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Biomedical subjects

P W Norup

Publications and source records attributed to P W Norup.

7 recordsLinked to original sources

Case report: obstructive sleep apnea--an air safety risk.

Aviation safety reports indicate that many incidents are related to fatigue. Obstructive sleep apnea (OSA) is characterized by irregular snoring with repeated apnea episodes during sleep and excessive daytime sleepiness. Deprived of sleep, patients suffer from daytime sleepiness and involuntary sleep attacks. The prevalence of OSA among adult men is more than one percent, 0.5% in women. Predisposed are men aged 40-65 yr. Many patients, including pilots, are unaware of their sleeping disturbance and the symptoms are not easily recognized. Therefore, this condition may not be discovered during a regular health examination. However, this condition can be effectively treated. In our opinion, pilots suffering from OSA do not necessarily have to lose their certificate. Diagnosis and treatment can be conducted, followed by regular check-ups. We suggest that questions about sleep be included in pilots' health examinations.

Adult↗

Airway dimensions and head posture in obstructive sleep apnoea.

The present cephalometric study aimed to describe the antero-posterior diameters of the pharyngeal airway in a sample of 50 male obstructive sleep apnoea (OSA) patients and a reference sample of 103 male students, and to examine the relationship between these diameters and the posture of the head and the cervical column. Subjects were recorded in the cephalometer standing with the head in its natural position (mirror position). Pharyngeal airway diameters were measured at seven levels ranging from the maxillary tuberosity to the vallecula of the epiglottis. The largest difference was observed at the level behind the soft palate where the diameter was 50 per cent narrower in the OSA sample than in the reference sample. Extension of the cranio-cervical angle and forward inclination of the cervical column were correlated with an increase in the three most caudal airway diameters in the OSA sample: at the uvula, the root of the tongue, and the epiglottis, but only to increase in the lowest diameter in the reference sample. The findings were considered to reflect a compensatory physiological postural mechanism that serves to maintain airway adequacy in OSA patients in the awake erect posture, most efficiently so at the lowest levels of the oropharyngeal airway.

Adult↗

[Sleep apnea. Improved quality of life with continuous positive pressure respiration].

Patients with obstructive sleep apnoea complain of excessive daytime sleepiness and unwanted sleep attacks. Treatment with nasal continuous positive airway pressure, CPAP, normalizes the sleep pattern and the daytime symptoms disappear. Twenty-five patients evaluated their situation by questionnaire before and during CPAP treatment. Treatment improved their working capacity and their social life. Almost all patients report treatment as giving them a new life, i.e. vastly improving their quality of life. CPAP treatment is cheap.

Adult↗

Treatment of sleep apnoea in spinal cord injured patients.

Little is known about sleep disorders in spinal cord injured (SCI) patients. Three SCI patients who reported severe daytime sleepiness and sleep complaints were evaluated with nocturnal polysomnography and oxygen saturation with pulsoximeter on several occasions at home. In addition respiratory registration was preformed during overnight stay in the hospital. Two patients who had sleep apnoea episodes with reduced oxygen saturation during sleep were treated with continuous positive airway pressure with good results on sleep architecture, oxygen saturation, and daytime sleepiness. One obese patient was advised to lose weight and to reduce smoking and alcohol consumption, and following this advice his sleep related problems were reduced with no further treatment necessary. It is suggested that SCI patients who complain about sleep related disorders should be appropriately screened, with inclusion of nocturnal polysomnography, oxygen saturation, and respiratory registration and, depending on the screening results, appropriate advice/treatment applied.

Airway Obstruction↗

[Obstructive sleep apnea and abnormal fatigue].

Obstructive sleep apnoea syndrome is characterized by irregular snoring during sleep, excessive daytime sleepiness and in some cases unwanted sleep attacks. The patient has a disturbed night sleep with numerous wakenings. Disturbed sleep at night causes daytime problems with attention, concentration and work performance. Furthermore, it may eventually result in errors and accidents. Excessive sleepiness sometimes necessitates the suspension of the patient's driving license. It is of importance to identify patients with obstructive sleep apnoea and daytime sleepiness, because the condition can be treated effectively. Many Danish patients are still unidentified. Diagnostic and treatment possibilities vary from one part of Denmark to another.

Fatigue↗

[Pulse oximetry and obstructive sleep apnea].

We report a case of a 54 years old man, treated with Methylphenidate (Ritalin) because of narcolepsy, who was referred with suspected vertebro-basilar insufficiency. In the hospital, apnoea during sleep attacks were observed. A polysomnography showed marked obstructive sleep apnoea with a disturbed hypnogram, but during the apnoeas the oxygen saturation only decreased by three to six percent. If a patient suspected for obstructive sleep apnoea has only small desaturations, an oximetry can be insensitive as the only "sleep examination", and a full polysomnography is recommended.

Humans↗