Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four boys aged 6-16 years with neurodevelopmental deficits were treated with CPAP for obstructive sleep apnoea. Their diagnoses were: Obesity with mild mental retardation, (2) attention deficit hyperactivity disorder, (3) epilepsy associated with left hemiparesis and (4) mild mental retardation due to fragile X syndrome. Previous therapeutic attempts, including adenotonsillectomy, amitriptyline and methylphenidate in our patients prior to CPAP treatment were unsuccessful. A follow-up period of 12-48 months demonstrated a number of clinical benefits such as improvement in sleep quality and daily arousal, and a decrease in the frequency of seizures and episodes of pneumonia. Polysomnographic studies indicated a significant improvement in sleep parameters such as apnoea frequency, awakenings, sleep efficiency and arterial oxygen saturation. Side effects were mild and readily alleviated. CPAP is a feasible therapeutic intervention in intractable obstructive sleep apnoea of childhood, even when associated with neurodevelopmental deficits.
 ...
PMID:CPAP treatment of obstructive sleep apnoea and neurodevelopmental deficits. 754 99

The sleep apnea syndrome is often associated with the syndromes of daytime exhaustion and involuntary daytime sleeping fits. The cause is assumed to be fragmentary sleep resulting from night-time arousal. The central nervous activation reactions caused by apnea or hypopnea, respectively, and not the movement arousal determine the sleep structure. We have examined 10 male patients in the age range 40-55 years (48 +/- 6 SD) before and during the first 3 nights of CPAP therapy. Cardiorespiratory polysomnography was performed in all four nights. Sleep way analyzed visually and differentiation was made between respiratory (RA) and movement arousal (MA). All 10 patients had a pronounced sleep apnea syndrome. Deep and dream sleep were reduced, significantly more respiratory arousals occurred than movement arousals. The SWS latency was shortened in the first therapy night, the deep and dream sleep proportions increased and the RA decreased significantly. No further significant changes in the sleep parameters occurred during the second and third nights. We found that the number of apnea/hypopnea was not equal to the number of RA. When less arousal was recognized it was suggestive of a deficit of the diversion function while more RA was indicative of additional respiratory events, e.g. pharyngeal obstructions and hyperventilations which were not recognized as apnea or hypopnea. In addition to its role in the differential diagnosis of sleeping disorders, in particular sleep apnea, arousal differentiation is also an important criterion for estimating the efficiency of CPAP therapy.
 ...
PMID:[Differentiation of arousal in sleep before and after CPAP therapy in patients with pronounced sleep apnea syndrome]. 761 93

Patients with obstructive sleep apnoea complain of excessive daytime sleepiness and unwanted sleep attacks. Treatment with nasal continuous positive airway pressure, CPAP, normalizes the sleep pattern and the daytime symptoms disappear. Twenty-five patients evaluated their situation by questionnaire before and during CPAP treatment. Treatment improved their working capacity and their social life. Almost all patients report treatment as giving them a new life, i.e. vastly improving their quality of life. CPAP treatment is cheap.
 ...
PMID:[Sleep apnea. Improved quality of life with continuous positive pressure respiration]. 765 69

All-night polysomnographic studies were performed on ten patients (all female) with rheumatoid arthritis complicated with temporomandibular joint destruction and cervical lesions. The mean age of these subjects was 67.5 yrs, ranging from 48-81 yr. They all had some morphologic abnormalities of cervical spines and/or temporomandibular joints. Sleep study revealed that all of them had sleep apnea; five of them were of obstructive type (obstructive group) while the remaining showed central type of sleep apnea (central group) predominantly. There were no statistically significant differences of the levels of apnea index, mean-nadir SO2 and the lowest SO2 between the obstructive group and the central group. No detectable differences of cephalographic measurements and MRI findings existed between the two groups either. In one patient, nasal-CPAP converted central apnea to normal breathing dramatically. Our observations indicate that the cause of central apnea in RA patients with temporomandibular lesions is collapse of upper airway, inducing inhibitory inputs from the mechanoreceptors in that region.
 ...
PMID:[Sleep apnea syndrome in rheumatoid arthritis (RA) patients complicated with cervical and temporomandibular lesions]. 773 87

