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At least 19 recordsLinked to original sources
PubMed1979

Endoscopic findings in sleep apnea syndrome.

Sleep apnea syndrome is a constellation of symptoms resulting from recurrent episodes of apnea during sleep. Often the upper airway becomes obstructed during slumber in this disorder. Symptoms relate to sleep deprivation and include morning headaches, daytime somnolence, personality changes with deteriorating intellectual capacity, nocturnal enuresis, and sexual dysfunction. Diagnosis is assisted by polysomnographic recordings. Therapy is directed at the cause of obstruction when one can be found, weight loss in massively obese patients, tracheostomy in the symptomatic patient. Four patients with documented sleep apnea syndrome are discussed. One patient, a thin adolescent female underwent adenoidectomy without improvement. Two massively obese adult males required tracheostomy with marked amelioration of symptoms. One additional adult male was found to have sleep apnea due to severe, acquired micrognathia; he was significantly improved by tracheostomy. All three adult patients were found by endoscopic visualization to have marked pharyngeal soft tissue collapse with inspiration during apneic episodes. Possible causes of pharyngeal collapse are discussed.

Adolescent↗
PubMed2001

[Eye diseases in sleep apnea syndrome].

Sleep apnea syndrome is characterized by recurrent complete or partial upper airway obstructions during sleep and recognized as an important risk factor for cardiovascular and cerebrovascular diseases. Several eye diseases have been associated with sleep apnea syndrome. Due to floppy eyelids often a chronic conjunctivitis occurs. A leaking mask used for apnea treatment may also induce a conjunctivitis. The lids may show an upper lid ptosis, lower lid ectropium, blepharochalasis, or trichiasis. Corneal findings include infectious keratitis, dry eye, recurrent erosion, keratoconus, and progressive endotheliopathy. Several optic neuropathies also seem to be associated with sleep apnea syndrome.

Blepharoptosis↗
PubMed1985

Sleep apnea syndrome.

Sleep apnea syndrome is estimated to affect as many as 2 to 3 percent of the adult male population. Excessive snoring and daytime sleepiness are but a few of the many clues to diagnosis. The hypoxemia occurring as a result of apnea may lead to pulmonary hypertension. Depressed respiratory center neural output or upper airway occlusion during sleep may cause the apnea. There are a number of treatment options available.

Acetazolamide↗
PubMed1994

[Screening for sleep apnea syndrome].

Sleep apnea syndrome (SAS) consists of nocturnal snoring interrupted by obstructive apnea and of diurnal symptoms like hypersomnolence as a consequence of sleep fragmentation. Cardiovascular morbidity and mortality associated with this syndrome justify early detection and appropriate treatment. Polysomnography is still a frequently used method for early detection; however, several disadvantages like duration, discomfort and expense led to a search for alternatives. Since the beginning of the eighties, oximetry allows recording of nocturnal oxygen saturation of hemoglobin even at home. Nocturnal oximetry reveals O2-desaturation associated with apnea and thus permits often to diagnose or exclude SAS. Diagnosis of SAS is made when at least 20 desaturations per hour with an amplitude of at least 4% are recorded. On the other hand, normal nocturnal oximetry nearly excludes SAS. In those cases where nocturnal oximetry is not diagnostic, polysomnography remains the method of choice. Departing from published work, a model for SAS detection, based mainly on nocturnal oximetry, is proposed.

Algorithms↗
PubMed1990

[Heart rate changes in sleep apnea syndrome].

Sleep apnea syndrome (SAS) is often associated with arrhythmias. The study was performed to clarify the characteristics and mechanisms of the heart rate (HR) changes during and after sleep induced apneas. Thirty-one patients with SAS without definitive heart disease, aged 17-78 years (mean 54.2 years), were examined by electroencephalograms, electrocardiograms, electrooculograms, nasal and oral breathing, thoracic and abdominal respiratory movements and arterial oxygen saturation (SaO2). [Results and Discussion] At the onset of sleep apnea, some showed progressive reductions in HR, followed by abrupt tachycardia on the resumption of breathing. Thirty-one patients with SAS were classified into three Groups (A, B, C). Group A demonstrated that HR changes occurred associated with apnea both in stage REM and in stage non-REM. Group B demonstrated that HR changes occurred associated with apnea only in stage REM. Group C demonstrated that HR changes did not occur associated with apnea. In Group A, apnea frequency and apnea index were higher than those of Group C. In Group A, the lowest SaO2 was lower than that of Group C, total time under 90% of arterial oxygen saturation (SaO2) was longer than that of Group C. There was a good negative correlation between oxygen saturation and HR changes. Further, HR changes were augmented by arousal response. This might be related to the arousal response as well as to the cardiostimulatory effects of hypoxia associated with increased ventilation. The arousability in response to apneas might be important in HR changes. In SAS, the degree of HR changes was related to apnea frequency, apnea index, apnea length and sleep stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

[The consequences of sleep structure disturbances in sleep apnea syndrome].

