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

Over the past decade substantial evidence has accumulated implicating disorders of sleep in the pathogenesis of various metabolic abnormalities. This review, which is based on workshop discussions that took place at the 6th annual meeting of the International Sleep Disorders Forum: The Art of Good Sleep 2008 and a systematic literature search, provides a critical analysis of the available evidence implicating sleep disorders such as obstructive sleep apnoea (OSA), insomnia, short or long-term sleep duration and restless legs syndrome as potential risk factors for insulin resistance, glucose intolerance, type 2 diabetes mellitus and the metabolic syndrome. The review also highlights the evidence on whether treatment of specific sleep disorders can decrease metabolic risk. In total, 83 published reports were selected for inclusion. Although several studies show clear associations between sleep disorders and altered glucose metabolism, causal effects and the underlying pathophysiological mechanisms involved have not been fully elucidated. OSA appears to have the strongest association with insulin resistance, glucose intolerance, type 2 diabetes and the metabolic syndrome. There are, however, limited data supporting the hypothesis that effective treatment of sleep disorders, including OSA, has a favourable effect on glucose metabolism. Large randomized trials are thus required to address whether improvement of sleep quality and quantity can curtail excess metabolic risk. Research is also required to elucidate the mechanisms involved and to determine whether the effects of treatment for sleep disorders on glucose metabolism are dependent on the specific patient factors, the type of disorder and the duration of metabolic dysfunction. In conclusion, there is limited evidence on whether sleep disorders alter glucose metabolism and whether treatment can reduce the excess metabolic risk.
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PMID:Do sleep disorders and associated treatments impact glucose metabolism? 2004 48

Sleep-disordered breathing (SDB) encompasses a group of disorders that include obstructive sleep apnoea (OSA), central sleep apnoea (CSA) and nocturnal hypoventilation. SDB commonly coexists with sleep disorders such as insomnia and restless legs syndrome, and sleep deprivation has been shown to play a role in the pathogenesis of SDB. Participants of a workshop, held at the 6th annual meeting of The International Sleep Disorders Forum: The Art of Good Sleep in 2008, evaluated whether the effective management of sleep disorders could result in a reduction in SDB. Following the workshop, a critical review of the literature in the field of sleep and SDB was conducted in order to assess the impact of improving sleep on SDB, and to determine whether measures taken to improve sleep result in a subsequent improvement in SDB. Results showed that studies evaluating the influence of improved sleep on respiratory abnormalities in patients with SDB are lacking. Studies in patients with OSA, with or without obesity-hypoventilation syndrome, show that therapy with continuous positive airways pressure and non-invasive ventilation improves sleep parameters with beneficial effects on SDB. Studies involving small numbers of patients have shown that the antidepressants fluoxetine and mirtazapine produce improvements in sleep parameters and the apnoea-hypopnoea index, and that acetazolamide may improve CSA. The benzodiazepines flurazepam, temazepam and nitrazepam, the hypnotic zolpidem, the melatonin receptor agonist ramelteon and gamma-hydroxybutyrate have all been shown to improve sleep, but are not associated with reductions or worsening in SDB. It is clear that there is a distinct knowledge gap with regard to the benefit of improving sleep disturbances for subsequent improvements in SDB. Randomized controlled clinical trials investigating the effect of pharmacological and non-pharmacological improvement of sleep disorders focusing on whether there is improvement in coexisting OSA/SDB are clearly needed. Furthermore, well-designed clinical trials investigating the role of hypnotic agents in improving SDB in certain phenotypes will enable the development of treatment recommendations for primary care physicians managing these patients in routine clinical practice.
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PMID:Can improving sleep influence sleep-disordered breathing? 2004 52

Reports from a large number of studies document significant associations between sleep duration and various health problems such as cardiovascular events, risk of stroke, incident artery calcification, changes in inflammatory markers and many more. Furthermore, some sleep duration studies have shown that shorter sleep precedes some adverse health outcomes, although a causal relationship has yet to be demonstrated. Whilst clinical studies have shown that de-fragmenting (reducing awakenings and improving sleep continuity) sleep can reverse the harmful consequences of sleep apnea, and other studies have demonstrated that adjunctive treatment of insomnia improves depression, evidence that treatment of insomnia results in health benefit is more controversial. This article documents the debate session from the 6th International Sleep Disorders Forum -The Art of Good Sleep, held in Toronto, Canada in September 2008; the topic of which was "Does an improvement in sleep positively impact on health?"
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PMID:Can an improvement in sleep positively impact on health? 2042 12

Sleep-disordered breathing is very common and is associated with poor health and cognitive outcomes in children and adolescents. Its prevalence is between 2% and 4% of the population this group. Problems such as life-threatening events, failure to thrive, cardiovascular insult, poor cognition, poor school performance, and psychiatric/behavioral problems have been reported. This chapter will outline how to diagnose and treat adolescents with sleep apnea.
Adolesc Med State Art Rev 2010 Dec
PMID:Diagnosis and treatment of sleep apnea in adolescents. 2130 55