We studied the effect of CPAP and BIPAP on cardiac output (CO) in 23 male obstructive sleep apnea (OSAS) patients with cardiac history but without congestive heart failure (CHF) during wakefulness using the thermodilution method. CPAP was applied at 10 cm H2O and 15 cm H2O, BIPAP at 10/0 cm H2O and 15/10 cm H2O. CO only decreased significantly by 14.6 +/- 11.8% at 15 cm H2O CPAP and by 13.4 +/- 10.0% at 15/10 cm H2O BIPAP. CPAP and BIPAP did not differ in altering hemodynamics. So sleep apnea patients without CHF develop no severe decrease of CO during nasal positive pressure ventilation up to 15 cm 2O.
 ...
PMID:[Effect of CPAP and BIPAP on stroke volume in patients with obstructive sleep apnea syndrome]. 775 70

A 12-year-old schoolgirl presented with severe obstructive sleep apnoea due to the Robin sequence. The sleep apnoea, together with the associated findings of daytime sleepiness, nocturia, right heart strain and growth retardation, were successfully reversed by nasal CPAP therapy. This therapy allows postponement of a decision concerning corrective surgery until after full growth has occurred.
 ...
PMID:Treatment of Robin sequence with nasal CPAP. 778 92

In a prospective study between 1989 and 1993, 50 patients (45 males, 5 females, mean age: 58.4 years; mean AHI = 37.8/h) suffering from obstructive sleep apnoea were examined. They underwent nocturnal polysomnography and were provided nightly treatment with nasal CPAP (Respironics Sleep-Easy III und REMSTAR, Respironics Inc, Monroeville, PA). 41 patients were given primary treatment with nCPAP. Nine patients were secondarily treated with a nCPAP mask after other modalities of therapy (weight reduction, mandibular positioning appliance, nasal surgery, uvulopalatopharyngoplasty) had been applied without success. All patients were controlled in the sleep laboratory nine to fourty-two months (mean: 18 months) after the masks were fitted. A questionnaire was used to evaluate subjective complaints, use of the CPAP mask, technical problems, partner's acceptance of the mask etc. 46 patients wore the mask on an average of 6.2 nights per week and 6.5 hours per night. These self-reported data from the questionnaire correlated only in 85 per cent of the cases with the data provided by the time clock installed in the CPAP machine. The long-term compliance with nCPAP of the studied group was 92 per cent. Four patients returned their masks within two months. It was possible to provide sufficient respiration to more than 90% of the patients using an average pressure between 7 and 8 cm water column. Respiration presented no problems for all six patients who had previously been treated with uvulopalatopharyngoplasty in our hospital. Despite the mask 41 patients slept with their partner in a common room.
 ...
PMID:[Nasal positive pressure ventilation (nCPAP) in therapy of obstructive sleep apnea: acceptance by 50 patients]. 781 43

