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Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants.

OBJECTIVE: Adenotonsillar hypertrophy (ATH) is the leading cause for obstructive sleep apnea syndrome (OSAS) in children. The peak age for adenoid and tonsillar hypertrophy and related OSAS is 3-6 years. It has been suggested that OSAS due to ATH is extremely rare in infants. The purpose of the present study was to delineate OSAS due to ATH in infants. METHODS: Twenty-nine consecutive infants <18 months of age who underwent polysomnography (PSG) and were diagnosed with OSAS due to ATH were studied. A pediatric sleep questionnaire was completed by parents of all infants. Information regarding …

[Chronic snoring and obstructive sleep apnea-hypopnea syndrome in children].

The problems children have in sleeping are manifold; the gamut of disorders that have been described ranges from simple, occasional snoring with no accompanying complications, through the syndrome of increased blockage of the upper airways to the obstructive sleep apnea-hypopnea syndrome (OSAHS) where respiratory difficulties accompanied by hypoxemia, hypercapnia and structural sleep difficulties. Mouth breathing and chronic snoring occur frequently in children, with the incidence of snoring, identical for both sexes, varying between 3.2 and 27%. Difficulties in sleeping begin between the ages…

Decreased pituitary-gonadal secretion in men with obstructive sleep apnea.

Decreased libido is frequently reported in male patients with obstructive sleep apnea (OSA). The decline in morning serum testosterone levels previously reported in these patients was within the normal adult male range and does not explain the frequent association of OSA and sexual dysfunction. We determined serum LH and testosterone levels every 20 min between 2200-0700 h with simultaneous sleep recordings in 10 men with sleep apnea and in 5 normal men free of any breathing disorder in sleep. The mean levels and area under the curve of LH and testosterone were significantly lower in OSA patie…

[Skin prick test results in snoring and sleep apnea patients].

BACKGROUND: In allergic rhinitis, nasal obstruction is a typical symptom. Reduced nasal ventilation is thought to be one causal factor for sleep breathing disorders. Whether or not snoring individuals with or without sleep apnea show more frequent or stronger reactions in skin prick tests (SPT) compared to non-snorers has not been investigated yet. METHOD: SPT on 20 most frequent allergens and standardized questionnaires of 412 patients of either sex who received a polysomnography at the sleeplab of the ENT department, University of Würzburg, Germany, were analysed retrospectively. In 351 pat…

Cardiorespiratory events in preterm infants referred for apnea monitoring studies.

BACKGROUND: Episodes of apnea, desaturation, and bradycardia are common in preterm infants. Such infants who have persistent cardiorespiratory events detected by clinical bedside monitoring often are referred for overnight apnea monitoring studies. OBJECTIVE: To characterize apnea, bradycardia, and desaturation events in infants referred for an overnight apnea monitoring study and compare them with corresponding events in control infants of similar age and weight with no bedside monitor alarms. METHODS: Twelve-hour bedside apnea monitoring studies were performed on 68 preterm infants before …

Ночные проблемы в постполиологическом синдроме: симптомы апноэ сна и ноктурии.

Ноктония, широко признанная как неизбежное последствие старения, является также симптомом потенциально смертоносного состояния - вредной апноэ сна (OSA). В описательном исследовании, о котором говорится в этой статье, рассматривались проблемы ноктурии и дыхания, связанные с сном, у лиц с постполийным синдромом (ППС), и была проведена проверка модели снотворного дыхания - ноктурии. Эта модель описывает каскад событий, которые приводят к полиурии у лиц с расстройствами дыхания, связанными с сном. Данные были проанализированы с помощью описательной и субъективной статистики. В информационном бюлл

Совпадение в аннотации оригинала
Nocturia, generally accepted as an inevitable consequence of aging, is also a symptom of a potentially lethal condition--obstructive sleep apnea (OSA). The descriptive study reported in this article examined nocturia and sleep-related breathing problems in persons with postpolio syndrome (PPS) and tested the Sleep Disordered Breathing--Nocturia Model. This m…

Fiberoptic nasopharyngolaryngoscopy for airway monitoring after obstructive sleep apnea surgery.

