrospective study of 25 casenotes of SAS patients who were resuscitated has enabled a comparison with 182 SAS patients who have never had acute respiratory failure. The intensive care consisted of controlled ventilation, following intubation, in a clinical context of acute respiratory failure with major problems of conscious level. The diagnosis of SAS was made using conventional or computerised polysomnography, or a computerised study of transcutaneous SaO2 (SaO2TC) which had been validated before. The results show that patients with SAS in an Intensive Care Unit, differs significantly from other patients with SAS by the permanent presence of alveolar hypoventilation in a stable state, associated with a significant decrease in the FEV1 (VEMS) in relation to the group that had not been in intensive care. However, the FEV1/VC ratio did not differ between the two groups which were expressed in absolute values or as a percentage of the theoretical value defined on the basis of their age. There was no difference on the data from the sleep studies and notably the hypoapnoeic indices, nor on age, the index of body mass or the sex ratio. We conclude that there is a need to look for SAS in the presence of acute respiratory failure in the obese without a recognised cause.
Rev Mal Respir 1994
PMID:[Sleep apnea syndrome in intensive care]. 812 89

The imaging techniques of the upper airway (UA) now permit a description of the characteristics of pharyngeal collapse during the course of obstructive apnoea. The start is oropharyngeal with active movements anterior and posterior of the soft palate and a falling back of the tongue. The extension occurs almost systematically towards the hypopharynx. A displacement of the hyoid bone and of the cervical spine is noted synchronously with thoracoabdominal movements. These imaging techniques of UA show the occurrence of passive pharyngeal collapse during certain types of central apnoea. In snorers and in apnoeics, there is a reduction of the calibre of the pharynx. However, these abnormalities are not specific and do not enable the diagnosis to be confirmed nor an estimate of the severity of the sleep apnoea syndrome. Cephalometry and computed tomography of the pharynx should be carried out particularly when a uvulopalatopharyngoplasty (UPPP) is envisaged. For practical purposes, the existence on cephalometry of retrognathism with an MP-H > 24 mm and a PAS distance of < 5 mm is associated with a poor result for UPPP. The same thing applies when macroglossia or a reduction of the surface of the hypopharynx is found on computed tomography.
Rev Mal Respir 1995
PMID:[Upper airways and sleep apnea syndrome]. 856 75

Nocturnal oximetry can show nocturnal oxygen desaturation. This examination was proposed as an investigation for the early detection of the sleep apnoea syndrome (SAS). We have compared the results of nocturnal oximetry and polysomnography in 329 consecutive patients seen in the department of thoracic medicine for the early detection of the SAS between June 1990 and June 1995. The diagnosis of SAS was confirmed at the time of polysomnography using an hypopnoea/apnoea index (IAH) greater or equal to 15 per hour. Two parameters of oximetry were well correlated with IAH less than 15 per hour: if the mean oxygen saturation is greater than 92% and for less than five per cent of the time of the examination there was a saturation of less than 90%. The sensitivity was 89.7% and the specificity was 57.8%. Among the 48 false positive cases on oximetry 17 patients were found to be suffering from COPD and 31 patients were probably suffering from a syndrome of upper airways resistance or possibly from the hypoventilation obesity syndrome. Amongst the 22 false, negatives to oximetry 10 non COPD patients with an IAH of greater than 30 per hour and diurnal somnolence had important anomalies of the oro-pharyngeal pathway as the origin of their nocturnal apnoea. The 12 other false negatives were patients with moderate SAS with an IAH of between 15 and 20 per hour. Logistical analysis has shown the association of the two oximetric criteria (mean oxygen saturation or percentage of time with a saturation of less than 5%) with clinical criteria (body mass index and formation on diurnal somnolence from a questionnaire) would enable a probable diagnosis of SAS in 75% of cases. Our study shows that nocturnal oximetry used an early diagnosis test, associated with clinical and respiratory function data enables the number of requests for polysomnography to be reduced.
Rev Mal Respir 1997 Jun
PMID:[Role of nocturnal oximetry in screening for sleep apnea syndrome in pulmonary medicine. Study of 329 patients]. 941 97


<< Previous 1 2 3 4 Next >>