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Biomedical subjects

C Guilleminault

Publications and source records attributed to C Guilleminault.

At least 289 records · Page 16Linked to original sources
PubMed1987

Central sleep apnea and partial obstruction of the upper airway.

Seven men with central sleep apnea underwent polygraphic monitoring during sleep for at least 3 nights, in combination with other tests. Five patients had complaints of disturbed sleep; the other 2 were selected because they had central sleep apnea caused by bilateral brainstem lesions. The first 5 had a small upper airway, documented by cephalometric roentgenograms. Nasal continuous positive airway pressure, administered to improve the suspected respiratory load during sleep, eliminated the central sleep apnea in the first 5 patients but had, as expected, no positive effect on the central apnea of the 2 patients with brainstem lesions.

Adolescent↗
PubMed1987

HLA-DR restriction-fragment-length polymorphisms in narcolepsy.

Seventeen white patients from the Stanford Sleep Disorders Clinic complaining of excessive daytime somnolence (EDS) were selected for restriction-fragment-length polymorphism (RFLP) studies. Fourteen of the patients with clinically diagnosed narcolepsy were seropositive for DR2. RFLP analysis of these patients compared with a homozygous DR2-Dw2 cell line failed to reveal any polymorphism when digested with six restriction endonucleases and hybridized with three different cDNA probes. None of the three patients with central nervous system hypersomnia, a syndrome similar to narcolepsy, were DR2-positive. We conclude that any polymorphism of the DR beta, DQ alpha, or DQ beta genes of DR2 narcoleptics that might distinguish them from DR2 normals cannot be resolved through RFLP analysis.

HLA-D Antigens↗
PubMed1987

Current surgical concepts for treating obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome is a relatively common disorder with potentially serious psychologic and physiologic consequences. A comprehensive method of evaluation is described. Presurgical tests are mandatory in order to logically direct surgical treatment. Current surgical treatment and new techniques are discussed.

Electrodiagnosis↗
PubMed1987

Inspiratory muscle activity as a trigger causing the airways to open in obstructive sleep apnea.

This report discusses mechanisms causing the airways to open during obstructive sleep apnea (OSAS). In 4 male patients with OSAS, 92 nonrapid eye movement (NERM) sleep apnea episodes and 37 rapid eye movement (REM) sleep apnea episodes were analyzed breath by breath during a one-night study. We calculated the pressure time index of the diaphragm (the product of inspiratory time/cycle duration (Tl/Ttot) and mean transdiaphragmatic pressure swing), evaluated the sleep stages via EEG, and performed frequency spectrum analysis of the EMG of the diaphragm. It was found that with each occluded inspiratory effort the tension time index of the diaphragm (TTdi) increased progressively to reach or slightly exceed the fatigue threshold, 0.15 to 0.18 (during NREM sleep the TTdi of the last occluded breath was 0.195 +/- 0.045 and during REM sleep the TTdi of the last occluded breath was 0.153 +/- 0.037); that a close time relationship was observed as well between the onset of arousal and the opening of the airways. Our data suggest that the airways may be triggered to open by a protective reflex originating in the larynx or the inspiratory muscles upon reaching a certain degree of contraction.

Adult↗
PubMed1987

Automatic respiratory failure: sleep studies and Leigh's disease (case report).

A 34-year-old woman with a history of chronic nephropathy, kidney transplant rejections, and repeated hemodialysis developed symptoms of automatic respiratory failure during all states of sleep. The neuropathologic examination revealed symmetric brainstem lesions, explaining the sleep-related respiratory failure. Histology affirmed the diagnosis of Leigh's disease.

Adult↗
PubMed1987

Nasal continuous positive airway pressure in atelectasis.

Nasal continuous positive airway pressure (CPAP) has been widely and safely used in the treatment of sleep disorders but has not been previously utilized for therapy of pulmonary atelectasis in adults. We observed three patients with significant atelectasis which was refractory to conventional chest physiotherapy. Bronchoscopy was not a viable therapeutic option in any patient. Therapy with continuous nasal CPAP was initiated at 10 to 15 cm H2O. The patients tolerated the therapy well and had prompt resolution of atelectasis. Nasal CPAP may be an effective modality for therapy of pulmonary atelectasis in spontaneously breathing patients, particularly when conventional therapies are not tolerated or are ineffectual.

Adult↗
PubMed1987

Obstructive sleep apnea syndrome. A review.

Obstructive sleep apnea syndrome (OSAS) is a complex disorder characterized by a sleep-related collapse of the upper airway. The most likely candidate for the common pathway linking various abnormalities casually associated with OSAS (such as adenotonsillar hypertrophy, obesity, retro- or micrognathia, acromegaly, or more subtle structural anomalies) is an abnormally small upper airway lumen. Symptoms of OSAS that appear during sleep include snoring, abnormal motor activity, disturbed nocturnal sleep, a sensation of choking, heartburn, nocturia, nocturnal enuresis, and heavy sweating. Daytime waking symptoms are dominated by often profound sleepiness, which may secondarily be associated with automatic behavior, retrograde amnesia, hypnagogic hallucinations, personality changes, sexual difficulties, and headaches. Careful evaluation, both sleeping and waking, are essential to select appropriate treatment. Treatments include nasal continuous positive airway pressure, tracheostomy, weight loss, uvulopalatopharyngoplasty, mandibular advancement, and so forth.

