SEARCH · PubMed Health

Results for “Sleep Apnea, Obstructive”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

PubMed2004

[Changes of sleep architecture in children with obstructive sleep apnea syndrome].

OBJECTIVE: To explore how obstructive sleep apnea syndrome (OSAS) affects children's sleep architecture. METHODS: Eighty-three children with OSAS were reviewed; every patient was monitored with polysommography for 7 hours at night for 11 parameters, including the number of arousal, snoring index, nadir O(2) desaturation, stage I %, stage II %, show wave sleep (SWS)% and rapid eye movement (REM)%. The basis for diagnosis of OSAS was the widely accepted pediatric diagnostic criteria of apnea/hypopnea index, apnea/ hypopnea index of > 1 episode/hour, nadir O(2) desaturation < 92%. Sleep was scored manually according to the standard set by Rechtschaffen. RESULTS: In OSAS group, the number of arousal was 22.5 +/- 1.4, snoring index was 70.6 +/- 16.5, and/or SaO(2) was (73.8 +/- 1.9)%. OSAS group had increased stage I : (45.8 +/- 2.0)% vs. (2.3 +/- 1.1)%, t = 22.46, P < 0.01 and decreased stage II : (23.9 = 1.7)% vs (47.9 = 4.4)%, t = - 14.18, P < 0.01, SWS (15.6 +/- 1.8)% vs. (21.1 +/- 5.0)%, t = - 3.123, P < 0.01, REM (14.7 +/- 1.5)% VS. (28.2 +/- 4.1)%, T = -8.923, p < 0.01. CONCLUSION: The severity of OSAS relates to changes of sleep architecture in children. Intermittent nocturnal hypoxia secondary to apnea/hypopnea, and frequent electroencephalogram arousals from sleep may result in significant sleep fragmentation. Children with OSAS had learning problems and failure to thrive.

Child↗

PubMed2006

[Revision of obstructive sleep apnea syndrome in the child].

The obstructive sleep apnea syndrome (OSAS) is frequent in infancy and childhood. It is caused by a prolonged upper respiratory airway obstructioon during sleep, and adenotonsillar hypertrophy is the most important cause. OSAS may have an impact on physical and cognitive development, but syntoms in children are subtle and may pass unrecognised. Polysomnography is the gold standard technique for OSAS diagnosis and surgical approach with adenotonsillectomy is the most frequently treatment indicated. Early diagnosis and treatment and adequate follow up are important to prevent physical disturbances secondary to chronic hypoxemia and to avoid cognitive deficits associated with disrupted sleep architecture.

Adenoidectomy↗

PubMed2002

Obstructive sleep apnea syndrome in ambulatory surgical patients.

Obstructive sleep apnea in the ambulatory surgery setting has become a more significant concern in recent years because its Identification and recognition are a critical part of preoperative patients' risk assessment. The types of surgeries that can be performed on an outpatient basis have increased and include many specialty procedures that previously were performed on an inpatient basis only. Ambulatory surgery has proven to be a cost-effective alternative for patients and physicians; however, patients in this setting often have complex surgical histories. Perioperative nurses must provide a more integrated approach to patient assessment to recognize, identify, plan, and implement a course of safe care for patients with obstructive sleep apnea. Reviewing patients' histories can help nurses identify symptoms of obstructive sleep apnea, allowing them to alert the surgical team of special requirements. Ambulatory patients with identified obstructive sleep apnea will require a planned course of care. Ambulatory care facilities should have a policy in place to ensure that safe care will be provided to patients for the entire perioperative course.

Ambulatory Surgical Procedures↗

PubMed1999

Nocturnal continuous positive airway pressure decreases daytime sympathetic traffic in obstructive sleep apnea.

