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

Continuous positive airway pressure as a long-term home treatment for sleep apnea syndromes would seem to present irreconcilable requirements; it must be simple and comfortable to use during sleep and it must be relatively inexpensive. The device described in this paper includes a compressor, an individually molded nose-mask and a water column. Improvements are still in progress, but, as it stands, it enables sleep apnea patients to be successfully treated at home.
Presse Med 1984 Dec 15
PMID:[Continuous positive pressure in the treatment of sleep apnea syndromes]. 624 49

It is generally believed that the first description of the sleep apnea syndrome was made by Charles Dickens in the Pickwick Papers and that the first medical description was published in 1956. In fact, some of the features of the sleep apnea syndrome were described in antiquity and brief medical reports were published prior to the Pickwick Papers. This article traces the literary and medical contributions to our understanding of sleep apnea.
Arch Intern Med 1983 Dec
PMID:Sleep apnea. From the needles of Dionysius to continuous positive airway pressure. 636 64

To evaluate the effect of continuous positive airway pressure via nasal mask (nasal CPAP) on occlusive, mixed, and central apneas (OA, MA, and CA, respectively), we performed nocturnal polysomnography without and with nasal CPAP on 21 patients with sleep apnea. Three patients were unable to tolerate nasal CPAP. The remaining 18 patients had significant reductions in the overall apnea frequency when using nasal CPAP (52.9 +/- 5 per hour slept vs 3.3 +/- 1 per hour slept, mean +/- SE, p less than 0.001). The use of nasal CPAP significantly reduced the frequency of OAs during both nonrapid eye movement (non-REM) and REM sleep (p less than 0.001). It also reduced the frequency of MAs during both non-REM and REM sleep (p less than 0.05). Nasal CPAP did not increase the frequency of CAs in patients who had MAs when sleeping without nasal CPAP indicating that both the "central" and obstructive portions of MA were eliminated. In those patients who had CAs while sleeping without nasal CPAP, the CA frequency was unchanged by nasal CPAP although there was a good deal of interindividual variability. We conclude that nasal CPAP is well tolerated and effective in reducing the frequency of OAs and MAs. The variability of the response of CA to nasal CPAP suggests that the pathogenesis of CA may not be homogeneous.
Chest 1984 Dec
PMID:Nasal CPAP effect on patterns of sleep apnea. 638 32

Anterior mandibulectomy can precipitate the development of sleep apnea. All head and neck tumor patients having had extensive composite anterior oral cavity resections should be evaluated for sleep apnea before decannulation of their tracheostomy tube. Subsequent flap and/or rigid reconstruction of the lower jaw appears to prevent the development of sleep apnea. Fascial sling suspension of the lower lip does not appear to prevent sleep apnea.
Laryngoscope 1984 Dec
PMID:Mandibulectomy without reconstruction can cause sleep apnea. 650 80

To determine the efficacy of theophylline treatment in infants at increased risk for SIDS, we obtained 24-hour cardiorespiratory recordings (pneumograms) in 80 infants given theophylline in whom the initial pneumogram was abnormal. Fifty-three infants had a clinical diagnosis of near-SIDS, and 27 were asymptomatic siblings with a positive family history for SIDS. The initial pneumogram was obtained at a mean age of 6.9 weeks, and the repeat pneumogram 2.3 weeks later, when the mean theophylline blood concentration was 11.2 +/- 0.5 micrograms/ml. Theophylline treatment resulted in comparable and highly significant improvements in both groups. Among all 80 infants, apnea density decreased from 1.6 +/- 0.2% (SEM) to 0.3 +/- 0.1% (P less than 0.001), periodic breathing episodes/100 minutes decreased from 2.7 +/- 0.4 to 0.3 +/- 0.1 (P less than 0.001), and the longest apneic period decreased from 13.5 +/- 0.7 to 10.1 +/- 0.5 seconds (P less than 0.001). Findings on the pneumogram became completely normal with theophylline therapy in 87% of infants with near-SIDS and 81.5% of asymptomatic siblings. Pneumogram normalization was associated with absence of further symptomatic sleep apnea in the near-SIDS group and with continued absence of any clinical symptoms in the asymptomatic family history group. There were no deaths from SIDS.
J Pediatr 1983 Dec
PMID:Theophylline improves pneumogram abnormalities in infants at risk for sudden infant death syndrome. 664 38

