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 1,062 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A sleep apnea syndrome due to upper airway obstruction was diagnosed in 25 adult men (25 to 65 years of age) using nocturnal polygraphic monitoring. Excessive daytime somnolence, hypnagogic hallucinations, and automatic behavior, personality changes with abnormal behavioral outbursts, impotence, morning headaches, abnormal motor activity during sleep, nocturnal enuresis, and high blood pressure should suggest this diagnosis when any of the symptoms are associated with loud snoring. Respiratory monitoring during sleep and nocturnal cardiovascular evaluation bring prognostic information and indications for therapy. Three types of therapeutic trials, namely, diet, medications with or without diet, and surgery have been performed. Only surgery has been beneficial in these cases.
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PMID:Sleep apnea syndrome due to upper airway obstruction: a review of 25 cases. 55 14

Eight children, 5 to 14 years of age, were diagnosed by means of nocturnal polygraphic monitoring with a sleep apnea syndrome similar to that seen in adults. Excessive daytime sleepiness, decrease in school performance, abnormal daytime behavior, recent enuresis, morning headache, abnormal weight, and progressive development of hypertension should suggest the possibility of a sleep apnea syndrome when any of these symptoms is associated with loud snoring interrupted by pauses during sleep. Surgery may eliminate the clinical symptomatology.
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PMID:Sleep apnea in eight children. 93 81

A questionnaire concerning problems inherent to ronchopathy was evaluated in order to assess its test-retest reliability and the interobserver variability of the items. The results indicate the existence of three orders of variables. The first (class A) was characterized by good intra- and inter- observer reliability. It included all interval variables (i.e. weight, height, arterial pressure) and most ordinal variables (i.e. grading of snoring, excessive daytime somnolence, morning headache, smoking, etc.). The second (class B) was characterized by good intra-observer and poor inter-observer reliability. It included snoring onset time and morning somnolence. The third class (class C) was characterized by both poor intra- and inter-observer reliability. It included sleep apnea. For large epidemiological survey purposes the authors suggest that only class A variables be used.
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PMID:[Test-retest reliability of anamnestic data on chronic obstructive apnea]. 209 68

Detailed data about sleep habits, sleep complaints, life style, work, past and present health were obtained from 1,502 industrial workers. In agreement with previous studies, one-third of the workers reported having problems with sleep. A relatively large percentage of workers complained of excessive daytime somnolence (EDS), which was unrelated to sex, age, education, and area of origin. Compared to the total population, workers complaining EDS had signficantly more pre- and postsleep complaints, midsleep disturbing phenomena, and work accidents, and they were less satisfied with their work. They also had a significantly higher prevalence of asthma, high blood pressure, headaches, and arthritis and ulcers, and they consumed significantly more medications. Based on the cluster of pre- and postsleep complaints of workers complaining of EDS, and on preliminary results from the second phase of this project (which includes laboratory polysomnographic recordings), it is suggested that in most cases, various forms of breathing disorders in sleep are responsible for EDS.
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PMID:Sleep habits and sleep disturbances in industrial workers in Israel: main findings and some characteristics of workers complaining of excessive daytime sleepiness. 725 75

Four hundred forty-one subjects 34 to 69 yr of age were recruited from a random sample of the community. The sample was biased in favor of men, snorers, and subjects with subjective sleep complaints. They answered a questionnaire and were monitored in their homes for sleep-disordered breathing (SDB). This report concerns the presence of symptoms associated with the obstructive sleep apnea (OSA) syndrome in the subjects with SDB detected in this community sample. Most of the symptoms commonly recognized as occurring in OSA were associated with SDB in our sample: snoring that disturbed the sleep of other persons, reports of apnea, reports of gasping or choking sounds during sleep, and finding the bedclothes in disarray in the mornings had significant univariate associations with SDB. Nocturnal choking and morning headache were negatively associated with SDB. Excessive daytime somnolence (EDS) was reported by 41% of those with SDB, but it was also reported by 37% of snorers without SDB and by 37% of nonsnorers. We conclude that the symptoms seen in clinic patients with OSA also occur in subjects with SDB who have not presented for medical attention. Enumeration of these symptoms by questionnaire, however, is a poor test for OSA in the community. EDS was reported by a higher than expected proportion of subjects not affected by SDB, suggesting that causes of self-reported EDS other than SDB may be common.
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PMID:A community study of snoring and sleep-disordered breathing. Symptoms. 763 30