Sleep apnea syndrome (SAS) disturbing the structure of normal sleep causes many diseases. Contemporary studies prove that apnea is an independent risk factor for hypertension and myocardial infarction. Moreover it is emphasized that SAS plays important role in the initiation of arrhythmias, left ventricle dysfunction, pulmonary hypertension, endocrinological disorders and many others. That is the reason of worsened quality of life and increased mortality, mainly as a consequence of cardiovascular complications or high accident rate. Early diagnosis and treatment's application allows to improve the prognosis in these patients. This article recapitulates the knowledge in the field of SAS complications and the potential mechanisms of their development.

Brain↗
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

[Sleep apnea syndromes].

Sleep apnea syndromes have been identified only relatively recently. Their most frequent form is characterized by a sleep-related upper airway obstruction resulting in apneas which may repeat themselves up to several hundred times during a night's sleep. Their mean duration is about 30 to 40 seconds, but some apneas last over one minute. Breathing resumption requires an arousal, which may be clearly identified on the EEG but usually goes unnoticed by the patient. The most immediate consequence are hypoxemia and sleep fragmentation. There may be associated arrhythmias and hemodynamic changes, especially in the pulmonary circulation. The predominant clinical signs are snoring (during the breathing resumption between the apneas) and daytime somnolence due to sleep fragmentation. In addition to the risks of work and traffic accidents, these patients run a long-term risk of cardiovascular accidents. About 20% develop pulmonary hypertension, a contributing factor to right heart failure. About 50% are hypertensive, which combined with a frequently observed polycythemia, makes them vulnerable to ischemic accidents. The treatment is based upon the use of continuous positive airway pressure (CPAP) during sleep. In case of failure, surgical alternatives may be considered.

Electroencephalography↗
PubMed2000

[Sleep apnea syndrome].

Sleep Apnea Syndrome is an understimated disease. We describe its diagnostic criterion and principal epidemiologic data. After a brief rememory about sleep and respiration, its physiopathologic consequences (especially respiratory, cardiovascular and cerebral) were detailed. The diagnostic of its different clinical presentations is suspected clinically but confirmed by polysomnography. His treatment, usually based on the CPAP, permits to prevent its complications.

Diagnosis, Differential↗
PubMed2000

Diagnosis and management of sleep apnea syndrome.

Sleep apnea is the cessation of breathing during sleep. These episodes result in hypoxemia and sleep disruption; thus the consequences are both cardiorespiratory and neural. Sleep apnea syndrome is defined by a constellation of signs and symptoms, with the main presenting symptom being excessive daytime sleepiness. A diagnosis requires documentation of episodes of abnormal breathing during sleep. This disorder, once thought to be very rare, is so common that it is unlikely that any busy clinician has not encountered a case. Facilities for the evaluation of sleep breathing disorders are now available in most communities. With the introduction of continuous positive airway pressure and other treatments, most patients have complete resolution of their disabling symptoms.

Diagnosis, Differential↗
PubMed1988

[Continuous nasal positive pressure respiration (nCPAP) as a therapeutic possibility in the sleep apnea syndrome].

Sleep apnea syndrome (SAS) is a rare disorder which is being diagnosed more often with increasing knowledge among physicians and patients. SAS presents with daytime hypersomnolence, intellectual deterioration and personality changes, chiefly in obese men, and is caused by intermittent upper airway obstruction during sleep at the level of the mesopharynx. Consecutive repetitive apneas of more than 10 seconds' duration are immediately abolished by pneumatic splinting with continuous positive pressure of 5 to 15 cm H2O with a nasal mask (nCPAP). A case report on a 31-year-old man with obesity and hypercapnia demonstrates that, although nCPAP by itself does not lead to weight reduction, it is more acceptable than surgical therapy (tracheostomy or uvulopalatopharyngoplasty).

Adult↗
PubMed1989

[Surgery for snoring disorders and sleep apnea syndromes].

Sleep apnea syndrome is a relatively recent notion, frequently associated with snoring. First, a tracheostomy was applied as surgical treatment for the most dramatic cases. Over many years a modified old technic, the uvulo-palato-pharyngoplasty (UPPP) has been applied with a success rate of 60%. This type of surgery seems very easy. Yet anatomic variations require changes in the surgical procedure to obtain an optimal result. This point is frequently not known by inexperienced surgeons. Finally, the complete treatment needs a medical and surgical team able to choose the best solution for each patient, and to follow the obtained results.

Humans↗
PubMed2005

[Surveillance of industrial physicians' knowledge and concern about sleep apnea syndrome].

Sleep apnea syndrome (SAS) is a risk factor in lifestyle-related disease known to be closely associated with traffic and occupational accidents. Because of its high morbidity in middle-aged men, early diagnosis and management by industrial physicians are important. We clarified the degree of knowledge and concern about SAS among industrial physicians. We e-mailed questionnaires to 199 industrial physicians belonging to the Industrial Medical Promotion Society, and Most answered that industrial received responses from 51 (40 contracted and 11 part-time industrial physicians). physicians should participate in the management of SAS to prevent doze accidents, to control lifestyle-related diseases, to judge vocational fitness, and to lower economical expense. Fewer than 30% of physicians had conducted educational activities, and even fewer had practiced interviews and screening for SAS. Financial difficulty, lack of specialized hospitals for SAS, lack of labor, and a lack of concern among executives are major obstacles to SAS screening for employees. We concluded that, despite the concern industrial physicians, SAS is practically disregarded in their work. Cost-and time-effective screening and guidelines for employees with SAS should be established to facilitate the management of SAS by industrial physicians.