BACKGROUND: Patients with obstructive sleep apnea (OSA) have high levels of muscle sympathetic nerve activity (MSNA). We tested the hypothesis that long-term continuous positive airway pressure (CPAP) treatment will decrease MSNA in OSA patients. METHODS AND RESULTS: We measured blood pressure, heart rate, and MSNA in 11 normotensive, otherwise healthy patients with OSA who were treated with CPAP. The measurements were obtained at baseline and after 1 month, 6 months, and 1 year of CPAP treatment. These measurements were compared with those recorded in 9 otherwise healthy OSA patients who were not treated with CPAP for 1 year. In both untreated and treated patients, blood pressure and heart rate did not change over time. MSNA was similar during repeated measurements in the untreated group. By contrast, MSNA decreased significantly over time in patients treated with CPAP. This decrease was evident after both 6 months and 1 year of CPAP treatment (P=0.02 for both). CONCLUSIONS: CPAP treatment decreases muscle sympathetic traffic in patients with OSA. This effect of CPAP is evident only after an extended duration of therapy.

Adult↗

PubMed2004

Erythropoietin and obstructive sleep apnea.

OBJECTIVE: We tested the hypothesis that repetitive severe hypoxemia resulting from obstructive sleep apnea would increase serum erythropoietin, and that this increase would be attenuated by effective treatment of obstructive sleep apnea. METHODS: We studied healthy untreated patients with obstructive sleep apnea (18 severe and 10 very mild) before and after acute treatment with continuous positive airway pressure, and 12 healthy control subjects free of obstructive sleep apnea. RESULTS: Baseline erythropoietin levels before sleep were similar in the obstructive sleep apnea and control groups. However, erythropoietin levels increased (by 20%, P =.037) in patients with severe obstructive sleep apnea after 3.5 hours untreated (lowest O2, 77% +/- 3%), and decreased after 4 hours of continuous positive airway pressure treatment (P =.001). Erythropoietin responses in patients with severe obstructive sleep apnea were different (F = 4.0, P =.03) from controls, in whom erythropoietin levels remained stable throughout the night (P =.94). Erythropoietin responses were similar in very mild obstructive sleep apnea and controls (P =.58). CONCLUSIONS: Our results indicate that untreated severe obstructive sleep apnea results in increased erythropoietin, which decreases after continuous positive airway pressure treatment. Increased erythropoietin may be a potential reversible mechanism to explain the association between obstructive sleep apnea and cardiovascular disease.

Adult↗

PubMed2006

[Effects of sleep architecture in different age children with obstructive sleep apnea syndrome].

OBJECTIVE: To explore how obstructive sleep apnea syndrome(OSAHS) affects different age children's sleep architecture. METHOD: One hundred and thirty three OSAHS children which divided into preschool age group and school age group, were monitored with polysomnography for 7 hours at night, sleep efficiency, stage I %, stage II %, SWS%, REM%, apnea/hypopnea index, arousal index and nadir O2 desaturation were recorded and analyzed. RESULT: Between preschool age group and school age group, sleep efficiency (88.0% +/- 4.0%) versus 94.1% +/- 1.30%), stage I% (14.2 +/- 2.5 versus 10.6 +/- 1.9), stage II% (40.15 +/- 4.6 versus 46.5 +/- 2.4), SWS% (27.4 +/- 6.4 versus 18.5 +/- 1.7), REM% (17.7 +/- 3.0 versus 22.3 +/- 2.0), apnea/hypopnea index (5.9 +/- 1.3 versus 7.7 +/- 2.6), arousal index (18.3 +/- 3.5 versus 22.4 +/- 2.7), nadir O2 desaturation (87.2 +/- 2.1 versus 90.1 +/- 0.8), the difference between preschool age group and school age group did not reach statistical significance. CONCLUSION: Under the state of obstructive sleep apnea syndrome (OSAHS) preschool age group and school age group have similar sleep architecture, and preschool age group have more "REM deprivation" than school age group.

Age Factors↗

PubMed1998

Obstructive sleep apnea in the obese.

Obstructive sleep apnea (OSA) syndrome occurs in 4% to 9% of middle-aged men and in 1% to 2% of middle-aged women. The incidence of OSA among morbidly obese patients is 12- to 30-fold higher. The pathophysiology of OSA is complex and incompletely understood. The important clinical symptoms of OSA include snoring, daytime sleepiness, restless sleep, morning fatigue, and headaches. The diagnosis is made by polysomnography. The possible sequelae of OSA are hypertension, left and right ventricular hypertrophy, sudden cardiovascular death, and increased risk for brain infarction. Nasal continuous positive airway pressure (nCPAP) appears to be the recommended treatment for OSA. Morbidly obese patients may also benefit from weight reduction gastric surgery.

