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Pulmonary dysfunction secondary to mandibular retrognathia in Marfan's syndrome.

Referrals to pulmonary physicians for polysomnography to evaluate snoring or the possibility of sleep apnea syndrome often evolve into a multidisciplinary clinical problem. We present a young woman with two congenital abnormalities (Marfan's syndrome and retrognathism) which both may affect her decreased exercise tolerance, daytime hypersomnolence, and fatigue. Polysomnography and pulmonary exercise testing documented improvement in her upper airway diameter and exercise capacity. Her improved sleep pattern and her understanding of her exercise performance limitations afforded her a new outloo…

Feasibility study of determining a risk assessment model for obstructive sleep apnea in children based on local findings and clinical indicators.

OBJECTIVE: To test a feasible and reliable model for diagnosing obstructive sleep apnea (OSA) in children, based on the clinically relevant parameters, in comparison to a polysomnography. METHODS: A total of 94 children with the suspected underlying OSA were included in the analyses. An association between clinical parameters (modified Mallampati score, tonsil size, adenoid size, age, gender, and body mass index) and apnea-hypopnea index (AHI) obtained following an overnight polysomnography was assessed, and significant variables were incorporated in the logistic regression model. Also, the s…

[Our results with respect to uvulopalatopharyngoplasty in patients with snoring and obstructive sleep apnea syndrome].

OBJECTIVES: In this study we evaluated the results of modified uvulopalatopharyngoplasty in patients with snoring and obstructive sleep apnea syndrome. PATIENTS AND METHODS: Twenty patients (9 females, 11 males; mean age 44.4 years; range 31 to 67 years) who were diagnosed to have obstructive sleep apnea syndrome and snoring and who underwent modified uvulopalatopharyngoplasty were evaluated prospectively. The patients were evaluated considering pre- and postoperative symptoms, polysomnography, and Epworth sleepiness scale. Postoperative polysomnography was performed in the 4th month at the e…

Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study.

OBJECTIVE: It is unclear whether objectively measured maternal sleep-disordered breathing (SDB) leads to poor fetal outcomes. In this study, we prospectively assessed whether polysomnography-based diagnosis of SDB in the third trimester is associated with the delivery of small for gestational age (SGA) infants. STUDY DESIGN: Participants were recruited from a multicentre pregnancy cohort study. Eligible participants were evaluated for SDB based on symptoms (snoring and/or witnessed apnoeas assessed using the Pittsburgh Sleep Quality Index questionnaire) and in-home complete polysomnography in…

The Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study: design, rationale, and methods.

PURPOSE: The goal of the Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study is to develop a prognostic model for cardiovascular outcomes, based on physiologic variables-related to breathing, sleep architecture, and oxygenation-measured during polysomnography in US veterans. METHODS: The DREAM study is a multi-site, retrospective observational cohort study conducted at three Veterans Affairs (VA) centers (West Haven, CT; Indianapolis, IN; Cleveland, OH). Veterans undergoing polysomnography between January 1, 2000 and December 31, 2004 were included based on referral for eval…

Why does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing?

PURPOSE: We analyzed the outcome of nocturnal enuresis after adenotonsillectomy in children with sleep disordered breathing. We also evaluated differences in demographic, clinical, laboratory and polysomnography parameters between responders and nonresponders after adenotonsillectomy. MATERIALS AND METHODS: We prospectively evaluated children 5 to 18 years old diagnosed with sleep disordered breathing (snoring or obstructive sleep apnea syndrome) on polysomnography and monosymptomatic primary nocturnal enuresis requiring adenotonsillectomy to release upper airway obstruction. Plasma antidiure…

Sleep disordered breathing in patients with acutely decompensated heart failure.

OBJECTIVE: The purpose of this study is to systematically characterize sleep disordered breathing (SDB) during acute heart failure (HF) deco … F without other active cardiorespiratory morbidity underwent echocardiography and overnight bedside polysomnography within 48h of admission. Ten patients underwent follow-up polysomnography just before or immediately after hospital discharge. RESULTS: Twenty-eight of 29 patients demonstrated an apnea+hypopnea index (AHI)>5 events/h (mean AHI 41+/-29/h); 22 patie …

[Subjective outcomes after modified maxillomandibular advancement for the treatment of obstructive sleep apnea syndrome].