Adolescent↗
PubMed1986

Small upper airway in near-miss sudden infant death syndrome infants and their families.

6 infants (index cases) from five different families had a near-miss sudden infant death syndrome event between 3 and 12 weeks of age and had polygraphically documented apnoeas during sleep. 4 of their siblings had died of SIDS. The index cases, their 4 living siblings, 10 parents, and 8 grandparents underwent respiratory studies during sleep. All the adults and 3 index cases had cephalometric X-rays. 2 index cases underwent volume computerised tomographic scans when awake and during sleep. Index cases had mixed and obstructive sleep apnoea. Several family members had obstructive sleep apnoea; cephalometric X-rays also showed small upper airways, particularly behind the base of the tongue. A small posterior airway at the level of the tongue may be a familial risk factor for apnoea of infancy.

Adult↗
PubMed1986

Narcolepsy, cataplexy, heart rate, and blood pressure.

Seven narcoleptic patients had serial measurements of blood pressure taken during nocturnal sleep over a period of 2 or 3 successive nights. Blood pressure was measured using a Doppler system with a cuff that automatically inflates every 15 min. There was no difference in the blood pressure measurements throughout the night compared with normal control subjects. Blood pressure followed the patterns of normal nocturnal variation; there was a nonsignificant increase in REM sleep compared with stage 3-4 NREM sleep. Studies of heart rate immediately preceding cataplectic attacks were inconclusive in identifying cardiovascular changes preceding muscle weakness.

Adult↗
PubMed1986

Comparative polysomnographic study of narcolepsy and idiopathic central nervous system hypersomnia.

Patients with a primary diagnosis of narcolepsy or idiopathic CNS hypersomnia seen at Stanford University Sleep Disorders Clinic over a 5-year period were studied retrospectively. The two patient groups were compared with respect to blood pressure, Minnesota Multiphasic Personality Inventory (MMPI) psychological profile, nocturnal sleep structure, prevalence and severity of sleep apnea and periodic leg movements in sleep, and daytime sleep tendency. Narcoleptic patients tended to have higher blood pressure, higher prevalence of abnormally elevated MMPI scores, more abbreviated and more disrupted sleep at night, and greater daytime sleep tendency. Sleep apnea and periodic leg movements were more prevalent in narcoleptic patients, but only periodic leg movements in sleep were more prevalent in narcoleptic patients than in the general population. Periodic leg movements during REM sleep were observed in more than one-third of narcoleptic patients, which may be an important pathophysiologic feature of this disorder.

Adolescent↗
PubMed1986

Monoamine interactions in narcolepsy and hypersomnia: a preliminary report.

Principal component analysis was performed on data obtained for the concentrations of 3,4-dihydroxyphenylacetic acid, 3-methoxy-4-hydroxyphenylethylene glycol, homovanillic acid, and 5-hydroxyindoleacetic acid in lumbar cerebrospinal fluid from a group of normal volunteers (n = 40), hypersomniac patients (n = 13), and narcoleptic patients (n = 8). All four compounds were shown to be highly intercorrelated in the normal volunteers. In the hypersomniac patients, 3-methoxy-4-hydroxyphenylethylene glycol did not appear to be correlated with the other three compounds. In the narcoleptic patients, homovanillic acid and 3,4-dihydroxyphenylacetic acid appeared not to be correlated with the other two metabolites. The results provide tentative support for a neurochemical distinction between narcolepsy and hypersomnia and suggest that attention should be given to a possible malfunction of the dopamine system in narcolepsy and norepinephrine in hypersomnia.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1986

Viloxazine hydrochloride in narcolepsy: a preliminary report.

Twenty-three narcoleptic subjects participated in a single-blind drug study with placebo-viloxazine hydrochloride (100 mg/day). One woman discontinued the study because of nausea and headaches during the treatment period. The remaining 22 subjects were polygraphically monitored during baseline, The remaining 22 subjects were polygraphically monitored during baseline, placebo intake, viloxazine treatment, and placebo intake following 48 h of drug withdrawal. Symptoms and side effects were evaluated subjectively and objectively. Except for the subject who discontinued the study, viloxazine was well tolerated, particularly in elderly subjects. The drug had an inhibitory effect on REM sleep, cataplexy, and other auxiliary symptoms. While there is no objective evidence that it heightens alertness, patients reported fewer sleep attacks.

Adult↗
PubMed1986

Narcolepsy 1985.

Explore the source record for details and available documents.

Animals↗
PubMed1986

Obstructive sleep apneic patients have craniomandibular abnormalities.

One hundred fifty-five unselected obstructive sleep apneic patients seen in succession had cephalometric roentgenograms and polygraphic recordings performed. These patients were compared to a group of 41 subjects who had consulted orthodontists for malocclusion and had no clinical indication of sleep apnea. The cephalometric landmarks were also compared to those published as normative data in the literature. The limits of "normalcy" were conservatively defined as mean +/- 2 standard deviations. Only two obstructive sleep apneic patients had normal cephalometric landmarks and 150 of the 155 patients had at least two significantly different landmarks from the normative data in the literature. The common findings were a retroposition of the mandible, a different cranial base flexure with a nasion-sella-basion angle more acute than expected, and a displacement of the hyoid bone to a lower position than expected. These combined changes reduced the space occupied by soft tissues anchored on the skull and mandible, and the length of the soft palate was increased.

Abnormalities, Multiple↗