Humans↗

PubMed1998

Decreasing surgical risks for patients with obstructive sleep apnea.

The prevalence of obstructive sleep apnea (OSA) has only recently been appreciated, in part because the signs and symptoms of OSA were previously overlooked. The identification of this disorder is extremely important before surgery to allow appropriate airway management. This article presents a brief overview of sleep apnea, its symptoms, and potential consequences. Nursing interventions are given for the preoperative, intraoperative, and postoperative phases. A resource list of agencies and internet sites that reference OSA is included for additional information.

Humans↗

PubMedDate not supplied

Assessing children for obstructive sleep apnea.

The incidence of obstructive sleep apnea (OSA) in children has only recently been appreciated. Early identification of this disorder is extremely important to minimize neurologic, cardiac, and/or developmental complications that may occur as a result of the syndrome. This article presents an overview of OSA syndrome, pediatric risk factors for sleep apnea, symptoms common in children with OSA, and assessment information to guide the health practitioner in identifying children whose sleep patterns require further evaluation.

Age Factors↗

PubMed2003

Abnormal vasoactive hormones and 24-hour blood pressure in obstructive sleep apnea.

BACKGROUND: Patients with obstructive sleep apnea (OSA) are at increased risk for hypertension. The mechanisms responsible for the development of hypertension are controversial. We hypothesized that patients with OSA had an abnormal 24-h blood pressure (BP) and an abnormal activity in vasoactive hormones, and that both BP and hormones were normalized during treatment with long-term nasal continuous positive airway pressure (CPAP). METHODS: The 24-h BP and plasma levels of the vasoactive hormones (renin, angiotensin II, aldosterone, atrial natriuretic peptide, brain natriuretic peptide, vasopressin, and endothelin-1) were measured in 24 patients with OSA and in 18 control subjects. Thirteen patients with OSA were reexamined after 14 months of CPAP therapy. RESULTS: Patients with OSA had significantly increased BP and heart rate and a reduced nocturnal BP drop. Both angiotensin II (13.3 +/- 1.6 v 7.8 +/- 1.0 pmol/L) and aldosterone (94.0 +/- 9.4 v 62.2 +/- 4.5 pmol/L) were significantly higher in OSA than in control subjects. Positive correlations were found between angiotensin II and daytime BP (systolic: r = 0.49, P <.01; diastolic: r = 0.52, P <.01). The CPAP therapy resulted in a decrease in BP, and this CPAP-induced reduction in BP was correlated with a decrease in both plasma renin (r = 0.76 to 0.92, all P <.01) and plasma angiotensin II concentration (r = 0.58 to 0.81, all P <.05). CONCLUSIONS: Plasma angiotensin II and aldosterone were elevated in OSA, and plasma angiotensin II was correlated with BP. Long-term CPAP reduced BP, and this decrease in BP was correlated with the reductions in plasma renin and angiotensin II levels. We suggest that OSA mediates hypertension, at least in part, via a stimulation of angiotensin II production.

Adult↗

PubMed1997

Mandibular reconstruction in children with obstructive sleep apnea due to micrognathia.

Obstructive sleep apnea in children with micrognathia may be severe enough to necessitate permanent airway maintenance. Affected children form a small, but important, group of patients because early reconstructive surgery to the mandible may permit decannulation. A policy of early and aggressive surgical management has been pursued for the past 15 years, and an audit of outcome was undertaken to confirm whether or not this policy has been justified. The records of 25 patients so treated between 1980 and 1994 were analyzed by an independent clinician. Decannulation was achieved in 20 of the children (80 percent). The conditions that were most amenable to successful treatment (100 percent) were hemifacial microsomia, temporomandibular ankylosis, and the Pierre Robin sequence. The outcome for children with Treacher Collins syndrome and Nager syndrome was less successful (75 and 60 percent, respectively). The worst outcome occurred in a mixed group of three children with other syndromes, two of whom failed decannulation. Surgery was most successful when carried out before the age of 2 years (87 percent) and after the age of 4 years (90 percent).

