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Sleep Apnea Syndrome

CCHS


Presentation

  • In this paper, the authors present a case of RPA with unusual and interesting presenting symptoms in a 10-month-old infant that exhibit new-onset and worsening snoring and sleep apnea.[ncbi.nlm.nih.gov]
  • Results: The COPD group presented higher parasympathetic modulation during APM when compared to the COPD OSAS group ( P 0.02). The COPD OSAS group presented higher sympathetic modulation during RSA-m when compared to the COPD group ( P 0.00).[ncbi.nlm.nih.gov]
  • CONCLUSION: The results of the present study suggest that OSAS is associated with OAB syndrome. As a key symptom of OAB, urgency correlates with hypoxia in cases with OSAS.[ncbi.nlm.nih.gov]
  • When the malformation is present, timely surgery can prevent irreversible neurologic damage.[ncbi.nlm.nih.gov]
  • His stormy postoperative course is presented with emphasis on glycemic control and hypertension.[ncbi.nlm.nih.gov]
Fatigue
  • Respiratory disturbances causing sleep fragmentation and repetitive nocturnal hypoxia are responsible for a variety of nocturnal and daytime complaints of sleep apnea patients, such as snoring, daytime sleepiness, fatigue, or impaired cognitive functions[ncbi.nlm.nih.gov]
  • Herein we present a female patient with diagnosis of FMS for 10 years who had complaints of morning fatigue, restless sleep, sleepiness during day and snoring besides musculoskeletal symptoms.[ncbi.nlm.nih.gov]
  • Complications can include: Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely.[mayoclinic.org]
  • ., a pulmonologist and sleep disorders expert: Take a simple one-page self-test questionnaire that can alert you to consider sleep apnea as the source of your fatigue.[healthyresources.com]
  • Symptoms • Day- time – Sleepiness – Morning Fatigue – Morning headache – Cognitive Impairment – Heartburn – Depression • Night- time – Snoring – Observed Gasping/ Apnea/ Choking – Repeated waking – Nocturnal sweating 10.[slideshare.net]
Sleep Apnea
  • We sought to determine the prevalence of complex sleep apnea syndrome and hypothesized that the clinical characteristics of patients with complex sleep apnea syndrome would more nearly resemble those of patients with central sleep apnea syndrome (CSA)[ncbi.nlm.nih.gov]
  • Sleep apnea was found in 11 patients. During follow-up, 15 patients died, including 9 with baseline sleep apnea.[ncbi.nlm.nih.gov]
  • Abstract To evaluate the effect of distraction osteogenesis in correction of micrognathia accompanying obstructive sleep apnea syndrome, a total of 28 patients with different severities of obstructive sleep apnea syndrome underwent mandibular distraction[ncbi.nlm.nih.gov]
Snoring
  • Conclusions: Serum leptin levels are affected by adiposity but not by OSAS severity among children with habitual snoring.[ncbi.nlm.nih.gov]
  • Subjective assessments of clinical symptoms/signs, including snoring visual analog scale (VAS), nasal obstruction, and mouth breathing, were recorded.[ncbi.nlm.nih.gov]
  • Snoring Studies have shown that up to 50% of adults snore. It is not very common in children, but it does occur. Snoring, when mild or infrequent, may not be a significant issue.[calsleep.com]
  • We present a 14-year-old girl whose initial diagnosis was obstructive sleep apnea syndrome (OSAS) with symptoms of habitual snore, sleep breath holding, shortness of breath, and lump in throat.[ncbi.nlm.nih.gov]
  • Both patients presented with a long-standing history of snoring, gasping for air while sleeping, excessive daytime sleepiness, and morning headaches. In both patients, the lesions were discovered by fiberoptic nasopharyngoscopy.[ncbi.nlm.nih.gov]
Loud Snoring
  • Some warning signs in adults Excessively loud snoring. A pattern of snoring interrupted by pauses, then gasps, is a sign that breathing stops and restarts. Falling asleep at the wrong times, such as at work or while driving.[prohealthcare.org]
  • Hypersomnia-sleep apnea syndrome A condition affecting obese and hypertensive middle-aged , which is characterized by daytime grogginess and loud snoring; these Pts are at risk for AMI and CVAs Secondary hypersomnia A symptom caused by focal CNS disease[medical-dictionary.thefreedictionary.com]
  • Loud snoring can keep anyone who sleeps near you from getting good rest. It's not uncommon for a partner to have to go to another room, or even to another floor of the house, to be able to sleep.[mayoclinic.org]
  • Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though.[nlm.nih.gov]
Hypertension
  • It was found: 36% of daytime hypertension, 52% nocturnal hypertension, 40% non-dipper profile, 16% of white coat hypertension and 28% masked hypertension. The prevalence of sleep apnea syndrome was 16%.[ncbi.nlm.nih.gov]
  • Abstract A 55-year-old female was admitted to our hospital with severe hypertension (274/140 mmHg).[ncbi.nlm.nih.gov]
  • His stormy postoperative course is presented with emphasis on glycemic control and hypertension.[ncbi.nlm.nih.gov]
