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)

Oxyhemogloblin affinity (P50 at pH 7.4, PaCO2 = 40 mm Hg, temperature = 37 degrees C) and 2,3-DPG concentration were assessed in 15 nonsmokers (14 men and one woman 46 to 63 yr of age) with sleep apnea syndrome (SAS) and in 10 normal subjects (eight men and two women 22 to 48 yr of age). In patients with SAS, mean nocturnal apnea index was 46 +/- 20/h, and mean nocturnal SO2 was 86 +/- 6% versus 94.6 +/- 1.8% during the daytime. Daytime mean P50 of the patients was 28.5 +/- 1.2 mm Hg versus 27.1 +/- 0.3 mm Hg in the normal subjects (p less than 0.05). Daytime mean 2.3-DPG was 1.23 +/- 0.25 moles DPG/mole hemoglobin versus 0.80 +/- 0.15 (p less than 0.05). Significant correlations were found in patients between P50 and mean nocturnal SO2 (r = -0.62, p less than 0.01) and between P50 and 2,3-DPG (r = 0.68, p less than 0.01). The measurements were repeated in five patients after surgical or positive-pressure treatment. P50 and 2,3-DPG both decreased and returned to normal values. In conclusion, the oxyhemoglobin dissociation curve is shifted to the right in patients with SAS and there is an increase in 2,3-DPG. These could be protective mechanisms against the development of polycythemia, pulmonary hypertension, and cor pulmonale.
 ...
PMID:Decreased oxyhemoglobin affinity in patients with sleep apnea syndrome. 190 Apr 1

All-night polysomnographic studies were performed on ten patients (all female) with rheumatoid arthritis complicated with temporomandibular joint destruction and cervical lesions. The mean age of these subjects was 67.5 yrs, ranging from 48-81 yr. They all had some morphologic abnormalities of cervical spines and/or temporomandibular joints. Sleep study revealed that all of them had sleep apnea; five of them were of obstructive type (obstructive group) while the remaining showed central type of sleep apnea (central group) predominantly. There were no statistically significant differences of the levels of apnea index, mean-nadir SO2 and the lowest SO2 between the obstructive group and the central group. No detectable differences of cephalographic measurements and MRI findings existed between the two groups either. In one patient, nasal-CPAP converted central apnea to normal breathing dramatically. Our observations indicate that the cause of central apnea in RA patients with temporomandibular lesions is collapse of upper airway, inducing inhibitory inputs from the mechanoreceptors in that region.
 ...
PMID:[Sleep apnea syndrome in rheumatoid arthritis (RA) patients complicated with cervical and temporomandibular lesions]. 773 87

It has long been known, that irregular, heavy snoring and daytime sleepiness are common features of acromegaly. Only recently has the high incidence (30-60%) and clinical relevance of the sleep apnoea underlying these symptoms been recognized. Both diseases have a group of common symptoms and prognostic features: Increased cardiovascular and respiratory mortality, elevated incidence of hypertension, daytime sleepiness, decreased vitality, headaches and depression. These are very prominent in sleep apnoea and often reversible under treatment. In acromegaly their etiology has been widely unexplained and they commonly persist even when human growth hormone (hGH) levels remain normal after operative treatment. We report on 2 patients presenting with excessive daytime sleepiness and severe obstructive sleep apnoea caused by acromegaly. Both had macroglossia and hypertrophy of hypopharyngeal tissues regressive after surgical therapy. The average hGH-levels were 20 and 31 ng/ml before and 3 and 1.7 ng/ml several months after operation respectively. Apnoea indices and minimal oxygen saturations (SO2) were 59/h and 55/h, and 60% and 58% initially and improved postoperatively to 40/h and 50/h, and 72% and 70%. Polysomnographic parameters were normalized by NCPAP-therapy pre- and postoperatively and daytime sleepiness improved dramatically. In one patient the NCPAP-pressure could be decreased postoperatively. Since patients with sleep apnoea have an increased perioperative risk of hypoxia and because transsphenoidal operation and postoperative nasal tamponade were performed, both patients were tracheostomized perioperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Sleep apnoea in acromegaly--prevalence, pathogenesis and therapy. Report on two cases. 783 Dec 13