Adolescent↗

PubMed1992

Changes of circulating atrial natriuretic peptide and antidiuretic hormone in obstructive sleep apnea syndrome.

Patients with obstructive sleep apnea (OSA) syndrome are known to exhibit nocturnal natriuresis/diuresis. We studied plasma and urinary levels of atrial natriuretic peptide (ANP), a potent natriuretic hormone released from the heart, and plasma antidiuretic hormone (ADH) levels in patients with OSA during awake and sleeping periods, to compare with those of normal subjects. Seven patients with OSA and 6 normal subjects were studied. Arterial blood samples were drawn during the awake and the sleeping period, while in patients with OSA, blood samples were obtained during the apneic period. Urine samples were collected over two 12-hour periods (9 a.m.-9 p.m. and 9 p.m.-9 a.m.) In patients with OSA, plasma ANP as well as urinary ANP excretion increased during the apneic period compared with the awake period. There was a significant negative correlation between plasma levels of ANP and ADH in patients with OSA. On the other hand, normal subjects had no apparent differences in plasma and urinary ANP levels between the two periods. It is suggested that nocturnal increase in ANP and decrease in ADH are responsible for the nocturnal diuresis and natriuresis associated with OSA.

Adult↗

PubMed1994

Efficacy of a Herbst mandibular advancement device in obstructive sleep apnea.

Treatment options for obstructive sleep apnea (OSA) may involve potential side effects or discomfort; nasal continuous positive airway pressure (CPAP) may not be tolerated by 25% of patients. We therefore sought to determine the efficacy of mandibular advancement as a treatment for OSA, and to investigate whether clinical and radiographic parameters can predict the response to this treatment. Sixteen male and 3 female subjects with documented OSA who had failed or been unable to tolerate nasal CPAP underwent baseline polysomnography and cephalometry, and were then fitted with a removable Herbst appliance to achieve forward mandibular advancement during sleep. All subjects then underwent a second cephalometric evaluation and polysomnography with the appliance in place. Fourteen of 15 subjects demonstrated significant improvement in the degree of OSA, based on the apnea-hypopnia index (AHI) (34.7 +/- 5.3 to 12.9 +/- 2.4 events/h, p < 0.002). Comparison of pre- and posttreatment cephalometric values revealed no significant change in the posterior airway space (PAS) despite a reduction in mean AHI. There was a significant decrease in the mandible-hyoid distance (MP-H) with treatment for the group as a whole. When the study population was evaluated on the basis of a successful response to mandibular advancement (posttreatment AHI < 10), the baseline MP-H was found to be significantly shorter in the responders than in nonresponders. MP-H after mandibular advancement was likewise shorter in responders than in nonresponders. In addition, the soft palate length (PNS-P) showed a significantly greater shortening in responders after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Flow limitation as a noninvasive assessment of residual upper-airway resistance during continuous positive airway pressure therapy of obstructive sleep apnea.

Many patients with obstructive sleep apnea syndrome (OSAS), despite therapy with nasal continuous positive airway pressure (CPAP), have persisting daytime somnolence that may be due to a persistently elevated upper-airway resistance associated with electroencephalographic (EEG) arousals. We tested the hypothesis that elevated upper-airway resistance can be inferred from the contour of the inspiratory flow tracing obtained from a conventional CPAP circuit. This may provide a noninvasive method for determining optimal CPAP. Data were collected during a CPAP titration of an upper-airway model and in eight patients with OSAS. Estimated inspiratory resistance was calculated from esophageal pressure, CPAP mask pressure, and inspiratory flow. At high CPAP, resistance was low and inspiratory flow contour was found to be rounded. At low CPAP, resistance was high and flow contour developed a plateau suggesting flow limitation. We also noted that the CPAP pressure at which high resistance developed, and at which flow limitation appeared, showed hysteresis. We conclude that when respiration is stable, the contour of inspiratory flow tracing from a CPAP system can be used to infer the presence of elevated upper-airway resistance and flow limitation. Optimizing flow contour may be an alternative to eliminating apneas in evaluation of the optimal therapeutic level of CPAP in OSAS.

