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

Polysomnography and blood gas measurements during sleep in a young man with craniofacial dysostosis, who presented with an extremely severe sleep apnea syndrome, are reported. Tracheostomy relieved all his complaints permanently, namely hypersomnia, deteriorated intellectual performance, automatic behaviour with hypnagogic hallucinations and snoring. Laboratory results also returned to normal. The polygraphic data of night sleep (and daytime naps) before and after surgery suggest that hypersomnia was primarily caused by severe nighttime oxygen desaturations and that the hypnagogic hallucinations were caused by apnea-induced chronic REM sleep deprivation. Furthermore, the periodic variation of central respiratory drive, which was also abolished after surgery, is interpreted as the cause of apnea-induced fluctuations between sleep stages in this case.
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PMID:Severe adult hypersomnia--sleep apnea syndrome in craniofacial dysostosis. 374 15

In a study of sleep-disordered breathing among 139 elderly individuals, sleep apnea (defined as 5 or more apneas per hour) occurred in 34 (41.7%) Alzheimer's subjects compared with 56 (5.4%) healthy controls, 35 (11.4%) depressive subjects, and 24 (16.7%) patients with mixed symptoms of both cognitive impairment and depression (p less than .001). Alzheimer's patients had a significantly higher proportion of NREM-related than REM-related apnea. Moreover, a significant (p less than .01) positive correlation between the apnea index and severity of dementia, as measured by the Blessed Dementia Rating Scale, was found in apnea-positive Alzheimer's patients, as well as in the entire sample of Alzheimer's patients (p less than .05). No such correlation was found in the mixed-symptoms group. Possible clinical and neuropathologic implications are discussed.
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PMID:Sleep-disordered breathing in normal and pathologic aging. 375 14

In order to evaluate possible deficits accompanying sleep-disordered breathing (SDB) in a subclinical population, the nocturnal respiration, health status, and sleep/wake cycle of 46 healthy, heavy-snoring men were measured. Sixty-two percent of these subjects had at least one episode of apnea/hypopnea, while 13% had high levels of apnea/hypopnea [apnea/hypopnea index (AHI) greater than or equal to 5]. Most events occurred in stages 1 or 2 or in REM sleep. Strong relationships between weight and SDB were observed, as were more modest relationships between age and SDB. Correlational procedures indicated relationships between SDB and higher blood pressure, subjective sleepiness, and napping. Because similar, but stronger, relationships involving these variables are observed in patients with a sleep apnea syndrome (SAS), it appears that a continuum exists between heavy-snoring men and patients with SAS. When these subjects were grouped by level of SDB, subjects with high levels of SDB (AHI greater than or equal to 5) had significantly lower nocturnal oxygenation parameters than the remaining subjects. However, there were no between-group differences in health or sleep/wake variables. It is concluded that while apnea/hypopnea events in subclinical populations may not be completely benign events, the level at which they may be considered frankly pathological is presently unclear.
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PMID:Sleep-disordered breathing and its concomitants in a subclinical population. 380 61

Two cases of myotonic dystrophy with excessive daytime somnolence are described. All-night polysomnographic studies were performed revealing high number of central sleep apnea which triggered micro-arousals and awakenings leading to decrease of sleep efficiency as well as of stage 3, 4 and REM. Obstructive and mixed apneas were found in the normal range. Hypoxia was not present in both recordings. Central sleep apneas and its secondary excessive daytime sleepiness may indicate early signs of the central nervous system impairment related to myotonic dystrophy, as a multi-organ disease.
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PMID:[Excessive daytime sleepiness, central type sleep apnea and myotonic dystrophy]. 383 40

The sleep-related respiratory and blood pressure changes in a patient with Shy-Drager syndrome associated with the sleep apnoea syndrome are reported. Polygraphic recordings showed repeated apnoeic episodes during both sleep and wakefulness. Systemic arterial pressure values during sleep tended to be lower than in two other patients with Shy-Drager syndrome, and, unlike observations in the sleep apnoea syndrome, nocturnal swings of arterial pressure related to obstructive apnoea were markedly reduced. As a result, the total sleep time was reduced; a sleep with several features similar to REM stage was identified; during this stage the arterial pressure reached the lowest levels recorded. A review of the literature revealed that nocturnal respiratory disturbances were detectable in a high percentage of patients with Shy-Drager syndrome. We suggest that such an association is not a chance one.
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PMID:Sleep-related respiratory and haemodynamic changes in Shy-Drager syndrome: a case report. 390 59

Hypoxaemia during the rapid eye movement phase of sleep is common in older healthy normal subjects over 55 years of age; the sleep apnoea syndromes--such as obstructive sleep apnoea, where oro-nasal airflow ceases for more than 10 seconds on many separate occasions throughout the night, due to failure of contraction of the genio-glossus muscle; "blue and bloated" patients with chronic bronchitis and emphysema, where profound nocturnal hypoxaemia is common in REM sleep, and is associated with further elevation of pulmonary arterial pressure; the overlap syndrome--where "blue and bloated" chronic bronchitis is associated with an obstructive sleep apnoea syndrome; and bronchial asthma, where hypoxaemia is associated with irregular breathing and possibly nocturnal bronchoconstriction. Although absolute recognition depends upon all night sleep studies, monitoring of ear oxygen saturation, breathing patterns, and EEG, the clinical features when awake can lead to suspicion of sleep hypoxaemia--as, for example, obesity and obstructive sleep apnoea with loud snoring and restlessness in sleep, hypoxaemia during wakefulness in the overlap syndrome, and nocturnal awakening with wheeze in bronchial asthma. Treatment depends on the cause, and may vary from weight loss and nasal continuous positive airway pressure in obstructive sleep apnoea, to nocturnal oxygen in "blue bloaters", a combination of these two in the overlap syndrome, and long acting bronchodilators such as slow release theophyllines in nocturnal asthma. Recognition and appropriate treatment of nocturnal hypoxaemia is an important new development in respiratory medicine.
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PMID:Breathing during sleep. 390 86

