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Biomedical subjects

C Guilleminault

Publications and source records attributed to C Guilleminault.

At least 307 records · Page 17Linked to original sources
PubMed1986

Maxillary, mandibular, and hyoid advancement: an alternative to tracheostomy in obstructive sleep apnea syndrome.

Nine patients with severe obstructive sleep apnea syndrome (OSAS)--for whom several therapeutic approaches, including palatopharyngoplasty, had failed--were treated with a combined maxillary, mandibular, and hyoid advancement. Objective evaluation--performed before and 4 to 18 months after surgery, using nocturnal polysomography--indicated that the OSAS had improved or had disappeared. This surgical approach is beneficial for specific cases of OSAS, which can be identified by mandatory presurgical tests.

Female↗
PubMed1986

Inferior sagittal osteotomy of the mandible with hyoid myotomy-suspension: a new procedure for obstructive sleep apnea.

Five patients were treated by inferior sagittal osteotomy and hyoid myotomy-suspension. In three of the patients, palatopharyngoplasty had previously failed. One of the patients was noted to have mandibular deficiency; the others had normal skeletal development. Nocturnal polysomnograms were performed preoperatively and postoperatively. All patients showed significant improvement.

Adult↗
PubMed1986

Olivopontocerebellar degeneration, abnormal sleep, and REM sleep without atonia.

Polygraphic studies during sleep performed in two patients with olivopontocerebellar degeneration (OPCD) revealed an abnormal control of muscle tone. It was demonstrated by bursts of EMG activity during sleep and progressive disappearance of muscle atonia during sleep. Muscle atonia disappeared during rapid eye movement (REM) sleep, permitting movements and expression of feelings probably associated with REM sleep-related oneiric activity. Patients, unaware of their nocturnal sleep disturbance, complained only of the resulting daytime tiredness and sleepiness.

Brain Diseases↗
PubMed1986

Obstructive sleep apnea and cardiac index.

Seventeen men (age range, 21 to 58 years) with severe obstructive sleep apnea syndrome (OSAS) documented by nocturnal polysomnography underwent hemodynamic investigations during sleep. We studied the evolution of the cardiac index during apneic events in both NREM and REM sleep using the thermodilution technique. Regardless of the patient's age, the sleep state, or the mechanism inducing the OSAS, the cardiac index decreased significantly from baseline during an apneic event and increased significantly from baseline at the resumption of ventilation.

Adult↗
PubMed1986

Alternative treatment to tracheostomy in obstructive sleep apnea syndrome: nasal continuous positive airway pressure in young children.

Two groups of prepubertal children with severe obstructive sleep apnea syndrome received continuous positive airway pressure (CPAP) treatment using a nasal mask. The five children in group A had nasal CPAP only in a hospital setting; the five children in group B received the treatment at home as well. Four of these five children, who have now been followed for as long as 10 months, have adapted well to the treatment at home. The problems encountered with nasal CPAP as a home treatment, such as poor cooperation from parents, allergic rashes, eye irritation resulting from air leaks, are discussed. Despite the problems, nasal CPAP is a valid alternative to tracheostomy in children as young as 3 years of age.

Child↗
PubMed1986

Mononucleosis and chronic daytime sleepiness. A long-term follow-up study.

Twelve patients between 14 and 26 years of age, ten with infectious mononucleosis and two with Guillain-Barré syndrome, all of whom were suspected of having had Epstein-Barr viral infection, developed daytime sleepiness. The daytime somnolence was confirmed objectively by polygraphic monitoring seven weeks to 4 1/2 months after the onset of clinical symptoms. The patients have been followed up for three to 12 years. None has had any other neurologic sequelae, but all have disabling daytime sleepiness. Treatment brings only mild relief. A retrospective chart study of 35 patients with infectious mononucleosis did not identify, on the basis of initial clinical symptoms, those patients who developed chronic impairment.

Adolescent↗
PubMed1985

Abnormal breathing patterns during sleep in diabetes.

