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

We used polysomnography, echocardiography and ventilatory measurements to study 50 patients suspected of having OSA to determine a link to RVH. Twenty-eight patients (56 percent) had OSA and 20 (71 percent) of those had isolated RVH. We evaluated patients with RVH and divided them into two groups, those with apnea and those without apnea. The patients with sleep apnea were younger, weighed more, had greater BSA and had lower average oxygen saturations during the sleep study period. We divided the group with apnea into those with RVH and those without it. Those patients with RVH had a higher AI, longer average apnea time, a greater duration of longest apnea and a lower average oxygen saturation for the period of the sleep study. In addition, those with RVH had a lower average oxygen saturation during each apneic episode with a p value equaling 0.09.
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PMID:Right ventricular hypertrophy detected by echocardiography in patients with newly diagnosed obstructive sleep apnea. 183 Aug 38

Sleep apnea syndrome is responsible for repeated and sometimes deep arterial oxygen desaturations occurring during apneas, followed by episodes of transient pulmonary hypertension (PH). In chronic obstructive pulmonary disease (COPD) patients with respiratory insufficiency, a worsening of hypoxemia occurs during sleep, due to alveolar hypoventilation and/or ventilation-perfusion mismatching. This hypoxemia is also responsible for pulmonary hypertensive dips due to pulmonary hypoxic vasoconstrictiveness. But there is presently no evidence that sleep-related and transient PH may lead to daytime and permanent PH, in either sleep apnea syndrome or COPD. In fact permanent PH seems to be related, in most cases, to the presence of daytime (permanent) hypoxemia.
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PMID:[Pulmonary artery hypertension and hypoxemia in sleep]. 185 26

Twenty-seven morbidly obese patients (13 men and 14 women) with body mass index greater than or equal to 40 kg m-2 were examined. The mean age of the subjects was 36.9 +/- 8.2 years (range 23-51 years), and the mean BMI was 50.2 +/- 6.2 kg m-2 (range 40.0-62.9 kg m-2). A whole-night sleep recording was made for all patients with signs or symptoms indicative of possible obstructive sleep apnoea syndrome (OSAS). If the first nocturnal sleep recording was abnormal, it was controlled after 1 year. Eleven (10 men and one woman) of the 27 patients had an oxygen desaturation index (ODI) of 10 h-1. They were symptomatic with excessive daytime sleepiness or other daytime symptoms of OSAS. The occurrence of OSAS in men and women was 76.9 and 7.1%, respectively. Arterial hypertension was associated with OSAS, but not with smoking or the degree of obesity. Antihypertensive treatment was received by nine of the 27 patients; six of them had OSAS. Thus six of the 11 (54.5%) patients with OSAS and three of the 16 (18.8%) nonapnoeic patients were treated for arterial hypertension (Fisher exact test, P = 0.042). The odds ratio of OSAS for arterial hypertension is 5.2 (95% CI, 0.71-43.6). Vertical-banded gastroplasty was performed in 14 patients, three of whom had OSAS. The selection of patients for gastroplasty was made without taking into account the results of sleep recordings. In the three OSAS patients, a 30-38% reduction in BMI was achieved by surgery. Eight patients with OSAS were treated with an intensified dietary regimen, and the reduction in BMI ranged from -2.6 to 33%. OSAS was either cured or significantly improved in six (55%) patients, with a mean reduction in BMI of 27%, while in patients with persistent OSAS the mean reduction in BMI was only 7%.
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PMID:Obstructive sleep apnoea syndrome in morbidly obese patients. 186 63

Nocturnal pulse oximetry is frequently used in screening studies when diagnosing nocturnal respiratory disorders. Short-term cyclic desaturations of oxygen can serve to indicate recurring apnoeas, whereas long-lasting phasic reductions of oxygen saturation are predominantly seen in hypoventilation. However, there are no uniform assessment criteria. We developed a computer programme for the differentiated assessment of cyclic and phasic oxygen desaturations. With this programme it is possible to characterise the individual phases in respect of gradient and duration of the decrease in oxygen saturation, of the starting, minimal and final values and the total duration of the desaturation phase. This enables determination of the rate of incidence of various forms of desaturation during nocturnal recording. The results of this differentiated analysis of nocturnal pulse oximetry in patients with sleep apnoea syndrome (n = 6) and with chronic obstructive airways disease with respiratory insufficiency (n = 6) and without respiratory insufficiency (n = 6) are demonstrated as model examples.
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PMID:[Assessment of cyclic and phasic oxygen saturation using pulse oximetry in the diagnosis of nocturnal respiratory disorders]. 186 99

It is known that patients suffering from severe cardiomyopathy may develop cyclic changes in breathing (Cheyne-Stokes-breathing) (2, 3). Coughing and dyspnea may be linked to periodic breathing. Specific detailed polysomnographic studies of sleep architecture and oxygen saturation have not been published. Eight patients suffering from dilatative cardiomyopathy (NYHA III-IV) were studied by pulse oximetry and polysomnography. Six of eight patients had severe breathing irregularities. These disturbances became manifest partially as Cheyne-Stokes breathing, partially as central sleep apnea. During these periods, oxygen saturation dropped as far as to 65 per cent of the original level.
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PMID:[Oxygen saturation and sleep structure in patients with dilated cardiomyopathy]. 186 3

