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At least 523 records · Page 29Linked to original sources
PubMed2005

[Long term use of nCPAP therapy in sleep apnoea patients].

INTRODUCTION: Although obstructive sleep apnoea syndrome (OSAS) is usually a lifelong condition, little is known about compliance with nasal continuous positive airway pressure (nCPAP) over longer periods of follow up. METHODS: Long term acceptance of nCPAP was evaluated retrospectively using a survival analysis in 137 consecutive patients who started nCPAP therapy for OSAS between 1985 and 1993. RESULTS: During a mean follow-up of 9.2 +/- 4.7 years, 30 patients died, 5 were lost of follow-up and 30 patients stopped their treatment most of them during the first 5 years. In compliant patients, the median value of daily nCPAP use was 7.5 hours. Kaplan Meier analysis showed that 82% of patients were still using nCPAP at 5 years, 77% at 10 years and 61% at 15 years. Multivariate analysis showed that OSAS severity was an independent predictor of long-term nCPAP use. The rate of nCPAP acceptance at 10 years was 82% in patients with an apnoea-hypopnoea index (AHI) > or = 30 compared to 58% in patients with AHI < 30. CONCLUSION: nCPAP is a suitable long-term therapy for OSAS, particularly in patients with more severe disease, with more than 80% of patients continuing to be compliant with treatment at 10 years.

Aged↗
PubMed2000

[Drug therapy for sleep apnea syndrome].

The number of patients suffering from sleep apnea syndrome(SAS) have been increased. In recent years, many therapeutic approaches such as nasal CPAP, dental appliance, upper airway surgery, pharmacological agents, have been used for the treatment of SAS. The various drugs(acetazolamide, some tricyclic antidepressant, progesterone, theophylline, aminophylline and so on) have been used for pharmacotherapy of SAS. Acetazolamide have been established as the best medication. But all approaches without acetazolamide, could not shown their satisfactory effects on SAS. In this article, drug therapy for SAS is described.

Acetazolamide↗
PubMed1978

[Therapy of sleeping disorders with l-tryptophane plus oxprenolol/a double-blind study (author's transl)].

38 psychiatric inpatients with various degrees of sleeping disorders were given L-tryptophane plus oxprenolol or placebo, each for two nights. Self-rating, rating of the nursing staff, tests of attention level and motor performance were the variables of the investigation. The statistical evaluation of the double-blind study shows no significant difference under these specific experimental conditions.

Adult↗
PubMed1993

[Quantitative studies assessing daytime fatigue, vigilance and attention before and after nCPAP therapy of sleep apnea syndrome].

As far as day symptoms are concerned, excessive drowsiness and tendency to fall asleep are signposts in diagnosis and treatment of sleep apnoea syndrome exercising a decisive influence on the patient's quality of life. Recent studies (Findley et al., 1988; George et al., 1987; Aldrich et al. 12/89) have shown that the patients are additionally endangered by an increased accident risk. After controversial data in the literature in respect of the usefulness of neuropsychological testing when going into this problem we tried to develop an alternative to MSLT (Multiple Sleep Latency Test) which is the clinical standard, since the technique required is so complicated that it is only rarely used in everyday practice. We aimed at easy application in clinical daily routine. We examined via computer-assisted neuropsychological testing the attention and concentration performance in 14 patients having a sleep apnoea syndrome of moderate severity, before and after a short treatment course of three nights with nCPAP, and compared the results with those obtained in 17 patients with a similar pattern of complaints in whom a sleep apnoea syndrome could be excluded. The test lasted for 45 minutes in each case. Various reaction time tests were performed with acoustical, optical and combined phenomena. The reaction times as well as the number of errors were noted. We could show that the treatment course resulted in an improvement of certain attention and concentration performances, above all however in continuous attention against a monotonous stimulation background (vigilance)--and improvement that can be measured already after a short therapy period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Effect on blood pressure of oral appliance therapy for sleep apnea syndrome.

PURPOSE: The aim of this study was to evaluate the effect of individually prescribed oral appliances for the treatment of obstructive sleep apnea syndrome (OSAS) on blood pressure, as well as factors influencing the efficacy. MATERIALS AND METHODS: One hundred sixty-one patients (121 men and 40 women, mean age: 54.3 +/- 13.7 years) diagnosed with mild to moderate OSAS (mean apnea-hypopnea index: 17.9 +/- 14.1) were studied before and after insertion of a mandibular advancement device, with a mean interval of 60 days. Systolic, diastolic, and mean blood pressure was taken using an automatic blood pressure monitor (132.0 +/- 16.1 mmHg, 82.1 +/- 10.6 mmHg, 107.1 +/- 12.9 mmHg, respectively, at baseline). RESULTS: The patients were subdivided into 3 groups: responder, partial responder, and nonresponder, according to the difference of mean arterial pressure fall after the treatment. The systolic, diastolic, and mean blood pressure decreased significantly (P < .001) (127.5 +/- 15.0 mmHg, 79.2 +/- 10.0 mmHg, 103.4 +/- 12.0 mmHg, respectively) after the insertion of the device. The oral appliance therapy produced falls in blood pressure (4.5 mmHg, 3.0 mmHg, 3.7 mmHg, respectively). The response was significantly (P < .001) correlated to baseline blood pressure. The responders (n = 70, mean blood pressure fall > 3.7 mmHg) and the partial responders (n=46, 0 < fall < or = 3.7 mmHg) showed significantly (P < .05; analysis of variance) higher reduction in apnea-hypopnea index (69.6%, 65.9%, respectively) than that (52.5%) of nonresponders (n=45, fall < or =0 mmHg). CONCLUSION: These data suggest that effective oral appliance therapy for OSAS patients with hypertension can lead to a substantial reduction in daytime blood pressure.