The development of inexpensive tools for diagnosing sleep apnea syndrome (SAS) is a result of the high prevalence of this condition and of the high cost of polysomnograms (PS). MESAM IV is a portable device that records changes in oxygen saturation (SO2), heart rate (HR) and snoring (S). Readings can be automatic or manual, the latter in function of an events index (EI), with a graph of the three variables generated. We carried out a simultaneous study of 51 subjects suspected of having SAS who were referred to the sleep unit by the pneumology outpatient clinic. PS was interpreted manually at 30-sec intervals as recommended by the American Thoracic Society. An apnea/hypoapnea index (AHI) > or = 10/hour of sleep was used as the cutoff point for SAS. Thirty-two (63%) subjects were found to have SAS as indicated by PS. The rate of agreement between AHI and automatic analysis of SO2, HR and S was only moderate (intra-group correlation coefficients -ICC- of 0.50, 0.40, and 0.53, respectively) and was inferior to manual analysis with EI (ICC of 0.77). Assessment of diagnostic efficacy of automatic analysis in terms of sensitivity (SEN), specificity (SPE), positive predictive value (PPV) and negative predictive value (NPV) yielded the following results: SO2 (SEN 94%, SPE 26%, PPV 68% and NPV 71%), HR (SEN 59%, SPE 58%, PPV 70%, NPV 46%); S (SEN 84%, SPE 26%, PPV 66%, NPV 50%). Manual analysis (EI) gave more valid results (SEN 100%, SPE 84%, PPV 91%, NPV 100%). If patients with chronic obstructive lung disease are excluded, however, the results for automatic analysis improve: SEN 100%, SPE 91%, PPV 96%, NPV 100%. These results show that MESAM IV is of great help in diagnosing SAS, allowing better screening for identifying candidates for PS.
 ...
PMID:[Validity of a portable recording system (MESAM IV) for the diagnosis of sleep apnea syndrome]. 795 34

The monitoring technique for assessing suspected sleep apnea syndrome is a polysomnogram (PSG) performed in hospital. The typical PSG includes EEG, EOG, EMG, air flow at the nose and mouth, SO2, thoracicoabdominal motion and snoring sound. But the PSG test is expensive, and also is a stress load for the patient because this test requires recording throughout the night. Recently, a home-type apnomonitor that is used at home has been developed for the screening of apnea, but this monitor can not distinguish obstructive sleep apnea (OSA) from central sleep apnea (CSA). We evaluated a new home-type apnomonitor that was able to distinguish OSA from CSA using the change of amplitude in the fingertip plethysmogram and respiratory flow curve attained by oronasal transducer. In this study, the respiratory flow curve became flat under OSA conditions, but the change of amplitude on plethysmogram corresponded to thoracioabdominal motion. On the other hand, the change of amplitude in the plethysmogram did not corresponded with thoracicoabdominal motion under CSA conditions. These findings suggest that it is possible to distinguish between OSA and CSA using an apnomonitor system which records a respiratory flow curve and a plethysmogram, and also to develop a new home-type apnomonitor.
 ...
PMID:[Novel apnomonitor for use at home]. 1367 40

When kidney failure occurs, patients are at risk for fluid overload states, which can cause pulmonary edema, pleural effusions, and upper airway obstruction. Kidney disease is also associated with impaired respiratory function, as in central sleep apnea or chronic obstructive pulmonary disease. Hence, respiratory and renal diseases are frequently coexisting. Hypoxemia is the terminal pathway of a multitude of respiratory pathologies. The measurement of oxygen saturation (SO2) is a basic and commonly used tool in clinical practice. Both arterial oxygen saturation (SaO2) and central venous oxygen saturation (ScvO2) can be easily obtained in hemodialysis (HD) patients, SaO2 from an arteriovenous access and ScvO2 from a central catheter. Here, we give a brief overview of the anatomy and physiology of the respiratory system, and the different technologies that are currently available to measure oxygen status in dialysis patients. We then focus on literature regarding intradialytic SaO2 and ScvO2. Lastly, we present clinical vignettes of intradialytic drops in SaO2 and ScvO2 in association with different symptoms and clinical scenarios with an emphasis on the pathophysiology of these cases. Given the fact that in the general population hypoxemia is associated with adverse outcomes, including increased mortality, cardiac arrhythmias and cardiovascular events, we posit that intradialytic SO2 may serve as a potential marker to identify HD patients at increased risk for morbidity and mortality.
 ...
PMID:Intradialytic Hypoxemia in Chronic Hemodialysis Patients. 2676 43