OBJECTIVE: To evaluate subjective outcomes after modified maxillomandibular advancement(MMMA) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: In the study, 15 patients underwent MMMA for the treatment of OSAHS and received presurgical and postsurgical polysomnography. A questionnaire was done pre- and postoperatively. The questionnaire included the Epworth sleepiness scale (ESS), snoring, witnessed apneas, CPAP use, and satisfaction of the treatment. RESULTS: The preoperative polysomnography results of the patients were as follows: apnea-hypopnea index, 40.5±…

Cyanotic breath-holding spells in children respond to adenotonsillectomy for sleep-disordered breathing.

Children with breath-holding (BH) spells may demonstrate sleep-disordered breathing (SDB) during polysomnography. We studied five young children with cyanotic spells retrospectively and found both SDB and a response to adenotonsillectomy. We therefore proceeded with a prospective investigation of treatment for SDB in children with comorbid cyanotic spells. Nineteen children with cyanotic BH spells were identified and enrolled in the prospective study. Parents chose either treatment or observation. Fourteen children underwent complete SDB evaluation and treatment trials while five selected obse…

[Clinical analysis of 68 patients with obstructive sleep-disordered breathing in children].

OBJECTIVE: To explore the clinical features and the diagnosis and the treatment of pediatric obstructive sleep-disordered breathing. METHOD: Sixty- disordered breathing. METHOD: Sixty eight cases with obstructive sleep-disordered breathing were reviewed including clinical features and cephalometric analysis and endoscopic examination, 46 of all them were study of polysomnography. RESULT: Forty-six cases were examined with polysomnography in preoperative. AHI 0.1 approximately 24.0 times/hour. Follow-up 3 months to 1.5 year, 68 patients were performed with adenotonsillectomy, upper airway ob…

The sleep apnea syndrome. Part I: Diagnosis.

Part I of this two-part article presents a review of the symptoms, pathophysiology, and diagnosis of the sleep apnea syndrome. The more common obstructive type is characterized by disturbed sleep and daytime hypersomnolence. Subjective signs and symptoms should be correlated with objective findings by way of polysomnography (sleep study) to confirm the diagnosis and determine the severity of obstructive sleep apnea. Electrocardiographic monitoring during polysomnography has revealed potentially life-threatening arrhythmias during sleep. Differential diagnosis should include central sleep apnea…

Frequency of moderate-to-severe obstructive sleep apnea syndrome among children with snoring and blood pressure in the hypertensive range.

BACKGROUND: It is recommended that children with hypertension and loud snoring should be referred for polysomnography. We aimed to compare the frequency of moderate-to-severe obstructive sleep apnea syndrome (OSAS) among snorers with and without hypertension. Thus, it was hypothesized that systolic or diastolic hypertension among children with snoring is a risk factor for moderate-to-severe OSAS. METHODS: Data of children with snoring and adenotonsillar hypertrophy and/or obesity referred for polysomnography were retrospectively analyzed. Blood pressure (BP) was measured three times in the mo…

Effectiveness of home respiratory polygraphy for the diagnosis of sleep apnoea and hypopnoea syndrome.

INTRODUCTION: Home respiratory polygraphy (HRP) may be a cost-effective alternative to polysomnography for the diagnosis of sleep apnoea-hypopnoea syndrome (SAHS), but stronger evidence is needed. Normally, patients transport HRP equipment from the hospital to home and back, which may create difficulties for some patients. OBJECTIVES: To determine both the diagnostic efficacy and cost of HRP (with and without a transportation service moving the device and telematic transmission of data) in a large sample compared with in-hospital polysomnography. METHODS: Patients suspected of having SAHS we…

Correlation between body mass index and obstructive sleep apnea severity indexes - A retrospective study.

PURPOSE: To evaluate if Body Mass Index (BMI) is correlated to Apnea-Hypopnea Index (AHI), mean arterial oxygen saturation (SaO2) and Nadir SaO2, which are all indexes defining the severity of the respiratory stress associated with Obstructive Sleep Apnea (OSA). MATERIALS AND METHODS: Seventy-five adult patients (mean age 51.4) referred for polysomnography were retrospectively recruited. BMI was calculated for each patient, as well as AHI, SaO2, and Nadir SaO2 recorded during polysomnography. Spearman's Rho test was used to evaluate if OSA severity was correlated to BMI values. First type err…

Sleep disordered breathing in children with mitochondrial disease.

