Search PubMed⌕ Search

Biomedical subjects

T Penzel

Publications and source records attributed to T Penzel.

At least 91 records · Page 5Linked to original sources
PubMed1990

MESAM: a heart rate and snoring recorder for detection of obstructive sleep apnea.

The high prevalence of sleep-related breathing disorders demands the development of ambulatory recording devices that can handle data with a high degree of selectivity and are easy to use and to interpret. A digital device based on the recording of heart rate and breathing sounds was developed. Patients with sleep-related breathing disorders can be preselected before they undergo sleep laboratory investigations. Treatment control can be achieved ambulatory, having an initial recording.

Ambulatory Care↗
PubMed1989

Effects of cilazapril on hypertension, sleep, and apnea.

Epidemiologic studies revealed that up to 10 percent of middle-aged men show more than 10 cessations of breathing of more than 10 seconds' duration. In these patients, increased morbidity and mortality rates have been proved. More than 50 percent of apnea patients exhibit arterial hypertension, and up to 50 percent of hypertensive patients experience sleep apnea. Patients with sleep apnea and essential hypertension need special attention paid to their antihypertensive therapy because the following side effects of drugs have to be avoided: increases of cardiac insufficiency, hyperviscosity of the blood, intensification of the hypersomnia by central sedation, intensification of a pre-existing tendency towards arrhythmias, and deprivation of deep and rapid eye movement sleep. In this study, the effects of angiotensin-converting enzyme inhibitors in patients with sleep apnea and hypertension are examined. An interim evaluation of six patients (aged 50 to 57) yielded the following results: Average Broca index, 124; average blood pressure before therapy, 159/102 mm Hg; average blood pressure after therapy, 132/78; a decrease of the apnea and hypopnea index from x = 31 (range, 12 to 77) to x = 20 (range, two to 54). Therapy did not influence sleep structure: before therapy, an average of 19 percent of sleep episodes were of the rapid eye movement type (range, 11 to 32 percent); after therapy, 23 percent were of this type on average (range, 21 to 25 percent). A final evaluation will be carried out after the second study phase for 12 patients who have been treated in a double-blind scheme with metropolol versus cilazapril.

Adult↗
PubMed1989

[Snoring and sleep apnea syndrome].

Sleep apnea and obstructive snoring are sleep related breathing disorders (SRBD). Nevertheless, there is only a quantitative difference between snoring and the obstructive form of sleep apnea. Snoring occurs in at least 20% of the population; 50% of the 50 year old male snore. Although in most of the cases only harmless snoring is concerned. It becomes serious if it leads as the independent SRBD "obstructive snoring" to a continuous oxygen desaturation and a sleep disturbance or, if in cases of sleep apnea a postapnoic snoring is concerned. The snoring pattern "loud and irregular" is always a sign for a serious SRBD. Still, no exact statement can be given concerning the frequency of obstructive snoring. However, the prevalence of sleep apnea in men of the mean age group has been determined to 10%. By the so-called sleep apnea syndrome are summarized clinical pictures with symptoms and findings caused by sleep apnea, respectively with those which can be reduced by sufficiently early introduced therapy. Most frequent symptoms and findings are: hypertension, loud and irregular snoring, daytime sleepiness and nocturnal cardiac arrhythmias. Especially hypersomnia has always to be taken seriously. In relation with other symptoms and findings associated with apnea it is always an indication for the examination for sleep apnea and obstructive snoring.

Brain↗
PubMed1989

A new method for the classification of subvigil stages, using the Fourier transform, and its application to sleep apnea.

An online classification for two-second segments of the EEG is developed. Based on the calculation of a norm and three characteristic frequencies the automatic classification shows satisfactory agreement with visual classification. The influence of the Fourier phase spectra is discussed. Trajectories in the parameter space are introduced. The automatic classification was applied to patients with a pronounced sleep-wake disorder and proved to be valuable in the diagnosis of a disturbed sleep structure.

Electroencephalography↗
PubMed1989

[Diagnosis of sleep apnea: required equipment for staged diagnosis].

In view of the high prevalence of sleep apnoea (SA) a stepped concept for diagnosis and therapy is needed. Such a concept requires appropriate instrumentation. The apparative requirement for a five-stage concept, and the experience gained with it, are presented, in particular these newly introduced stages: screening instrument, based on an analysis of heart rate and breathing sounds, and a mobile sleep laboratory based on oxygen saturation measurement combined with inductive plethysmography and four further parameters. Experience obtained with such a stepped concept demonstrates its efficiency and necessity in the diagnosis of sleep-related breathing disturbances.

Electrocardiography, Ambulatory↗
PubMed1989

[Diagnosis of sleep apnea: initial experiences with a staged procedure].

The high prevalence of sleep-related breathing disturbances (SRBD), in association with cardiopulmonary disease, and the impairment by such disorders of the quality of the patients life, together with the good response of SRBD to therapy when diagnosed early on, point up the importance of incorporating the diagnostic evaluation of SRBD into the routine medical and pneumological diagnostic work-up. Since classical polysomnography requires a considerable effort, a stepwise diagnostic procedure was needed for use in practice. This includes a narrowing down of the indications, a brief questionnaire and a detailed questionnaire. For positive demonstration of a respiratory disturbance or differential diagnostic purposes, the following measures are employed on an outpatient basis in the following order: High-resolution 24-hour (Holter) ECG; analysis of heart rate and respiratory sounds, including, in particular snoring, with the MESAM system; induction plethysmography and continuous oxygen partial pressure measurement (pO2tc). Only after exhaustive use has been made of the ambulatory work-up, are the following diagnostic inhospital measures employed in the order indicated: 10-channel recording using the SIDAS system (respiration 3 channels, oxygen saturation, EOG, actogram, heart rate, intrathoracic pressure fluctuations), complete polysomnography. Once SRBD has been established, the patient is sent to the sleep laboratory to establish a baseline. Baseline measurement is accompanied by the determination of a marker, that is, a readily determined parameter capable of providing information about the success of therapy, is established. This permits complete polysomnography to be concentrated on differential-diagnostic and treatment-refractory problem cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1986

Sleep apnea and pulmonary hypertension.

The pulmonary artery pressure values of 65 patients with sleep apnea syndrome were measured at rest and during ergometer exercise up to 100 W. Pulmonary hypertension at rest was found in 13, and during exercise in 31 more patients. Only 8 patients with pathological pressure findings suffered from pulmonary hypertension in combination with a pulmonary or cardiac disease. In the other 36 patients, no indication of a primary cause of pulmonary hypertension apart from sleep apnea syndrome could be found. Out of the 65 patients, 11 with a finding of more than 20 apnea episodes per hour's sleep underwent polysomnographic recordings in the sleep laboratory. The hemodynamic parameters were continuously measured. All 11 patients had a finding of severe sleep apnea with more than 300 apnea episodes during the night of recording. In 6 patients, the appearance of apnea episodes was accompanied by only moderate changes in pulmonary artery pressure. In 5 patients, there were critical increases in pulmonary artery pressure, which went along with increases in cardiac output and in pulmonary capillary wedge pressure. Increases in pulmonary vascular resistance were established in 3 out of these 5 patients, and a slight decrease in 2. The mechanism of hypoxic vasoconstriction of the pulmonary arteries may account for the pressure increases in 3 of our patients, but fails to explain the findings in the other 2 patients. Nocturnal changes in pulmonary artery pressure in patients with sleep apnea may therefore have different causes. Pulmonary hypertension constitutes a severe complication in patients with sleep apnea.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