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Biomedical subjects

W Conway

Publications and source records attributed to W Conway.

23 records · Page 2Linked to original sources
PubMed1982

Sleep, arousals, and oxygen desaturation in chronic obstructive pulmonary disease. The effect of oxygen therapy.

In order to assess the role of hypoxemia in the sleep disruption of patients with COPD, we studied patients breathing air and oxygen during sleep. In 24 patients with COPD, we determined the 95% confidence bands for arterial O2 saturation (SaO2) in the various sleep stages. The lowest mean SaO2 was during REM sleep. Patients spent 22.4% of the night desaturated (SaO2 more than 5% below awake SaO2). Apneic episodes were uncommon and occurred in only 2 patients. When compared with established age-matched normal subjects from another center, poor sleep quality was indicated by reduced sleep time, increased sleep stage changes, and increased arousal frequency. Oxygen therapy had no apparent effect on sleep quality. Arousal frequency was independent of measurements of awake pulmonary function or chemical control of breathing. During room air breathing, arousals were strongly associated with periods of arterial oxygen desaturation. However, relief of the hypoxemia with supplemental oxygen had no effect on arousal frequency. This suggests that it is not hypoxemia per se, but an associated phenomenon such as hypercapnia that causes the arousals.

Aged↗
PubMedDate not supplied

Anatomic abnormalities in obstructive sleep apnea.

Both muscular hypotonia and anatomic abnormalities have been implicated in the pathogenesis of the obstructive sleep apnea syndrome (OSAS). The upper airways of 25 patients with OSAS were evaluated to determine potential sites of obstruction. Significant airway compromise was found in all patients with some patients having multiple sites of airway narrowing.

Adult↗
PubMedDate not supplied

Surgical correction of anatomic azbnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty.

Excessive daytime sleepiness and loud snoring are the major symptoms of obstructive sleep apnea, often leading to serious medical complications if unrecognized and untreated. Tracheostomy has been the only effective treatment in most adult cases. This paper reports on a new surgical approach to treat obstructive sleep apnea by uvulopalatopharyngoplasty designed to enlarge the potential airspace in the oropharynx. Twelve patients underwent this operation. In nine there was relief of symptoms and in eight there was objective improvement in nocturnal respiration and sleep pattern, demonstrated by polysomnography.

Adult↗
PubMedDate not supplied

Effects of uvulopalatopharyngoplasty on the daytime sleepiness associated with sleep apnea syndrome.

Pre- and post-treatment nocturnal polysomnography and multiple sleep latency tests (MSLT) were done in thirty-one patients with obstructive sleep apnea syndrome who underwent uvulopalatopharyngoplasty. The treatment reduced by half the frequency of apneas and hypoxemia occurring during sleep and improved the excessive daytime sleepiness, but not all patients responded similarly. Among patients classified as responders, the frequency of apnea was reduced to a level seen in healthy adults of the same age, measures of sleep approached normal, and excessive sleepiness was eliminated. In nonresponders, frequency of apneas and consequent disruption of sleep was not reduced, but hypoxemia was improved. The MSLT differentiated responders from nonresponders who showed no MSLT improvement, although 70% reported a subjective improvement in excessive sleepiness. Measures of the apneas' disruptive effect on sleep and not its hypoxemic consequences were most predictive of improvement in excessive sleepiness.

Humans↗