Accidents, Occupational↗
PubMed2006

The eye in sleep apnea syndrome.

Sleep apnea syndrome (SAS) is a disease characterized by recurrent complete or partial upper airway obstructions during sleep. The majority of patients with SAS demonstrate this obstruction either at the nasopharynx or the oropharynx. Risk factors for SAS include obesity, male gender, upper airway abnormalities, alcohol use, snoring, and neck girth of more than 17 in. in men or 16 in. in women. Reported ophthalmic findings in patients with SAS include floppy eyelid syndrome (FES), glaucoma, and non-arteritic anterior ischemic optic neuropathy (NAION).

Anti-Bacterial Agents↗
PubMed2000

Arnold-Chiari malformation presenting as sleep apnea syndrome.

Sleep apnea syndrome is a recognized manifestation of Arnold-Chiari malformation that almost invariably has been described in association with other neurological findings. We report a 39-year-old man who presented with severe daytime hypersomnolence. A detailed neurological examination was completely normal. Polysomnography revealed moderately severe mixed central and obstructive sleep apnea and hypopnea with persistence of central apnea and hypersomnolence despite nasal continuous positive airway pressure therapy. A history of severe headaches precipitated by sustained laughter prompted the consideration of an Arnold-Chiari malformation (ACM). A type I ACM with no evidence of syringomyelia or hydrocephalus was confirmed by MRI and successfully decompressed by suboccipital craniotomy and upper cervical laminectomies. Post-operatively the patient's headaches and hypersomnolence disappeared and a repeat polysomnography showed marked improvement in the sleep-disordered breathing. Physicians should be aware that severe sleep- disordered breathing may be the initial and sole presenting feature of Arnold-Chiari malformation.

Journal Article↗
PubMed2000

[Endocrine disturbances in sleep apnea syndrome].

Sleep apnea may interact endocrine rhythms by a number of mechanisms. Repetitive apneas will cause sleep fragmentation and disorganization of sleep stages and cycles. How this compares with hormonal changes secondary to sleep deprivation is unclear. Hypoxia may have direct central effects on neurotransmitters, which in turn will affect hypothalamic-pituitary hormone production. And, sudden arousal from sleep may produce a central stress response leading to hormonal changes. These factors may interact and lead to changes in the central of sleep and endocrine rhythms. We describe Growth hormone and Androgens secretion during sleep with obstructive sleep apnea patients.

Endocrine System Diseases↗
PubMed1997

[Efficacy of nasal bi-level positive airway pressure ventilation in a patient with olivo-ponto-cerebellar atrophy suffering from sleep apnea syndrome].

Sleep apnea with neuromuscular disorders has been successfully treated with bi-level positive airway pressure ventilation (BiPAP), which, unlike continuous positive airway pressure ventilation (CPAP), creates pressure difference between expiratory and inspiratory phases. Hence if the respiration of patients stops longer than a pre-set duration, BiPAP can automatically force them to breath through a nasal mask. We report a 60-year-old woman with olivo-ponto-cerebellar atrophy (OPCA), whose mixed-type sleep apnea was difficult to treat with conventional CPAP. We therefore tried BiPAP on this patient at night. Nocturnal CO2 retention was nearly resolved, and unexpectedly daytime PaCO2 was also corrected with marked improvement of daytime somnolence. BiPAP is totally non-invasive, and may be one of the most effective treatments in patients with OPCA suffering from sleep apnea.

Female↗
PubMed1995

[Differentiation of arousal in sleep before and after CPAP therapy in patients with pronounced sleep apnea syndrome].

The sleep apnea syndrome is often associated with the syndromes of daytime exhaustion and involuntary daytime sleeping fits. The cause is assumed to be fragmentary sleep resulting from night-time arousal. The central nervous activation reactions caused by apnea or hypopnea, respectively, and not the movement arousal determine the sleep structure. We have examined 10 male patients in the age range 40-55 years (48 +/- 6 SD) before and during the first 3 nights of CPAP therapy. Cardiorespiratory polysomnography was performed in all four nights. Sleep way analyzed visually and differentiation was made between respiratory (RA) and movement arousal (MA). All 10 patients had a pronounced sleep apnea syndrome. Deep and dream sleep were reduced, significantly more respiratory arousals occurred than movement arousals. The SWS latency was shortened in the first therapy night, the deep and dream sleep proportions increased and the RA decreased significantly. No further significant changes in the sleep parameters occurred during the second and third nights. We found that the number of apnea/hypopnea was not equal to the number of RA. When less arousal was recognized it was suggestive of a deficit of the diversion function while more RA was indicative of additional respiratory events, e.g. pharyngeal obstructions and hyperventilations which were not recognized as apnea or hypopnea. In addition to its role in the differential diagnosis of sleeping disorders, in particular sleep apnea, arousal differentiation is also an important criterion for estimating the efficiency of CPAP therapy.

Adult↗