Twenty patients complaining of excessive daytime somnolence (EDS) secondary to significant head trauma were studied objectively. Several polygraphic recording protocols were performed over the 12-year study period. Eighteen of the 20 patients were objectively sleepy, 8 of them presented mixed sleep apnea syndrome that fragmented their sleep, 5 patients' sleep-related breathing problems improved over time, 9 patients presented daytime somnolence, and 1 reported abrupt bouts of muscle weakness and had two sleep onset rapid eye movement (REM) periods during daytime testing. Cerebrospinal fluid analysis for specific neurotransmitter metabolites' evaluation, pre- and postprobenecid, did not differentiate posttraumatic EDS patients from narcoleptics or other patients with EDS. Two patients (one with organic brain syndrome, the other depressed) reported subjective sleepiness, not confirmed by objective data. Objective testing in posttraumatic sleepiness is recommended because of the plurality of problems and medicolegal implications.
Neurology 1983 Dec
PMID:Posttraumatic excessive daytime sleepiness: a review of 20 patients. 668 31

Excessive daytime sleepiness (EDS) in certain patients with sleep apnea syndrome may be the result of intermittent upper airway obstruction during sleep. The possible occurrence of daytime hypertension and pulmonary hypertension (PH) in these patients has been emphasized. Transient and sometimes severe elevations of systemic and pulmonary arterial pressures during sleep as a result of intermittent upper airway obstruction may lead to EDS, daytime hypertension, and PH. The aim of the present study was to investigate whether daytime hypoxemia and hypoxemia during sleep contribute to EDS, daytime hypertension, and PH. The results indicate that: (1) sleep disturbance and blood gas changes while awake and asleep may play a role for EDS, although these abnormalities were not present in some cases, (2) hypoxemia while awake and asleep is probably not involved in daytime hypertension, and (3) mean resting pulmonary arterial pressure is correlated with daytime PO2, PCO2, %IBW, %FVC, and FEV1.0%, Cardiopulmonary hemodynamic function may return to normal in some patients who receive appropriate treatment.
Nihon Kyobu Shikkan Gakkai Zasshi 1994 Dec
PMID:[Sleep apnea syndrome]. 760 17

The complications of endotracheal intubation are particularly frequent in patients with obstructive sleep apnoea syndrome (OSAS). We prospectively tested nasal ventilation in such patients admitted for acute respiratory failure. Six consecutive patients, aged 17-70 yrs, were selected for the study. All patients were confused or severely obtunded, Glasgow Coma Score (GCS) 10 (SD 2). With nasal bi-level positive airways pressure (BiPAP) all these patients improved clinical status and arterial blood gas values, avoiding intubation and invasive mechanical ventilation. The median pH increased from 7.26 (SD 0.06) to 7.36 (0.01) and to 7.43 (0.02) after, 1-3 and 24 h of nasal ventilation, respectively. Nasal ventilation lasted an average of 21 (3) h on the first day. All patients were discharged home after a median hospital stay of 28 (11) days.
Monaldi Arch Chest Dis 1994 Dec
PMID:Acute respiratory failure, due to severe obstructive sleep apnoea syndrome, managed with nasal positive pressure ventilation. 771 17

This is the first report on a case of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with Gerhardt syndrome (paralysis of bilateral vocal cords). A 67-year-old Japanese man suffering from progressive autonomic failure was diagnosed as having Shy-Drager syndrome (SDS) with hyponatremia due to SIADH and severe sleep apnea caused by a bilateral recurrent nerve palsy. Water load test showed alteration in diuresis which was corrected by phenytoin. Arginine vasopressin secretion was not suppressed by plasma osmolality below 280 mOsm/kgH2O. Impairment of the afferent pathways of baroreceptors, or impairment of the osmoreceptors could be speculated as the etiological factor of the SIADH observed in this case.
Intern Med 1994 Dec
PMID:Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and Gerhardt syndrome associated with Shy-Drager syndrome. 771 59

Obstructive sleep apnoea syndrome is characterized by irregular snoring during sleep, excessive daytime sleepiness and in some cases unwanted sleep attacks. The patient has a disturbed night sleep with numerous wakenings. Disturbed sleep at night causes daytime problems with attention, concentration and work performance. Furthermore, it may eventually result in errors and accidents. Excessive sleepiness sometimes necessitates the suspension of the patient's driving license. It is of importance to identify patients with obstructive sleep apnoea and daytime sleepiness, because the condition can be treated effectively. Many Danish patients are still unidentified. Diagnostic and treatment possibilities vary from one part of Denmark to another.
Ugeskr Laeger 1994 Dec 12
PMID:[Obstructive sleep apnea and abnormal fatigue]. 783 15


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