Adult↗

PubMed1997

Heat shock protein 72 level decreases during sleep in patients with obstructive sleep apnea syndrome.

Patients with obstructive sleep apnea syndrome (OSAS) suffer from stresses related to repetitive apneas during sleep. To examine whether the level of 72 kDa heat shock protein (HSP72) increases during sleep, 11 OSAS patients (apnea-hypopnea index: 63.5 +/- 36.1, mean +/- SD) underwent polysomnography and their peripheral blood mononuclear cells (PBMC) were isolated before, during, and after sleep. HSP72 level was determined by Western blotting and hsp72 mRNA level was quantified by Northern blotting. Nine normal subjects without OSAS were examined as normal controls. HSP72 level decreased progressively during sleep and its level at 8:00 A.M. was 78.0 +/- 17.5% of that at 8:00 P.M. (p < 0.01). No such decrease was seen in normal subjects. When OSAS patients received nasal continuous positive airway pressure (NCPAP) therapy, HSP72 level did not decrease significantly. In untreated OSAS patients, hsp72 mRNA level decreased during sleep (p < 0.01). When OSAS patients were treated with NCPAP therapy, the decrease in hsp72 mRNA level was not observed. HSP72 level before sleep in OSAS patients was higher than that in normal subjects (p < 0.01). We concluded that repetitive apneas caused high HSP72 level before sleep in OSAS patients and that NCPAP therapy had significant effect on HSP72 levels during sleep.

Blotting, Northern↗

PubMed1992

Cardiac function in obstructive sleep apnea patients following uvulopalatopharyngoplasty.

Obstructive sleep apnea syndrome (OSAS) is associated with severe cardiac arrhythmias and conduction abnormalities. Cor pulmonale and right-sided heart failure may ensue. Uvulopalatopharyngoplasty (UPPP) is one of several treatment modalities suggested for OSAS. Tracheotomy and CPAP treatment in adult OSAS patients and adenotonsillectomy in children with OSAS were shown to lead to improvement in some cardiac parameters. Cardiac function was prospectively evaluated in 19 OSAS patients before and after UPPP. No significant changes after surgery were noted on electrocardiographic studies. Improvement in global and regional function of both ventricles was seen in 91% of the patients. A trend toward significant elevation in left ventricular ejection fraction and a statistically significant increase in right ventricular ejection fraction were observed (45% +/- 9% to 50% +/- 7% [p = 0.007]). Our results support performance of UPPP in selected OSAS patients for relief of potentially life-threatening cardiac pathologies.

Adult↗

PubMed2000

Cardiovascular disease and obstructive sleep apnea: implications for physicians.

Obstructive sleep apnea (OSA) has been strongly associated with several cardiovascular disorders during the past decade, and studies suggested that there might be a causal relationship. Recent studies have described several pathophysiologic mechanisms that are active in OSA and may participate in the development of cardiovascular disorders. Primarily, the repetitive respiratory events that occur in OSA cause hypoxia, hypercapnea, arousals, or disrupted sleep singly or in combination. These abnormal physiologic events result in increased sympathetic outflow, alterations in blood pressure control mechanisms, dysfunctional ventilatory regulation, and vascular alterations. As a consequence of the relative impact and the genetic predisposition, these pathophysiologic alterations may lead to or complicate a wide variety of cardiovascular disorders. Frequently, patients who have OSA present with complaints of excessive daytime sleepiness, chronic fatigue, snoring, morning headache, and nocturnal arousals. Difficult-to-control hypertension, recurrent exacerbations of congestive heart failure, and nocturnal angina are common cardiovascular manifestations of undiagnosed OSA. This article reviews the major cardiovascular disorders associated with OSA and the pathophysiologic mechanisms associated with their development.

Cardiovascular Diseases↗

PubMedDate not supplied

[A case of obstructive sleep apnea].

A case of obstructive sleep apnea (OSA) is presented which led to cor pulmonale. The diagnosis was based on polysomnography (PSG) which demonstrated OSA periods with hypoxemia. The patient was qualified for uvulopalitopharyngoplasty. Also CPAP is being considered.

Humans↗