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PubMed1999

[Objective value of adenotonsillectomy in the child. A prospective study of incidence of tonsillitis, snoring, pulse oximetry and polysomnography and general development before and after adenotonsillectomy].

65 children were analysed prospectively before and after adeno-tonsillectomy to determine the incidence of upper airway infections, snoring and nocturnal obstructive symptoms. The weight and height percentiles were also determined before and after adeno-tonsillectomy. The Oxygen Desaturation Index (ODI) was measured in 27 children suspected of having a sleep apnea syndrome. In six of these children polysomnographic studies were carried out. A statistically significant reduction (p < 0,005) of upper airway infections could be seen six to twelve months after adeno-tonsillectomy. In 25 children (38%), we observed a postoperative weight gain and in eight cases (12%) a height gain. The obstructive symptoms, especially snoring and respiratory apneas, disappeared or were significantly reduced in 90% of the cases after adeno-tonsillectomy. All preoperatively pathological ODI and AHI normalised after the operation (p < 0,005).

Adenoidectomy↗
PubMed2000

Diagnostic values of polysomnography in forensic medicine.

A man accused of a first-degree murder of a two-year-old girl claimed that he had not been conscious during the time of the alleged murder. The possibility that he may have committed the crime while "sleepwalking" was raised. The forensic psychiatrist looked to the sleep disorders facility to conduct polysomnographic investigation of the accused in order to investigate the possibility that he had a parasomnia. Overnight sleep recordings with video surveillance carried out for two consecutive nights showed no evidence of parasomnia. On the basis of the full assessment, the final report of the forensic psychiatrist did not support a legal defense of non-insane automatism and "sleepwalking" was withdrawn as a possible defense by the lawyer of the accused.

Adult↗
PubMedDate not supplied

[The efficacy of ropinirole in the treatment of chronic insomnia secondary to restless legs syndrome: polysomnography data].

INTRODUCTION: Following the line of our earlier investigations, we made an open pilot study using a polysomnograph to objectively show the efficacy of Ropinirole in the treatment of chronic insomnia secondary to the restless legs syndrome (RLS). PATIENTS AND METHODS: We did polysomnograph studies on 5 patients with the characteristics of primary RLS, according to the criteria of the International Group for the study of RLS, who had had chronic insomnia for over 5 years. We used Spiegel's questionnaires to show subjective improvement. RESULTS: The following parameters were significant between the first night (without treatment) and the second night (with 0.25 mg of Ropinirole) and between night 30 without (treatment) and night 31 (with 0.25 mg of Ropinirole). The results were expressed as average values for the 5 patients with their respective standard deviations. Efficiency of sleep: 62.62% +/- 11.31 as compared with 82.82% +/- 8.80, p = 0.010. After 30 days: 64.88% +/- 17.17 against 88.75% +/- 2.09, p = 0.014. Total time asleep: 295' +/- 51.76 against 397.7 +/- 38.50, p = 0.006. After 30 days: 294.6' +/- 87.40 against 391' +/- 22.38, p = 0.025. Number of periodic movements: 91 +/- 33.59 against 30.8 +/- 35.56, p = 0.011. After 30 days: 189.8 +/- 99.79 against 36.2 +/- 21.56, p = 0.013. All patients had subjective improvement in the parameters of Spiegel's test (p = 0.0005). CONCLUSIONS: The improvement in efficiency of sleep seen on polisomnography, total time slept and reduction in periodic limb movements were statistically significant. The subjective improvement described was also confirmed by Spiegel's questionnaire.

Chronic Disease↗
PubMed2000

[Manifestations of abnormal behavior during REM sleep in all-night polysomnography in patients with Parkinson disease].

REM sleep behaviour disorder (RBD) is characterized by savage extremities movements and by vocalizations associated with vivid dreams in REM sleep and by insufficient muscle atonia in REM sleep. Videopolysomnography was performed in nine patients (six men and three women, average age 59.8, SD +/- 7.2 years) suffering from Parkinson's disease (PD). The insufficient muscle atonia was found in the records of four subjects. No behavioural symptoms of RBD were observed. The authors stress on the disposition to RBD in great number of patients with RBD and on the necessity to look for RBD by detailed disease history.

Female↗
PubMed2000

[Experience with polysomnography in the diagnosis of sleep apnea].

Whole-night recording of 9-30 parameters and calculation of various indices allow differentiation of various sleep related breathing disorders and estimation of their severity (Fig. 1, 2). Parallel monitoring of changes in ventilation, arterial oxygen saturation, ECG, EEG, EMG and others, give a possibility to appreciate the gradual development of cardiovascular, neuropsychic, endocrine-metabolic and other consequences of sleep related breathing disorders, their dependence on different phases and stages of sleep as well as their alterations by treatment.