The first series of children with obstructive sleep apnoea syndrome was reported in 1976. Later it became apparent that children may have breathing disorders during sleep without frank apnoea or 'hypopnoeas'. This pattern could be detected by measuring the oesophageal pressure. This led to the concept of sleep-disordered breathing as a spectrum that combines obstructive sleep apnoea syndrome and the upper airway resistance syndrome. Studies that do not take into account this spectrum may misclassify symptomatic patients as 'primary snorers'. The exact prevalence of sleep-disordered breathing in children is unknown but may be as high as 11%. There is a familial predisposition to sleep-disordered breathing. Nasal obstruction and mouth breathing influence facial growth, which may further lead to difficulty in breathing while asleep. Symptoms include an increase in total sleep time, nonspecific behavioural difficulties, hyperactivity, irritability, bed-wetting and morning headaches. Clinical signs include failure to thrive, increased respiratory effort with nasal flaring and suprasternal or intercostal retractions. Also, abnormal paradoxical inward motion of the chest may occur during sleep. Excessive daytime sleepiness and obesity are not always present. Untreated children may develop cardiovascular complications. The condition is treatable with continuous or bilevel positive airway pressure, and may be cured with surgery.
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PMID:Sleep-disordered breathing in children. 978 33

Excessive daytime sleepiness (EDS) may limit the symptomatic treatment of Parkinson's disease and can alter the patient's lifestyle significantly. Ten consecutive patients with Parkinson's disease on various dopaminergic drugs and EDS were recruited to a 4-week open-label trial of modafinil. Patients were evaluated using the Epworth Sleepiness Scale and Unified Parkinson's Disease Rating Scale part III. All but three patients, with previous history of intolerability of a dopamine agonist caused by EDS, remained on their baseline medications. Modafinil was titrated as needed to a maximum of 400 mg/day. The mean Epworth Sleepiness Scale score at baseline of patients completing the study (n = 9) was 14.22 (+/- 3.03). After completing the study on an average dose of 172 mg/day, the Epworth Sleepiness Scale score was 6.0 (+/- 4.87). Unified Parkinson's Disease Rating Scale scores were not affected by this medication. Side effects encountered were headache, generalized paresthesias, and hallucinations (n = 1 each, the patient developing hallucinations dropped out of the trial before completing 4 weeks of the study drug). The three patients who did not tolerate any increments of dopamine agonist before modafinil were able to tolerate further upward titration of the dopamine agonist. Modafinil may be effective in reducing EDS in patients with Parkinson's disease treated with dopaminergic drugs. It does not seem to worsen parkinsonian symptoms and may allow further increase in dopaminergic therapy in patients previously unable to tolerate this because of EDS.
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PMID:Treatment of excessive daytime sleepiness in patients with Parkinson's disease with modafinil. 1198 Dec 39

The various neurological guises in which obstructive sleep apnoea syndrome (OSAS) may present are illustrated by reporting four previously undiagnosed patients seen by one consultant neurologist in general neurological outpatient clinics. Presenting features were episodes of loss of consciousness (2), stroke, and excessive daytime somnolence; morning headache and cognitive decline were also observed. Two patients had been involved in road traffic accidents. Diagnoses suggested by the referring doctors included epilepsy, stroke and narcolepsy. Since OSAS is associated with increased morbidity and mortality, yet is frequently amenable to treatment, neurologists should be familiar with the heterogeneous presentations of this condition.
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PMID:Obstructive sleep apnoea syndrome presenting in a neurology outpatient clinic. 1266 3

Lipoma of the retropharyngeal space is a very rare benign tumor often causing unspecific clinical symptoms. The most common symptoms are dysphagia and/or respiratory disturbances. The clinical diagnosis may be difficult. The radiological imaging techniques (CT and MRI) can provide adequate information with regard to the composition and extension of the tumor, although final histological confirmation is essential. Surgery is the treatment of choice. We present a case of 40-year-old male patient complaining of obstructive sleep apnea symptoms (respiratory disturbances, excessive daytime somnolence, morning headache). The radiological examination (CT) showed a huge (11.7 x 7.2 cm) lipoma of the retropharyngeal space extending from the nasopharynx to the superior mediastinum. The tumor was removed via transcervical approach with complete amelioration of symptoms.
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PMID:Huge retropharyngeal lipoma causing obstructive sleep apnea: A case report. 1667 79

An observational study of cases of obstructive sleep apnoea-hypopnoea syndrome (OSAHS), both suspected and established, presenting to general neurology outpatient clinics over a 5-year period was undertaken. Only eight new cases of OSAHS, confirmed by sleep studies, were identified, most with neurological problems (poor seizure control, blackouts and headache) in addition to excessive daytime somnolence. OSAHS appears to be a rare cause of new symptomatic neurological presentations, although cases may have been overlooked as judgement was based on the index of clinical suspicion alone.
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PMID:Obstructive sleep apnoea-hypopnoea syndrome presenting in the neurology clinic: a prospective 5-year study. 1879 71


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