PURPOSE: This study evaluated the upper airway characteristics in the early postoperative period after reconstructive surgery for obstructive sleep apnea (OSA). METHODS: During a 24-month period, the upper airway of patients who underwent uvulopalatopharyngoplasty (UPPP) with genioglossus advancement (GA) or hyoid myotomy (HM) or maxillomandibular advancement (MMA) were evaluated with fiberoptic nasopharyngolaryngoscopy (NPG) preoperatively and 24 to 72 hours postoperatively. RESULTS: NPG was performed on 271 patients. One hundred seventy-three patients had UPPP with GA or HM, and the remain…

Facial patterns of obstructive sleep apnea patients using Ricketts' method.

To analyze the facial patterns of obstructive sleep apnea syndrome (OSAS) patients, we took lateral cephalograms of 31 OSAS patients and 26 non-OSAS controls and utilized Ricketts' method. In addition, we measured the hyoid bone position, the length of mandibular plane to H-point, the length of soft palate, and lower pharynx. The facial patterns of OSAS patients were dolico, the hyoid bone was positioned low, the soft palate was longer and the width of the airway was narrower than that of the non-OSAS controls.

[Predictive value of nocturnal pulse oximetry in sleep apnea screening].

The monitoring of overnight oxygen saturation is widely used for sleep apnoea screening. The point of this screening has been questioned as a wide range of sensitivity has been reported in the literature. In a prospective study 70 subjects presenting with a possible sleep apnoea-hypopnoea syndrome had overnight oximetry followed by polysomnography 2 to 4 months later. Compared to polysomnography, the sensitivity of oximetry for sleep apnoea-hypopnoea was 85.2%, the specificity 77.8% and the predictive value positive 96.3%. When short, non-significant, repetitive desaturations have been declare

Long-term results of uvulopalatopharyngoplasty for obstructive sleep apnea syndrome.

OBJECTIVES: Assessment of the long-term effect of uvulopalatopharyngoplasty (UPPP) on snoring, excessive daytime sleepiness, and nocturnal oxygen desaturation index (ODI) in patients with obstructive sleep apnea syndrome. STUDY DESIGN: Evaluation of snoring, excessive daytime sleepiness, and ODI in patients treated by UPPP earlier. MATERIALS AND METHODS: Patients (n = 58) with a follow-up period of 11 to 74 months (median, 34 mo) were included in this study. Snoring and excessive daytime sleepiness were scored on specially designed semiquantitative scales. In all patients ODI was calculated …

Site of airway collapse in obstructive sleep apnea after uvulopalatopharyngoplasty.

The objective of this prospective study was to determine the site and pattern of upper airway collapse by a multiple-catheter technique in subjects demonstrated to have obstructive sleep apnea (OSA) after uvulopalatopharyngoplasty (UPPP). Standard diagnostic nocturnal polysomnography (PSG) was done on all subjects. The PSG recordings included electroencephalogram, electrooculogram, electrocardiogram, chin and leg electromyograms, nasal and oral airflow, and abdominal effort. Polysomnography with a multiport flexible airway Gaeltec catheter was performed in 22 subjects. The Gaeltec flexible air…

[Validation of half-night polysomnography for sleep apnea/hypoapnea syndrome].

UNLABELLED: A diagnosis of sleep apnea/hypopnea syndrome (SAHS) is based on clinical signs and nighttime polysomnograms. Brief polysomnography has been proposed as an alternative to all-night recording. OBJECTIVES: The aim of this study was to determine whether a polysomnograms obtained during the first half of the night is sufficient for establishing a diagnosis of SAHS and to determine the correlation between polysomnographic variables recorded during the first four hours (half the study time) with those recorded over the full eight hours (full study time), as well as to determine diagnosti…

Predictive value of pulmonary function parameters for sleep apnea syndrome.

Nocturnal polysomnography is the standard diagnostic test for sleep apnea syndrome (SAS) but is both expensive and time-consuming. We developed a predictive index for SAS based on pulmonary function data, including respiratory resistance determined by the forced oscillation technique, from 168 obese snorers with suspected SAS. Our model used logistic regression to obtain case-by-case predictions of the probability of SAS, defined as an apnea-hypopnea index (AHI) > or = 15 during overnight polysomnography. We then tested our model in a prospective group of 101 similar patients. Specific respira…

[Sleep apnea syndrome in acromegaly. Treatment and development-- retrospective analysis].