Humans↗
PubMed2001

[Clinical value of polymesam recording in diagnosis of obstructive sleep apnea. Can we replace polysomnography with polymesam?].

UNLABELLED: Polymesam (PM) recordings was performed in 320 patients admitted to Sleep Laboratory with suspicion of OSA. OSA was diagnosed in 179 of them (55.9%), group (PM-Ch). These patients were obese (BMI--34.3 +/- 6.7 kg/m2) and had moderately-severe OSA (RDI--41.5 +/- 19.9 and ODI--43.7 +/- 21.5). They suffered from excessive daytime sleepiness (ESS = 12.2 +/- 5.5). PM was negative in 141 person (44.1%), (PM-Z). Subjects PM-Z had significantly lower BMI and rarely suffered from excessive daytime sleepiness. In 38 subjects PM-Z a full PSG was performed. In 12 PSG confirmed OSA (AHI--31.6 +/- 19.9). Both studies (PM and PSG) were negative in 26 subjects. In 10 obese subjects PM-Ch full PSG confirmed diagnosis. CONCLUSIONS: PM recording can replace full PSG in majority of patients suspected of OSA. Patients with typical symptoms of OSA and negative PM require PSG.

Adult↗
PubMed2002

[Objective assessment and therapeutic efficacy of an improved mandibular advancement device for snoring and sleep apnea syndromes with polysomnography].

In the treatment of snoring (SN) and sleep-related breathing disorders (SRBD), mandibular advancement devices (MAD) are of increasing importance. Their mode of action is based on the advancement of the mandible, thereby increasing various upper airway dimensions and thus airway patency and airflow during sleep. The aim of the present study was to investigate efficacy and tolerability of an individually fitted MAD on 11 patients (10 males, 1 female), mean age 57 years, using sleep laboratory methods in 3 subsequent nights (adaptation-, baseline-, treatment night). The MAD consists of 2 separate parts that attach to both dental arches. On occlusion the upper maxillary part with a protruding cone meets an inclined plane of the lower mandibulary part, thereby forcing the mandible to advance. 10 patients (6 with obstructive sleep apnea, 3 with obstructive hypopnea and 1 primary snorer) tolerated the MAD well; one patient (primary snorer) removed the MAD after 1 hour. Regarding the target variable, the snoring index (SI), confirmatory statistics demonstrated a significant improvement from 108 to 53/h sleep, though normalisation could not be achieved. Descriptive data analysis showed significant improvement of the apnea-hypopnea index (AHI) from 15 to 5.5/h and of the oxygen desaturation index (O2-DI) from 21 to 13/h sleep. Arousal variables and periodic leg movement index (PLMI) improved as well. Objective sleep efficiency and subjective sleep- and awakening quality remained unchanged. Thus, besides the good therapeutic efficacy (the medians of improvement of the SI, AI, AHI, O2-DI and PLMI were 37, 48, 53, 51 and 29%, respectively), acute acceptance of the MAD was also satisfactory. Last but not least our present study showed once more the necessity of an adaptation night, as from the first to the second sleep laboratory night respiratory indices deteriorated significantly.

Adult↗
PubMed2003

[Effect of the first sleep night in polysomnography: classification by variable sensitivity and factorial analysis of differences between nights].

It has been known since the sixties that a habituation phenomenon is present in polysomnographic analyses of sleep, the first night including more awakenings and less Rapid Eye Movement sleep (REM) than consecutive ones. Results about Non-Rapid Eye Movement sleep (NREM) are less clear. The study presented here attempted to classify the variables in function of their sensitivity to this phenomenon by comparing inter-night and inter-subject effects in a series of ANCOVA analyses and on the other hand, to group the same variables in function of a factorial analysis on the differences between the two first nights. The study included 26 subjects with no somatic nor psychiatric disorder and was performed at their homes for four consecutive nights. The most sensitive variables were, in descending order: Ultra-Slow spectral power band, REM sleep, Sleep Efficiency Index, Delta spectral power band, number of awakenings, duration of awakenings, number of ultradian sleep cycles and Total Sleep Time. The factorial analysis showed 7 factors, grouping separately the two series of results from the spectral analysis (corresponding to visually-scored NREM and REM sleep), awakenings, sleep duration variables, variables linked to REM sleep, microarousals and deep sleep.

