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

Knowledge of the level of pharyngeal obstruction during sleep is an important factor in deciding whether or not a patient suffering from obstructive sleep apnoea syndrome (OSAS) will benefit from uvulopalatopharyngoplasty. The Muller manoeuvre has been advocated as a method of obtaining this information. We compared the findings from the technique of sleep nasendoscopy, which actually allows visualization of the level of obstruction in the sleeping patient, with the results of the Muller manoeuvre performed in the same patients while awake. We found the Muller manoeuvre to be less accurate than previously believed.
Clin Otolaryngol Allied Sci 1991 Dec
PMID:A comparison of sleep nasendoscopy and the Muller manoeuvre. 178 19

A programme for the differential diagnosis of rhonchopathy is reported, based upon the MESAM system developed at the University of Marburg. With this biparametric long-term monitor the snoring noise and the heart beat frequency (a beat-by-beat analysis) were recorded in 94 patients with a history of snoring. Other investigations included tape recordings of the snoring noise, nasoendoscopy, pulsed cineradiography of the pharynx and the recording of the character of the snoring. This programme is much cheaper than a sleep laboratory, but it can distinguish between obstructive sleep apnoea syndrome, habitual rhonchopathy and non-snorers, mainly by means of the characteristic patterns of MESAM recordings. A sleep apnoea syndrome was diagnosed in 19 patients and habitual rhonchopathy in 38 patients, whereas 33 patients were regarded as non-snorers. Ten of our 19 patients with sleep apnoea were re-examined by a sleep laboratory and the diagnosis was proved in all of these cases. In the 38 patients with habitual rhonchopathy auditory analysis of the snoring noise classified 23 patients as velar and 10 as pharyngeal snorers; 5 patients showed a mixed type of rhonchopathy. The questionnaire accompanying the MESAM system, nasal endoscopy and cine films support the individual diagnosis by revealing typical complaints and characteristic organic findings and thus contribute to the differential diagnostic screening. However, the three groups do overlap quite markedly with respect to symptoms und organic findings. In summary, the MESAM system provides an economically viable examination programme that can be used routinely by the otorhinolaryngologist for the differential diagnosis of rhonchopathy.
HNO 1991 Dec
PMID:[Differential diagnosis of rhonchopathy using the MESAM system]. 179 59

A 56-year-old male was admitted because of respiration arrest during sleep, and precordial crushing sensation which repeatedly occurred early in the morning. He had been hypertensive and aware of daytime sleepiness for ten years. After admission, all night polysomnography was recorded a total of four times. Apnea index was 37.5 times/hour, and central type apnea was predominant. The diagnosis of sleep apnea syndrome was made. In the early morning of the fourteenth day after admission, the patient developed anterior chest pain associated with ST elevation in leads II, III, and aVF of the electrocardiogram. Thus, the case was thought to be complicated by variant angina. There were no anginal attacks during the all night polysomnography recordings. However, a causal relationship between the sleep apnea and variant anginal attacks was suspected. Since both the sleep apnea and the variant anginal attacks tended to occur during the stages of REM sleep, and they are both related to changes in activity of the autonomic nervous system. It was considered that hypoxemia following sleep apnea and/or the hyperventilation after the apneic episodes might be the cause of the variant anginal attacks.
Nihon Kyobu Shikkan Gakkai Zasshi 1991 Dec
PMID:[A case of sleep apnea syndrome with variant angina]. 180 88