Antihypertensive Agents↗
PubMed1988

Screening compounds for sleeping sickness therapy without relapse.

The finding of an intracellular stage of Trypanosoma brucei in ependymal cells of the choroid plexus (Abolarin et al., 1986) and of the lining of the ventricles (Ormerod and Hussein, 1986) has suggested a new technique for screening trypanocidal compounds against the failure of drugs to eliminate "occult" stages of the infection (Raseroka and Ormerod, 1986). A (donor) mouse, infected for 28 days, is dosed with a drug, or combination of drugs, and samples of blood, cerebral cortex, choroid plexus and lining of ventricle are injected into clean (recipient) mice. The response of recipient mice shows whether the part, under examination, of the donor mouse has been cleared of trypanosomes. Suramin clears the blood and cerebral cortex but not sites containing ependymal cells (i. e. choroid plexus and lining of ventricle). Melarsoprol is active in all sites but is not always effective. DFMO clears the ependymal cells but its action elsewhere is difficult to evaluate. Metronidazole (inactive on its own), when given with suramin is active at all sites. Bleomycin was the most effective single compound. Bleomycin, an anti-cancer agent registered for use in man, should receive clinical evaluation for sleeping sickness: there is evidence, however, of incompatibility with DFMO.

Animals↗
PubMed2006

Effects of antenatal magnesium sulfate and corticosteroid therapy on sleep states of preterm infants.

This exploratory longitudinal study was designed to compare the neonatal illness severity, sleep-wake, and respiratory sleep behaviors of preterm infants whose mothers received prenatal corticosteroids and/or magnesium sulfate (MgSO4) with those of infants whose mothers did not receive these medications. The 134 infants were divided into four groups: those whose mothers received MgSO4 only, those who received steroids only, those who received both MgSO4 and steroids, and those who received neither. The groups did not differ on infant characteristics or illness severity. Infants exposed to MgSO4 had more active sleep without rapid eye movement, indicating poorly organized active sleep. The MgSO4 -only group had higher quiet sleep regularity scores and fewer state changes. These findings suggest that fetal exposure to MgSO4 may subtly affect the central nervous system.

Adrenal Cortex Hormones↗
PubMed2000

Physical Exercise as an Adjunct Therapy in Sleep Apnea-An Open Trial.

BACKGROUND: The aim of this study was to determine in an open trial if physical exercise in sleep apnea patients is safe and/or influences respiratory disturbance index (RDI). METHODS: After being treated 3 months or more with nasal CPAP for moderate to severe sleep apnea syndrome, eleven patients (1 female, 10 male, mean age 52.2 years) began a six-month period of supervised physical exercise twice a week, 2 hours each time. Before and after this period a Polysomnography without CPAP was recorded, along with a bicycle exercise test with lactate profile, echocardiography, body-weight, and body-height measurement. RESULTS: No adverse effects or cardiopulmonary problems were observed. There was no significant change in body weight with physical training; no significant difference in either min SaO2 nor mean SaO2; and no significant improvement in fitness. No adverse cardiopulmonary effects or problems were observed. There was a decrease of the RDI from 32.8 to 23.6 (p < 0.05), without a significant change in the REM-sleep portion of total sleep time (TST), NREM sleep, or TST. CONCLUSIONS: A prescription for mild to moderate exercise is safe in the management of sleep apnea, and, even in the absence of a fitness improvement, there occurred a decrease in RDI without a change in sleep architecture.

Journal Article↗
PubMed1994

Prosthetic therapy for sleep apnea syndrome.

Twenty patients with sleep apnea syndrome were examined polysomnographically with and without an Esmarch sleep apnea appliance. The relationship between the therapeutic effect of the device and dentofacial morphologic characteristics of the patients were analyzed with the use of diagnostic casts and cephalometric radiographs. The apnea index or number of apneic episodes per hour decreased significantly (p < 0.0001) after insertion of the appliance. The diagnostic casts and cephalometric analyses revealed that the device was most effective for patients who exhibit a tendency toward micrognathia (p < 0.03) and a short soft palate (p < 0.01). The Esmarch appliance is indicated for the treatment or diagnosis of sleep apnea syndrome.

Adult↗