Nineteen diabetic patients, 12 type I (insulin-dependent) and 7 type II (late-onset, non-insulin-dependent), underwent nocturnal polygraphic monitoring after a daytime medical evaluation that included tests of vagal responses and, in 6 patients, pulmonary function and hypercapnic and hypoxic responses. Five lean type I patients had abnormal sleep-related breathing patterns with central or obstructive sleep apnea and brief breathing irregularities during stages 3 to 4 non-rapid-eye-movement sleep, compared with only 1 overweight type II diabetic with moderate obstructive sleep apnea. There was no correlation between daytime ventilatory study findings and abnormal breathing patterns during sleep, but there was a clear relationship between neuropathy and sleep-related breathing abnormalities in type I insulin-dependent diabetics.

Adolescent↗
PubMed1985

Diabetic autonomic dysfunction, blood pressure, and sleep.

We measured serially the blood pressure of 7 normal controls and 11 Type I insulin-dependent and 6 Type II non-insulin-dependent diabetic patients during sleep. All subjects underwent 2 or 3 nights of monitoring during which blood pressure was measured with an arteriosonde, a Doppler-type system with a cuff that automatically inflates every 15 minutes. All 7 normal controls, 3 of 11 Type I, and all 6 Type II diabetic patients had normal results from bedside tests of autonomic function. The Type I patients had abnormal systolic blood pressure measurements throughout the night. Unlike normal controls and Type II diabetics, their blood pressure did not rise progressively in the early morning hours. During rapid eye movement (REM) sleep, their blood pressure measurements were significantly higher and lower than values measured during non-REM sleep, in sharp contrast to those in the other two groups, whose REM sleep-related blood pressure values were slightly above the preceding non-REM sleep measurements.

Adult↗
PubMed1985

Motility and arousal in near miss sudden infant death syndrome.

Developmental sleep patterns were compared in infants at known risk for "near-miss" sudden infant death syndrome and age-matched normal infants. Near-miss SIDS infants had significant differences suggestive of a temporary developmental delay. They retained rapid eye movement (REM) sleep at neonatal proportions, and stage 2 non-REM sleep appeared later. They also had a significantly increased apnea index. Twenty-four-hour recordings of sleep and respiratory patterns in near-miss SIDS infants from 3 weeks through 6 months of age showed a significant reduction in number of body movements in REM, non-REM, and total sleep time and in percentage of movement time at 3 weeks through 3 months of age. These findings can be used to address the role of arousal threshold in infants at risk for SIDS.

Arousal↗
PubMed1985

Preliminary communication: intellectual deficit and sleep-related respiratory disturbance in the elderly.

Polysomnography and neuropsychological tests administered to 41 nondemented male subjects (mean age, 69.5) indicated that impaired performance was associated with sleep-related respiratory disturbance. Such deficits could reflect deficits in vigilance or cortical insult resulting from nightly hypoxemia. Whether the degree of impairment observed here predicts more severe dementia will await longitudinal studies.

Aged↗
PubMed1985

Palatopharyngoplasty failure, cephalometric roentgenograms, and obstructive sleep apnea.

Nine patients with obstructive sleep apnea who underwent unsuccessful palatopharyngoplasty (PPP) as documented by polygraphic monitoring had abnormal cephalometric roentgenogram measurements. Findings indicated a small posterior airway space and inferiorly placed hyoid bone. Cephalometry performed with appropriate techniques to investigate soft tissue location should be obtained systematically in obstructive sleep apneic patients before any surgery is performed. The roentgenogram finding is a helpful guide in deciding whether PPP alone or PPP in combination with other surgical procedures would be more efficacious.

Adult↗
PubMed1985

Sleep apnea in normal subjects following mandibular osteotomy with retrusion.

Two women, 43 and 46 years old, weighing respectively 51 kg and 49 kg, underwent mandibular osteotomy with retrusion, after which they began to snore heavily at night. The initial events were central; obstructive apneic and hypopneic events, documented by polysomnography, developed over time. When patient 2 was on her back, she frequently had central apneas (identified by esophageal pressure monitoring) preceded by increasing swings in pressure, indicative of increased airway resistance without oxygen desaturation.

Adult↗
PubMed1985

Sleep and respiration: a postscript.

The recent advances in our understanding of breathing in sleep include an evolution in the selection and surgical therapy of patients with the sleep apnea syndrome. Recent work suggests that shorter polysomnographic studies may be adequate for diagnostic purposes in many sleep apnea patients. It is now clear that central apnea may occur, paradoxically, in patients with either very blunted chemical drives to breathe or increased drives to breathe.

Acetazolamide↗