In order to determine whether the clinical features of obstructive sleep apnoea (OSA) are the same in men and women we reviewed the records of 22 women with OSA. The women were matched with 44 men of similar age (+/- 5 years) and frequency of respiratory events (less than or equal to 15/hr, 16-40/hr, 41-70/hr and greater than 70/hr). The degree of daytime somnolence was similar in men and women. Women are more likely than men to complain of morning fatigue and morning headache, and less likely to report restless sleep or to have been told of apnoea during sleep. Difficulty initiating sleep (DIS) was twice as common in women as in men (p less than 0.05). Most of these differences were also seen when women and men who snored but did not have OSA were compared. Arterial hypertension was less common in women (3/22) than in men (18/44), (p less than 0.001). More striking than the differences between men and women in the prevalence of single symptoms was the existence of a subgroup of women (9/22) with no complaint of either apnoea, choking arousals or restless sleep, and normal blood pressure, complaining only of fatigue and morning headache, and in three cases DIS as well. We concluded that OSA may be commoner in women than previous reports suggest, and that the clinical features may be misleading in women.
Aust N Z J Med 1991 Dec
PMID:Differences in the symptoms of men and women with obstructive sleep apnoea. 181 45

Ambulatory blood pressure monitoring can determine the average blood pressure level and the short- and long-term blood pressure variability (circadian rhythm). The circadian blood pressure rhythm appears to be mediated mainly by the circadian rhythm of the sympathetic tone which is linked to changes in physical and mental activity, e.g. the waking-sleeping cycle. A statistically significant circadian blood pressure rhythm was observed in approximately 80% of mild to moderate essential hypertensive patients as well as in normal subjects. However, in patients with Cushing's syndrome, under glucocorticoid treatment, or with hyperthyroidism, central and/or peripheral autonomic dysfunction (Shy-Drager syndrome, spinal cord injury, brainstem lesions, diabetic neuropathy, uremic neuropathy, etc), chronic renal failure, eclampsia, malignant hypertension, sleep apnea syndrome or systemic atherosclerosis, the normal circadian blood pressure rhythm appears to be eliminated or reversed, while in those with primary aldosteronism, renovascular hypertension, pheochromocytoma without paroxysmal hypertension, diabetes insipidus, acromegaly, hyperparathyroidism or hyperprolactinemia, the nocturnal blood pressure fall has been observed as in normal subjects. The alteration in the circadian blood pressure rhythm was observed with different pathophysiological conditions, although no specific pattern was observed for any condition. A disturbance in any part of the hierarchy of factors that regulate the circadian rhythm of sympathetic neural tone seems to disturb the circadian blood pressure rhythm. We conclude that ambulatory blood pressure monitoring is not critically important in the diagnosis of secondary hypertension although it does help in screening for secondary hypertension.
J Hypertens Suppl 1990 Dec
PMID:Does ambulatory blood pressure monitoring improve the diagnosis of secondary hypertension? 208 1

The daily variation in blood pressure (circadian blood pressure rhythm) is characterized by a nocturnal fall and a diurnal rise. The circadian blood pressure rhythm seems to be mediated mainly by the circadian rhythm of sympathetic tone, linked to changes in physical and mental activities, e.g. the waking-sleeping cycle. Statistically significant circadian blood pressure rhythms have been confirmed in approximately 80% of mild to moderate essential hypertensive patients as well as in normal subjects. However, the normal pattern of circadian blood pressure rhythm is reversed in elderly people and in those with Cushing's syndrome, those undergoing glucocorticoid treatment, and those with hyperthyroidism, central and/or peripheral autonomic dysfunction (Shy-Drager syndrome, tetraplegia, diabetic or uremic neuropathy, etc), chronic renal failure, renal or cardiac transplantation, congestive heart failure, eclampsia, sleep apnea syndrome, malignant hypertension, systemic atherosclerosis and accelerated hypertensive organ damage. However, in those with primary aldosteronism, renovascular hypertension, pheochromocytoma without paroxysmal hypertension, or those with cardiac pacing, a nocturnal blood pressure fall is ordinarily observed. It may be that a fall in cardiac output rather than in peripheral resistance may be mainly responsible for the nocturnal fall in blood pressure. It also seems that a nocturnal heart rate fall is not responsible for it, since the nocturnal blood pressure fall remained unchanged in patients undergoing cardiac pacing and was disturbed in patients with Cushing's syndrome or hyperthyroidism in whom the circadian heart rate rhythm remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
J Hypertens Suppl 1990 Dec
PMID:Circadian blood pressure variations under different pathophysiological conditions. 209 80