  • Masked hypertension is defined as an average clinic BP of 1, 2, 18, 19 Masked hypertension includes morning hypertension, stress-induced hypertension, such as workplace hypertension, 1 and nocturnal hypertension.[nature.com]
  • Abstract Obstructive sleep apnea syndrome (OSAS) causes resistant hypertension and a hypopnea-related nocturnal blood pressure (BP) surge.[ncbi.nlm.nih.gov]
Blurred Vision
  • The SPK, red eye and blurred vision completely resolved after surgery without additional treatment. The corneal sensation also recovered gradually during the next 7 years. However, the floppy eyelid did not resolve.[ncbi.nlm.nih.gov]
Morning Headache
  • Both patients presented with a long-standing history of snoring, gasping for air while sleeping, excessive daytime sleepiness, and morning headaches. In both patients, the lesions were discovered by fiberoptic nasopharyngoscopy.[ncbi.nlm.nih.gov]
  • During last year, the patient was accusing excessive daytime somnolence, breath arrests during sleep, intense snoring, morning headaches, morning oral dryness, pin point chest pain, nocturia (4-5 nocturnal urination), concentration difficulties and an[ncbi.nlm.nih.gov]
  • Morning headaches or nausea. Some warning signs in children Being overweight or having enlarged tonsils and/or adenoids. Certain birth defects that affect size/shape of throat, face or chin such as Down Syndrome.[prohealthcare.org]
  • OSAS Symptoms Extreme snoring Drowning nightmares Daytime sleepiness Morning headaches Mental deficits Erectile dysfunction Relationship between OSAS & Hypertension The prevalence of obstructive sleep apnea is higher in patients with cardiac disorders[meditech.hu]
  • Symptoms • Day- time – Sleepiness – Morning Fatigue – Morning headache – Cognitive Impairment – Heartburn – Depression • Night- time – Snoring – Observed Gasping/ Apnea/ Choking – Repeated waking – Nocturnal sweating 10.[slideshare.net]
Somnolence
  • In epilepsy patients with risk factors (eg, obesity) or markers (eg, habitual snoring, daytime somnolence) for sleep apnea, a careful sleep history should be elicited and a polysomnogram obtained when indicated.[ncbi.nlm.nih.gov]
  • During last year, the patient was accusing excessive daytime somnolence, breath arrests during sleep, intense snoring, morning headaches, morning oral dryness, pin point chest pain, nocturia (4-5 nocturnal urination), concentration difficulties and an[ncbi.nlm.nih.gov]
  • Recognition of its relevance in medicine is relatively recent, although clinical reports of SDB were first made in the 19th century. 1 Likely influenced by such observations, descriptions of an entity constituting obesity and extreme somnolence were highlighted[accessmedicine.mhmedical.com]
  • […] or involuntary napping, but not due to any other physical or psychological condition. hy·per·som·ni·a ( hī'pĕr-som'nē-ă ), A condition in which sleep periods are excessively long, but the person responds normally in the intervals; distinguished from somnolence[medical-dictionary.thefreedictionary.com]
Difficulty Concentrating
  • You might have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. People with sleep apnea have an increased risk of motor vehicle and workplace accidents.[mayoclinic.org]
  • In all types of sleep apnea, the disturbances in sleep can result in daytime sleepiness, fatigue, irritability, headaches in the mornings, slowness of thought, and difficulty concentrating.[msdmanuals.com]
  • Sleep apnea is a common problem associated with decreased overall health and a higher risk of life-threatening complications, such as motor vehicle accidents, difficulty concentrating, depression, heart attack, and stroke.[medicalnewstoday.com]
  • In all types of sleep apnea, the disturbances in sleep can result in daytime sleepiness , fatigue, irritability, headaches in the mornings, slowness of thought, and difficulty concentrating.[merckmanuals.com]
Sleep Disturbance
  • Sleep disturbances may lead to musculoskeletal pain and some studies suggest a relation between OSAS and FMS.[ncbi.nlm.nih.gov]
  • In conclusion, didgeridoo playing improved daytime sleepiness in patients with moderate snoring and obstructive sleep apnoea and reduced sleep disturbance in their partners.[bmj.com]
  • Clinicians should include sleep evaluation in patients diagnosed of COPD asking about daytime sleepiness, snoring, pauses while sleeping and insomnia symptoms, referring to the specialist when necessary to address treatment options of comorbid sleep disturbances[copdfoundation.org]
  • Muscarinic supersensitivity: A possible model for the sleep disturbance of primary depression? Psychiatry Res. 1979 ;1(1): 17 – 22. Google Scholar 31. Kupfer, DJ, Ehlers, CL, Frank, E.[doi.org]
Sleep Attack
  • All of the patients, both obese and non-obese, presented abnormal oral glucose tolerance test (OGTT) and plasma insulin level. (1) A 17-year-old girl (BMI 20.3) with a two-year history of daytime sleep attacks (e.g. on the bus, in a classroom, while reading[ncbi.nlm.nih.gov]
  • Episodes of narcolepsy have been described as “sleep attacks” and may occur in unusual circumstances, such as walking and other forms of physical activity.[web.archive.org]