Nocturnal sleep studies of 12 patients with obstructive sleep apnea and a matched control group of 12 subjects without the sleep apnea syndrome were analyzed to compare arterial oxyhemoglobin saturation (SaO2) during REM and non-REM sleep. Mean percentage of total sleep time spent in REM sleep was not significantly different in patients with obstructive sleep apnea and in subjects without significant apnea (14.2 +/- SEM 2.2 percent in patients vs 12.0 +/- 2.2 percent in nonapnea subjects). Apneas were longer during REM than non-REM sleep in all 12 patients (p less than 0.01). Oxyhemoglobin desaturations were more frequent during REM than non-REM sleep in both apnea patients and the control subjects. In addition, there was a greater mean fall in SaO2 per desaturation episode in both the apnea patients and non-apnea subjects. We conclude: 1) sleep apneas are longer during REM sleep than non-REM sleep in patients with obstructive sleep apnea; 2) hypoxemia is greater during REM sleep than non-REM sleep in subjects with and without the sleep apnea syndrome.
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PMID:Apnea duration and hypoxemia during REM sleep in patients with obstructive sleep apnea. 397 29

By means of polygraphic sleep recording, the sleep apnea profile with respect to the number and duration of inactive, obstructive and mixed apneic episodes as well as periodic breathing has been investigated in infants born preterm at 40, 52 and 64 weeks conceptional age and compared to that of term infants. At 40 weeks preterm infants showed significantly more apnea and periodic breathing compared to term infants. The difference was essentially due to obstructive and mixed apnea in non-REM sleep. There was a sharp decrease in all apneic variables--inactive, obstructive and mixed apnea as well as of periodic breathing--at 52 weeks conceptional age in infants that were previously preterm. Both groups exhibited a rather identical sleep apnea profile at 64 weeks. Two prospectively studied infants in the preterm group later became SIDS victims. One of them might have been identified as being at risk on the basis of his apnea profile compared to the normative data now available.
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PMID:Infant sleep apnea profile: preterm vs. term infants. 398 27

The obstructive sleep apnoea syndrome occurs predominantly in men. To determine the effect of testosterone on ventilatory function and whether testosterone may play a role in the development of obstructive apnoea, we performed waking ventilatory drive studies and sleep studies in five hypogonadal men. These androgen-deficient subjects were studied both while receiving no treatment and after six weeks of testosterone replacement therapy (testosterone oenanthate 200 mg i.m. every 2 weeks). Hypoxic ventilatory drive decreased significantly, from 158 +/- 39 (mean +/- SEM) off testosterone to 88 +/- 19 on testosterone therapy (P less than 0.05). Hypercapnoeic ventilatory drive did not change significantly on testosterone. Obstructive sleep apnoea developed in one man and markedly worsened in another man in association with testosterone administration. Both of these subjects also exhibited marked decreases in oxygen saturation with the development of cardiac dysrhythmias during sleep and large increases in haematocrit. The remaining three hypogonadal men did not demonstrate significant sleep apnoea either on or off testosterone. The percentage of sleep time spent in REM sleep increased from 14 +/- 3% to 22 +/- 2% when the men were receiving testosterone (P less than 0.01), but the episodes of sleep apnoea tended to occur during non-REM sleep. We conclude that in some hypogonadal men, replacement dosages of testosterone may affect ventilatory drives and induce or worsen obstructive sleep apnoea. The obstructive sleep apnoea syndrome is a potential complication of testosterone therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Testosterone replacement in hypogonadal men: effects on obstructive sleep apnoea, respiratory drives, and sleep. 401 61

Low-flow oxygen decreases the frequency of the 3 types of apnea (central, mixed, and obstructive) in patients with predominantly obstructive sleep apnea. The decrease in frequency appears to be accompanied by a shift in apnea distribution, consisting of a decrease in the proportion of central and mixed apneas and an increase in that of obstructive apneas. To determine whether this shift represents a greater inhibitory effect on central and mixed apneas or an increased tendency toward obstructive apneas, we administered low-flow oxygen during sleep to 9 patients who demonstrated predominantly central and mixed sleep apnea (51 +/- 33% and 33 +/- 21% of apneic events, respectively, mean +/- SD) and had resting, room air, oxygen tensions of 83 +/- 11 mmHg. During non-REM sleep, oxygen increased the baseline oxyhemoglobin saturation while reducing the average peak fall in oxyhemoglobin saturation during each apneic event. Oxygen reduced the overall apnea frequency from 66 +/- 7.8 (mean +/- SE) to 43.0 +/- 10.7 episodes per hour (p less than 0.02). Central and mixed apneas decreased markedly from 31.4 +/- 0.6 to 6.4 +/- 4.3 episodes per hour (p less than 0.02) and from 20.9 +/- 5.0 to 4.9 +/- 1.5 episodes per hour (p less than 0.02), respectively. However, obstructive apnea frequency more than doubled from 13.9 +/- 7.0 to 32.1 +/- 9.2 episodes per hour (p less than 0.02). We conclude that in these patients oxygen tension altered both the frequency and distribution of sleep-induced apnea, with a lower oxygen tension increasing the frequency of central and mixed apneas and a higher oxygen tension increasing the frequency of obstructive apneas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A shift from central and mixed sleep apnea to obstructive sleep apnea resulting from low-flow oxygen. 402 46


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