This article reviews the essential features, types, prevalence, pathophysiology, and neuropsychological correlates associated with the sleep apnea syndrome. Persons who experience the intermittent hypoxia and fragmented sleep characteristic of the sleep apnea syndrome tend to exhibit moderate symptoms of diffuse cognitive dysfunction as well as multiple emotional and psychosocial sequela. It is concluded that more research is required in order to elucidate the relationship between the hypoxic parameters and neurocognitive deficits seen in the sleep apnea syndrome, and that neuropsychological assessment might represent a means whereby the effectiveness of various treatments for sleep apnea may be evaluated.
Neuropsychol Rev 1990 Dec
PMID:Sleep apnea syndrome: symptomatology, associated features, and neurocognitive correlates. 215 34

A simplified sleep apnea investigation consisting of combined oximetry and respiration movement monitoring was compared with conventional polysomnography. These two types of recordings were performed simultaneously during one night in 77 patients with suspected obstructive sleep apnea syndrome (OSAS). A static charge sensitive bed (SCSB) was used in the simplified recording because it provides a comfortable and reliable means of recording respiration movements. Periods of obstructive apneas gave a diamond-shaped periodic respiration movement pattern in the SCSB, usually accompanied by repetitive oxygen desaturations. The average number of desaturations greater than or equal to 4 percent per sleeping hour was termed the oxygen desaturation index (ODI) and compared with the apnea index (AI). In the whole population they were well correlated (p less than 0.0001, R2 = 0.41), but in individual cases there were considerable discrepancies. Patients with periodic respiration movements less than 18 percent of total sleeping time and ODI less than 2 never had AI greater than or equal to 5, whereas patients with periodic respiration greater than 45 percent and ODI greater than 6 always had AI greater than or equal to 5. Fifty-one of the 77 patients fulfilled these criteria. A bradycardia response to apneas was absent in 29 percent of patients with AI greater than or equal to 5. A combination of respiration movement and oximetry recording thus seems to give sufficient information to confirm or negate a diagnosis of OSAS in a majority of patients with clinical symptoms. In borderline patients, further investigations should be performed.
Chest 1990 Dec
PMID:A limited diagnostic investigation for obstructive sleep apnea syndrome. Oximetry and static charge sensitive bed. 224 72

While insomnia is a familiar management problem for most doctors, disorders of hypersomnolence are much less familiar. The evolution of sleep monitoring at a major South African teaching hospital is described and the classification of sleep disorders reviewed. Analysis of the first 5 years' experience revealed that 27 of 46 patients had sleep apnoea (all obstructive, but 13 with a central component), while 3 had narcolepsy. Contributing causes of sleep apnoea included obesity (25 patients), tonsillar enlargement (3), acromegaly (3), rheumatoid cervical spondylosis (1), Hunter's syndrome (1) and haemangioma of the throat (1). Death from sleep apnoea occurred in 3 cases. Treatment of specific causes was effective in abolishing sleep apnoea, although attempts at weight loss were effective in a minority only. Nasal continuous positive airway pressure was effective in achieving symptomatic relief. Sleep monitoring was found to be valuable, provided all-night study facilities are available, and provided that patients who simply snore are excluded by prior clinical evaluation.
S Afr Med J 1990 Dec 15
PMID:The diagnosis and management of respiratory sleep disorders--the first 5 years at Groote Schuur Hospital. 225 27

Episodic nocturnal phenomena represent a separate cluster of disturbances within the classification of sleep disorders. The reported case history covers paroxysmal signs occurring secondary to a REM-dependent mixed sleep apnoea syndrome. The pathophysiology of similar episodes in elderly (non)epileptic patients is discussed. Ambulatory monitoring is an appropriate technique for investigation if respiratory and motor activity, and EEG and ECG are recorded simultaneously.
Int J Psychophysiol 1990 Dec
PMID:Ambulatory monitoring in sleep apnoea presenting with nocturnal episodic phenomena. 227 65


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