Workup

  • The prolonged apneic periods with tonic muscle contracture lasting minutes and occurring exclusively at night with ensuing confusional state posed diagnostic difficulties because of the negative EEG at the beginning of the workup and the absence of other[ncbi.nlm.nih.gov]
  • The common physical findings in OSA are listed in Table 3. 43,44 Because many patients with OSA have an upper airway abnormality, an ear, nose and throat evaluation is essential in the diagnostic workup.[web.archive.org]
Hypercapnia
  • An arterial blood gas analysis showed hypercapnia. Polysomnography showed a respiratory disturbance index of 108 events/h, and all were central apnea events. Treatment with adaptive servo-ventilation was initiated, and central apnea was resolved.[ncbi.nlm.nih.gov]
  • Related Testing An arterial blood gas (ABG) is needed to evaluate patients with suspected hypercapnia. Hypercapnia is defined as the PaCO2 being greater than 42 mm Hg.[ncbi.nlm.nih.gov]
  • Sleep apnea syndrome is a disorder of abnormal respiration during sleep that results in a combination of hypoxemia and hypercapnia.[epilepsy.com]
  • Neural responses to hypoxia and hypercapnia have not been well studied in children with obstructive sleep apnea and underlying syndromes.[emedicine.com]

Treatment

  • The recommendations for treatment of CSAS are summarized as follows: CPAP therapy targeted to normalize the apnea-hypopnea index (AHI) is indicated for the initial treatment of CSAS related to CHF.[ncbi.nlm.nih.gov]
  • The most common standard treatment for OSAS, continuous positive airway pressure, was found to have beneficial effects on cardiovascular sequelae of OSAS. Additionally, commercial companies promote nonprescription treatments for OSAS.[ncbi.nlm.nih.gov]
  • […] does not tolerate continuous positive airway pressure or cannot afford this treatment, a fact quite common in Brazil and other developing countries.[ncbi.nlm.nih.gov]
  • When endoscopic examinations were performed in conjunction with n-CPAP, the treatment was observed to act on the pharynx and to expand the airway in all cases Combined medical treatments were effective in cases where n-CPAP alone was ineffective due to[ncbi.nlm.nih.gov]
  • Forty (40) males with mild and moderate OSAS were assessed pretreatment and 2-months post-treatment after wearing an MRA.[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis is similar to obstructive sleep apnea. The central apnea component in most patients on followup using CPAP therap, has resolved.[ncbi.nlm.nih.gov]
  • Herein, we describe the history, diagnosis, treatment, and prognosis of a rare case.[ncbi.nlm.nih.gov]
  • INTRODUCTION: Sleep apnea is very frequent in multiple system atrophy (MSA) and may contribute to the poor prognosis.[ncbi.nlm.nih.gov]
  • Retinal vessel is the only vessel that can be observed directly and noninvasively; retinal vascular abnormalities can serve as a predictive marker for the occurrence, clinical course, and prognosis of cardiovascular and cerebrovascular diseases.[ncbi.nlm.nih.gov]
  • With treatment, the prognosis is usually excellent. Life span is not affected, and most serious complications can be prevented. Losing weight, quitting smoking, and not using alcohol excessively can help.[msdmanuals.com]