It is assumed, that patients with coronary heart disease (CHD) more often suffer from sleep related disorders of breathing than healthy subjects. A relation to an impaired left ventricular performance is discussed. In 40 CHD-patients and 30 cardio-respiratory healthy controls we therefore measured arterial oxygenation during sleep by means of pulse-oximetry. Our results show a marked increase in the frequency of nocturnal oxygen-desaturations along with the degree of impaired left ventricular function independent of a special sleep apnea risk. In case of cardiac insufficiency at rest cyclical oxygen-desaturations were observed ten times as often as in the healthy controls. A central disturbance of the respiratory control, which leads to periodic breathing (type Cheyne-Stokes) has to be discussed. Because of the general high risk of CHD-patients concerning the development of nocturnal complications of their disease, sleep-related disturbances of ventilation have to be detected early by means of routinely applied screening-methods.
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PMID:[Nocturnal oxygen saturation in patients with coronary heart disease--dependent on degree of left ventricular functional impairment]. 186 4

Fifty-seven patients with obstructive sleep apnoea (OSA) were treated for at least six months with nasal continuous positive airway pressure (CPAP). At follow-up, sleep studies were performed in which CPAP was not used for the first half of the night. We compared the severity of OSA at follow-up without CPAP to the severity of OSA during the patient's initial diagnostic study. Apnoea and hypopnoea index (AHI) fell from 41.4 +/- 7.5 (mean +/- 95% CI) to 34.8 +/- 7.9 (p = 0.06 by Wilcoxon test) and minimum oxygen saturation rose from 71.6 +/- 3.2 to 78.5 +/- 2.6 (p less than 0.001). Some of this change may have been due to reduced REM sleep in the follow-up study (10.5 +/- 2.1% Total Sleep Time vs 7.4 +/- 2.4% TST, p less than 0.05). Long-term nasal CPAP was not associated with any reduction of obesity (BMI before CPAP 31.9 +/- 1.0, after CPAP 31.7 +/- 1.0 (p = 0.39). Systolic arterial pressure fell (before CPAP 143.0 +/- 4.5 mmHg, after CPAP 136.3 +/- 4.6, p less than 0.05) but diastolic pressure did not (before CPAP 88.5 +/- 3.0 mmHg, after CPAP 85.6 +/- 2.9 mmHg, p = 0.11). We concluded that the effect of CPAP treatment for six or more months was a small fall in AHI and a small rise in minimum SaO2, but that this would be of marginal clinical significance, and may be artefactual.
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PMID:Long-term nasal CPAP does not ameliorate obstructive sleep apnoea. 187 51

We report a 2-year-old infant with severe obstructive sleep apnoea. The symptoms had deteriorated for several months, and indicated complete obstruction shortly after the child fell asleep, with reduction of the oxygen saturation to under 30%. Since the obstruction could only be interrupted by waking the child, a tracheostomy was proposed. Endoscopy under general anaesthesia revealed no pathological findings. The stenosis could only be seen using transnasal fibre-optic endoscopy when the obstruction occurred during sleep: the oropharyngeal wall collapsed at the level of the velopharyngeal sphincter. A tube passed through the nose and through the collapsing section of the pharynx to the entrance of the larynx prevented the apnoea. The parents were taught to introduce and fix the tube. After an observation period of 1 year the larynx had stabilized spontaneously, and the tube has to be introduced only rarely.
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PMID:[Functional nasopharyngeal fiberoptic endoscopy for pre-therapeutic diagnosis of sleep apnea syndrome in infants. A case report]. 187 38

There is no information of the prevalence and severity of obstructive sleep apnoea (OSA) in Asian snorers. One reason is the complexity and cost of a full polysomnographic recording. We have studied 37 snorers using an ambulatory recording system (Vitalog CA). Overnight recordings for seven hours were made of: 1) Respiratory pattern using respiratory inductance plethysmography; 2) Heart rate from the electrocardiograph (ECG); 3) Body position; 4) Body movements; 5) Oxygen saturation using finger-probe oximetry. The data were stored and analysed and scored using a dedicated microcomputer. Twenty-eight patients had OSA based on polygraphic criteria. The most consistent clinical findings in these patients were daytime somnolence and short thick necks. Respiratory events, oximetry and arousals during sleep showed a graded response according to the severity of excessive daytime somnolence. We conclude that OSA may not be uncommon in Asian patients and that the clinical severity can be confirmed by simplified polygraphic recordings using microcomputer analysis.
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PMID:Evaluation of obstructive sleep apnoea in Singapore using computerised polygraphic monitoring. 188 76

Nasal CPAP has been shown to improve nocturnal asthma in those patients with associated sleep apnea. We studied seven nonapneic, nonsnoring asthmatics to determine the effect of CPAP in this patient population. On the CPAP night vs the baseline night, there was a significant worsening of sleep architecture. This included increased awake time and decreased REM sleep. For the group, the overnight decrement in FEV1 was not improved. Of interest, two patients did have a marked improvement in FEV1 associated with improved oxygen saturation on the CPAP night. These individuals were restudied only on supplemental oxygen. This intervention also improved the overnight FEV1 and allowed the patients to have better sleep compared to the CPAP night. We concluded that CPAP is associated with disrupted sleep architecture in nonapneic asthmatics and nocturnal oxygen desaturation may play a role in the development of nocturnal asthma.
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PMID:Nasal CPAP in nonapneic nocturnal asthma. 191 51


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