Adolescent↗
PubMed2005

Ictal video-polysomnography and EEG spectral analysis in a child with severe Panayiotopoulos syndrome.

OBJECTIVE: To describe the ictal polysomnographic features of a patient with Panayiotopoulos syndrome, a peculiar epileptic syndrome characterized by infrequent, often single, prolonged, nocturnal, focal seizures comprising an unusual constellation of autonomic symptoms (malaise, nausea, pallor, tachycardia, vomiting) and unilateral deviation of the eyes at the onset of seizures. These clinical, ictal manifestations are rarely followed by post-ictal headache. In the literature, there is little information on the ictal EEG characteristics of Panayiotopoulos syndrome and, in particular, on certain autonomic manifestations, such as tachycardia, as the sole ictal phenomena at the onset of seizures. METHODS AND RESULTS: One, all-night videopolysomnography, during which one seizure was recorded. Video-EEG data were evaluated visually and by means of quantitative spectral analysis. The spectral analysis of the recorded seizure showed a complex ictal pattern of cortical involvement with focal onset in the right occipital area followed by the recruitment of widespread extra-occipital cortical regions. CONCLUSIONS: This is the first such analysis of this peculiar epileptic condition. Most of the symptoms were consistent with a diagnosis of severe Panayiotopoulos syndrome, although the patient also presented "atypical findings": a relatively high frequency of seizures, post-ictal headache, no spontaneous remission of seizures with age, and late onset of visual hallucinations; this last finding is more frequent in "Gastaut-type childhood occipital epilepsy", in which onset typically occurs later than in Panayiotopoulos syndrome. [Published with video sequences].

Anticonvulsants↗
PubMed1993

[Polysomnography findings in middle-aged and elderly narcoleptics].

The comparison of 24 hours polysomnographic recordings of middle-aged narcoleptic subjects (39-51 years, group A) with 11 twenty four hours and 3 nighttime recordings of elderly narcoleptic subjects (aged 60-72 years, group B) using T test for non paired values was made. No difference was found in parameters of nighttime registrations: total sleep time (A:510.4 +/- 71.2 min., B: 475.9 +/- 92.4 min), intrasleep wakefulness (A: 107.5 +/- 75.3 min., B: 112.3 +/- 65.3 min), latencies of sleep stages (1NREM-A: 3.4 +/- 2.8 min, B: 4.3 +/- 3.7 min, 2NREM-A: 7.4 +/- 7.6 min, B: 6.6 +/- 12.7 min, 3NREM-A: 27.2 +/- 10.4 min, B: 51.6 +/- 62.6 min, REM-A: 62.2 +/- 59.5 min, B: 64.6 +/- 71.6 min), relative duration of each sleep stage (1NREM-A: 20.0 +/- 9.5%, B: 21.4 +/- 13.2%, 2NREM-A: 51.3 +/- 8.5%, B: 51.9 +/- 14.2%, 3 +/- 4NREM-A: 8.2 +/- 6.5%, B: 7.2 +/- 6.5%, REM-A: 20.4 +/- 4.5%, B: 19.1 +/- 5.7%), and sleep continuity index (A: 0.83 +/- 0.11, B: 0.81 +/- 0.11). Total sleep time in the daytime was similar (A: 160.5 +/- 53.8 min, B: 180.5 +/- 59.9 min), the number of sleep episodes during the day was in elderly patients higher (A: 3.4 +/- 1.2, B: 4.8 +/- 1.3, P < 0.05) and the number of sleep onset REM periods was in elderly subjects slightly higher (A: 1.9 +/- 1.1, B: 2.7 +/- 1.7). The authors conclude that the nocturnal sleep of both age groups of narcoleptic subjects is disturbed and the character and the intensity of this disturbance are similar. Elderly narcoleptic subjects displayed more daytime sleep periods.

Adult↗
PubMed1993

[EEG and polysomnography findings in patients with dyskinesia].

It is known that EEG findings reveal various abnormalities in patients with involuntary movement. But these findings are not specific. It has been reported to be related to myoclonus and spike. The other involuntary movement is unknown to the relation to EEG findings. The involuntary movement usually disappears during sleep, but a certain involuntary movement appears only during sleep. In the patient with Huntington's chorea and dystonia musculorum deformans, PSG reveals an increase in interspersed wakefulness, decrease of deep sleep and prolongation of REM latency. Periodic limb movement and nocturnal paroxysmal dystonia appear only during sleep. Nocturnal sleep studies are important for exploring the pathophysiology in involuntary movement.

Electroencephalography↗