Etiology

  • These bite changes were related to molar extrusion in two patients, whereas in the other two patients no obvious etiology was found.[ncbi.nlm.nih.gov]
  • Etiologies and risk factors Epilepsy and sleep apnea syndrome have a reciprocal influence on one another that may exacerbate the processes of both conditions: The apneic episodes lead to hypoxemia and to chronic sleep deprivation, because multiple arousals[epilepsy.com]
  • As the understanding of the etiology of OSA increased, treatment options began to emerge.[accessmedicine.mhmedical.com]
  • The trends in obesity prevalence are not consistent with a single etiologic factor; indeed, recent increases are likely multifactorial with both inherited and environmental determinants.[healio.com]

Epidemiology

  • The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008;5:136-43. 11. Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population – A review on the epidemiology of sleep apnea.[thoracicmedicine.org]
  • Limited epidemiologic data, however, indicated that symptoms and objective manifestations of Sleep Apnea Syndrome occurred commonly in the population.[clinicaltrials.gov]
  • This review summarizes the recent literature on the epidemiology of adult obstructive sleep apnea (OSA) from various population-based studies.[doi.org]
  • Population-based epidemiologic studies have uncovered the high prevalence and wide severity spectrum of undiagnosed obstructive sleep apnea, and have consistently found that even mild obstructive sleep apnea is associated with significant morbidity.[doi.org]
  • Sullivan, PhD ** Departments of Medicine, Epidemiology, and Health Services Search for other works by this author on: Bruce M.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • We believe that this case exemplifies the relevant pathophysiological interdependence between obesity, metabolic syndrome and OSAS.[ncbi.nlm.nih.gov]
  • The driving forces in the pathophysiology are felt to be ventilator instability associated oscillation in PaCO2 arterial partial pressure of Carbon Dioxide, continuous cositive airway pressure (CPAP) related increased CO2 carbon dioxide elimination, and[ncbi.nlm.nih.gov]
  • Abstract Chronic obstructive pulmonary disease (COPD) is associated with an increased cardiovascular risk, although the pathophysiological mechanisms responsible for this interdependence are not completely known.[ncbi.nlm.nih.gov]
  • Right to left shunting through a PFO may be encouraged by the respiratory physiology of OSAS, contributing to the disease pathophysiology.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: OSAS and FMS were highly prevalent, which indicated that oxidative stress might play a role in the pathophysiology of both diseases, especially if they co-exist in the same patient.[ncbi.nlm.nih.gov]

Prevention

  • We conclude that lingual tonsillectomy using SonoSurg, which we have frequently used, should be the first choice of treatment for snoring and sleep apnea caused by hypertrophy of the lingual tonsils from the viewpoints of effectiveness, prevention of[ncbi.nlm.nih.gov]
  • When the malformation is present, timely surgery can prevent irreversible neurologic damage.[ncbi.nlm.nih.gov]
  • […] information 1 Department of Orthodontics, University of Milan, Milan, Italy. roberto.biagi@unimi.it Abstract The diagnosis, the therapy and the monitoring of the obstructive sleep apnea syndrome (OSAS) are to be considered as critical factors in order to prevent[ncbi.nlm.nih.gov]
  • It was concluded that magnetic treatment was unsuccessful in reducing OSAS symptoms in our patient and may even increase possible cardiovascular and stroke risks by preventing the patient from pursuing an adequate medical treatment, such as continuous[ncbi.nlm.nih.gov]
  • Noninvasive continuous positive airway pressure (CPAP) therapy prevented the recurrence of CVT as well as of headache. OSAS may be one of the multiple risk factors of CVT as well as arterial ischemic stroke. [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]

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