In total 56 subjects with acromegaly (37 men and 19 females) were examined in attempt to find sleep apnoea syndrome (SAS). The examination consisted of clinical examination and of all-night monitoring MESAM4 or polyMESAM. The diagnosis of SAS was established in 76.4% of subjects: 31 men and 11 females, average age 51.8 (SD +/- 9.6) years. The average ODI (oxygen desaturation index--number of oxygen saturation drops per 1 hour of sleep) of SAS patients was 29.2 (+/- 20.7). The therapy of SAS was recommended to 27 patients: sleeping position on the side (3 patients), reduction of the weight (8 p

[Central apnea with consciousness impairment due to Listeria rhombencephalitis sequelae].

Listeria neuromeningitis presents as febrile rhombencephalitis in half the patients, often with persistent sequelae such as cranial nerve palsy. We report the case of a man who developed central apnea with simultaneous consciousness impairment subsequent to an infectious disease. Magnetic resonance imaging showed low signal intensities in T1 and T2, particularly in the medulla. Neither acidosis, hypoxia nor hypercapnea stimulated the respiratory centers during episodes of apnea; ventilation started again only with strong voluntary stimulation. Pons and medulla lesions of the reticular formatio…

Heart rate variability and apnea during sleep in Down's syndrome.

Autonomic system dysfunction has been reported to occur frequently in patients with Down's syndrome (DS) and is constituted mainly by an imbalance between the sympathetic and vagal systems. The analysis of heart rate variability (HRV) during sleep is a quantitative reliable method for studying such a mechanism, but it has not yet been extensively and adequately applied in DS. In this study, HRV during sleep was evaluated in seven DS patients and in six normal controls, by also controlling for the presence of sleep apnea or arousal. The main results were an increased sympathetic function (low-f…

Effects of cardiac dysfunction on non-hypercapnic central sleep apnea.

INTRODUCTION: Non-hypercapnic central sleep apnea (CSA) commonly occurs during nonrapid eye movement (non-REM) sleep in adults with congestive heart failure (CHF) and in some subjects without signs or symptoms of CHF. Hyperventilation, reduced lung volume, and circulatory delay are known to contribute to CSA, but to differing degrees depending on presence or absence of CHF. AIM: To determine whether the pattern of ventilation during sleep could be used to determine the presence of CHF. METHODS: Full polysomnographs demonstrating CSA were examined in 10 consecutive subjects with CHF and in 10…

Treatment of obstructive sleep apnea syndrome by rapid maxillary expansion.

The precise role of maxillary constriction in the pathophysiology of obstructive sleep apnea (OSA) is unclear. However, it is known that subjects with maxillary constriction have increased nasal resistance and resultant mouth-breathing, features typically seen in OSA patients. Maxillary constriction is also associated with alterations in tongue posture which could result in retroglossal airway narrowing, another feature of OSA. Rapid maxillary expansion (RME) is an orthodontic treatment for maxillary constriction which increases the width of the maxilla and reduces nasal resistance. The aim of…

Apnea following spinal anaesthesia in two former pre-term infants.

PURPOSE: To report the occurrence of apnea and bradycardia in two former pre-term infants who received spinal anaesthesia without inhalational or intravenous anaesthetic agents during inguinal herniorrhaphy. CLINICAL FEATURES: Two former pre-term infants who had no recent history of apnea or bradycardia and who had been discharged from the hospital presented for anaesthetic care during inguinal herniorrhaphy. Spinal anaesthesia using 1 mg.kg-1 tetracaine in dextrose 10% was performed. A sensory level of T4-6 was obtained in both infants. Neither infant received intravenous, oral, or inhalatio…

[Event related potentials and neuropsychological studies in sleep apnea patients].

Patients with obstructive sleep apnoea syndrome (OSAS) commonly complain about daytime sleepiness and a decline of cognitive functions. Several diagnostic tools have been established to judge objectively vigilance and cognitive impairment. Forty OSAS patients aged between 34 and 74 years were examined via several neuropsychological tests (e.g. vigilance test of the Wiener Testsystem, number connection test ("Zahlenverbindungstest-ZVT") to assess working velocity and information processing, d2-test to rate concentration on exertion) before starting continuous positive airway pressure (CPAP) the