Nasal continuous positive airway pressure (N-CPAP) is now the treatment of choice for patients with sleep apnea syndrome (SAS). Side effects and adverse reactions have been described with this device. We have therefore systematically studied side effects of N-CPAP in 193 patients recruited consecutively from two French sleep centers (Lyon and Grenoble). Patients were followed up with repeated polysomnography, clinical assessment, and a formal questionnaire about subjective benefits and side effects of treatment. The patients (mean age, 59 +/- 12 years) were obese (body mass index, 32 +/- 7 kg/m2) and had been using N-CPAP for 19 +/- 17 months for moderate to severe SAS (respiratory disturbance index [RDI] = 53 +/- 25/h). The clinical presentation was the same in the two sleep centers. Fifty percent of the patients complained of at least one side effect due to the nasal mask (allergy to the face, air leaks, abrasions of the ridge of the nose). Using individually molded masks, the patients exhibited fewer abrasions of the bridge of the nose (p < 0.01) and had red eyes every morning in only 9% of cases vs 24% for the patients using industrial silicone nasal masks (p < 0.025). Patients with silicone nasal masks also had more allergic reaction to the face (13% vs 5%), but this difference did not reach significance. Dry nose or mouth in the morning affected 65% of the patients. Sneezing and nasal drip were present in more than 35% of the subjects and nasal congestion in 25%. When the patients were separated in two groups, whether or not using a humidifier, no difference was found for any of the side effects described. The clinical presentation as to the clinical benefits obtained from N-CPAP were different when comparing mild vs moderate-to-severe SAS. However, no differences were shown in the two subgroups regarding the side effects due to the nasal mask. The discomfort of the N-CPAP apparatus in terms of noise was described more frequently in the subgroup with mild SAS. We did not observe any correlation between the side effects and the level of pressure used during N-CPAP. The rate of compliance remains high with a daily use of 6.5 +/- 3 h, with 88% of the patients using their device every night. This could be explained by the clinical benefit obtained: only 1% of the patients had no subjective benefit induced by their therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Side effects of nasal continuous positive airway pressure in sleep apnea syndrome. Study of 193 patients in two French sleep centers. 758 73

Treatment of sleep apnea patients may be justified even when symptoms are absent. On the one hand, hypersomnia or daytime sleepiness are subjective symptoms and only reflect one aspect of the clinical syndrome of sleep apnea. On the other hand, an apnea index in excess of 5, e.g. the "laboratory diagnosis" of sleep apnea, has been reported as an independent risk factor for myocardial infarction. The main problem is scientific definition of cut-off points for treatment. There is no controversy about whether patients with symptoms should be treated or not. A CPAP trial seems to be justified in asymptomatic patients with an apnea/hypopnea index in excess of 20-30 and in patients with cardiovascular risk factors when the apnea/hypopnea index is in excess of 5. These laboratory cut-off values are not absolute values but represent flexible guidelines for initiating a CPAP trial in asymptomatic patients with apnea. The reasons for uncertainty whether or not to treat patients with asymptomatic sleep apnea are discussed.
 ...
PMID:[Should patients with asymptomatic sleep apnea syndrome be treated with CPAP?]. 789 63

We have previously shown that hypocapnia triggers Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) in patients with congestive heart failure (CHF). Nasal continuous positive airway pressure (NCPAP) may attenuate CSR-CSA in patients with CHF and CSR-CSA. Accordingly, we hypothesized that attenuation of CSR-CSA by NCPAP would be related to an increase in PCO2. Therefore, we examined the effect of NCPAP on the frequency of apneas and hypopneas, transcutaneous PCO2 (PtcCO2), and minute volume of ventilation (VI) in 12 consecutive patients with CHF and CSR-CSA during stage 2 sleep. A control group of six patients, who did not receive NCPAP, was also studied. In the control group, there were no changes from baseline to 1 mo in the frequency of central apneas and hypopneas, mean PtcCO2, mean VI, or mean SaO2 during stage 2 sleep. In contrast, from baseline to 1 mo the NCPAP group experienced a decrease in the frequency of apneas and hypopneas (58.7 +/- 5.2 to 23.2 +/- 6.0/h of sleep, p < 0.001), an increase in mean PtcCO2 (34.6 +/- 1.4 to 40.8 +/- 1.1 mm Hg, p < 0.001), a reduction in mean VI (8.1 +/- 1.0 to 5.2 +/- 0.5 L/min, p < 0.01) and an increase in mean SaO2 (91.6 +/- 1.1 to 95.0 +/- 0.5%, p < 0.025) during stage 2 sleep while on 10.2 +/- 0.5 cm H2O nasal CPAP. We conclude that likely mechanisms through which NCPAP reduces CSR-CSA are by increasing SaO2 and raising PaCO2 during sleep toward or above the apneic threshold.
 ...
PMID:Effect of continuous positive airway pressure on central sleep apnea and nocturnal PCO2 in heart failure. 795 21


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>