A retrospective chart review study was performed to determine the presence of sleep disordered breathing (SDB) in children with primary mitochondrial disease (MD). The symptoms, sleep-related breathing, and movement abnormalities are described for 18 subjects (ages 1.5 to 18 years, 61% male) with MD who underwent polysomnography in our pediatric sleep center from 2007 to 2012. Of the 18 subjects with MD, the common indications for polysomnography were excessive somnolence or fatigue (61%, N = 11), snoring (44%, N = 8), and sleep movement complaints (17%, N = 3). Polysomnographic measurements s…

[Atlantoaxial dislocation with ventilatory insufficiency--report of two cases].

We performed electromyography and polysomnography in two cases of atlantoaxial dislocation with ventilatory insufficiency to determine the patients' respiratory patterns. The results showed that hypertrophic sternocleidomastoid muscles (SCMs) played an important part in their respiration. The diaphragm and intercostal muscles did not display marked electromyographic (EMG) activity, but the SCMs showed a great deal of phasic inspiratory activity during the daytime that decreased or disappeared during sleep. A 6-year-old boy with atlantoaxial dislocation related to spinal abnormalities was chief…

Central sleep apnea in otherwise healthy term infants.

STUDY OBJECTIVES: To describe the outcomes of central sleep apnea requiring home supplemental oxygen therapy in otherwise healthy term infants. METHODS: All children < 1 year of age undergoing polysomnography between 2015 and 2020 at the Queensland Children's Hospital were retrospectively studied. Children with gestational age < 37 weeks, underlying syndrome, cleft palate, those with obstructive apnea-hypopnea index > 50% of total apnea-hypopnea index, or with underlying cardiac or pulmonary parenchymal pathology were excluded. Polysomnography parameters were extracted for periods both on and…

Association of Central Hypersomnia and Fatigue in Patients With Multiple Sclerosis: A Polysomnographic Study.

OBJECTIVE: To evaluate sleepiness and central hypersomnia in multiple sclerosis (MS)-associated fatigue, we performed long-term polysomnography in patients with MS and healthy controls. METHODS: Patients with MS and healthy controls completed questionnaires on sleep, fatigue, sleepiness, and depression. They underwent nocturnal polysomnography, multiple sleep latency tests, and bed rest 24-hour polysomnography. Patients were divided into 3 groups (fatigue and sleepiness, fatigue and no sleepiness, neither fatigue nor sleepiness). RESULTS: Among 44 patients with MS, 19 (43.2%) had fatigue and…

Frequency of sleep-disordered breathing in a referral population of Somali-Americans.

STUDY OBJECTIVES: To study the frequency of obstructive sleep apnea (OSA) in individuals of Somali ancestry referred to a clinical sleep laboratory. METHODS: This was a retrospective study using a large registry of patients who underwent diagnostic polysomnography between 17 November 2009 and 15 April 2017. Adult patients self-reporting as being of Somali origin were confirmed using the electronic medical record. RESULTS: Somali-American patients comprised approximately 0.2% of all patients undergoing polysomnography at the Mayo Clinic Center for Sleep Medicine. The median (interquartile ran…

Патология сна в болезни Креуцфельдта-Якоба.

ЦЕЛИ ИССЛЕДОВАНИЙ: Все более очевидным становится связь между сном и нейродегенеративными заболеваниями. Цель этого исследования состоит в том, чтобы охарактеризовать распространенность и тип патологии сна в болезни Креуцфельдт-Якоб (CJD), быстро прогрессирующей, смертельной нейродегенеративной болезни. МЕТОДЫ: В ходе этого исследования, проведенного с участием различных групп, мы провели ретроспективный анализ признаков сна и симптомов у ряда пациентов с определенным КЖД в медицинском центре третичной медицинской помощи (n = 28). Полисомнография была проведена у 14 пациентов. РЕЗУЛЬТАТЫ: Хотя

Совпадение в аннотации оригинала
STUDY OBJECTIVES: Associations between sleep and neurodegenerative diseases have become increasingly evident. This study aims to characteriz … ms in a consecutive group of patients with definite CJD at a tertiary care medical center (n = 28). Polysomnography was performed in 14 patients. RESULTS: Although only 5 of 28 patients carried a premorbid sleep diagnosis, signs/symptoms of sleep pathology were present in 25 patients. Eleven reported hypersomnia whereas 13 reported insomnia. Seven had restless l …