1/8. Polysomnographic and urodynamic changes in a case of obstructive sleep apnea syndrome with enuresis.A 53-year-old female patient with obstructive sleep apnea syndrome was reported. She had complained of enuresis as well as a 15-year history of snoring, but she had no complaint of sleep and awake disturbance. Polysomnographic study showed repeated obstructive apnea and hypopnea with an apnea/hypopnea index of 52.6, and severe oxygen desaturation during sleep. On cystometography during sleep, the changing amplitude of the spike wave corresponds to the changes of respiratory efforts against a closed upper airway. The patient was treated successfully with imipramine and acetazolamide for the obstructive sleep apnea and enuresis. apnea/hypopnea index, nocturnal oxygen desaturation, and sleep architecture were improved, and enuresis completely disappeared. Cystometrography during sleep showed that the average amplitude of the spike wave tended to be low. Percentage urinary volume during sleep compared with 24 h volume was significantly reduced. We considered that the enuresis was mainly related to increased intra-abdominal pressure produced by respiratory efforts and enhanced nocturnal urine production.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/8. prader-willi syndrome with sleep disordered breathing: effect of two years nocturnal CPAP.We report a case of a 3-year-old child with prader-willi syndrome who had severe sleep disordered breathing with daytime hypersomnolence. His daytime blood gases showed type II respiratory failure. He was effectively treated with continuous positive airway pressure (CPAP) and has used this form of therapy for 2 years now with improvement in daytime somnolence, improved mental acuity and normalisation of daytime blood gases.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/8. Genioglossal advancement--a simple surgical procedure for sleep apnea. Case report and literature review.Although the use of a standard nasal continuous positive airway pressure device to combat obstructive sleep apnea is often effective, it is neither curative nor universally well tolerated. Thus, surgical intervention is often inevitable. We describe a simple, conservative surgical procedure performed on a patient with profound mandibular retrognathia (dolichofacial type), accompanied by sleep apnea. The procedure resulted in a significant pharyngeal airway enlargement of 53 and 87% at the mandible angle and hyoid bone levels, respectively, increased oxygen saturation, reduction in the respiratory disturbance index by 50%, and improved sleep quality. We present a procedure for patients whose sleep apnea is due to extensive mandibular retrognathism with concomitant retrolingual narrowing and collapse.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/8. Obstructive sleep apnea in pregnancy.A 25-year-old woman, gravida 4 para 2, at 37 weeks gestation was evaluated and treated for preeclampsia. Overnight, the patient had a witnessed apneic episode with maternal oxygen desaturation and concurrent fetal heart rate deceleration. She subsequently delivered an infant that was small for gestational age. This is the first case described with confirmed obstructive sleep apnea by formal polysomnography and witnessed maternal desaturation with fetal heart rate decelerations. Recognizing obstructive sleep apnea (OSA) early in gestation will help dictate treatment options and may prevent adverse maternal fetal outcomes. continuous positive airway pressure (CPAP) seems to be a safe treatment with minimal adverse effects. Questioning of patients at the first prenatal visit and monitoring for increased snoring during gestation may help detect early signs and symptoms of OSA. Treatment of OSA with CPAP might improve perinatal outcomes.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/8. Long-term treatment of sleep breathing disorder in a patient with Huntington's disease.Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder. An association with sleep breathing disorder has not previously been established in the literature. We report the case of a 45-year-old woman with HD, presenting with snoring and observed apnea. polysomnography showed obstructive sleep apnea with an apnea-hypopnea index (AHI) of 6.6 per hour including events up to 57 s long during rapid eye movement (REM) sleep. A trial of continuous positive airway pressure (CPAP) resulted in significant improvement in sleep structure, nocturnal respiration, daytime alertness, and subjective memory. snoring, apneas, and respiratory arousals were abolished on CPAP. HD patients may suffer from sleep breathing disorder, and in spite of potential chorea, CPAP is feasible and may significantly improve their quality of life.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/8. Uvular edema secondary to snoring under deep sedation.A 57-year-old male with a documented history of obstructive sleep apnea with loud snoring received deep intravenous sedation with midazolam, fentanyl, ketamine, and propofol infusion and a left interscalene brachial plexus nerve block for a left biceps tendon repair. Loud snoring during the case was noted. On the second postoperative day, he was observed to have significant uvular edema. After due consideration of the various elements in the differential diagnosis, it was concluded that negative pressure trauma from deep snoring during the sedation was the most likely etiology.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/8. Sleep and breathing abnormalities in a case of prader-willi syndrome. The effects of acute continuous positive airway pressure treatment.This report describes the polysomnographic findings and the respiratory alterations during sleep in a 20-year-old patient with the prader-willi syndrome. Nocturnal recordings and a variant of the multiple sleep latency test showed excessive daytime sleepiness, sleep onset rapid eye movement episodes, snoring and sleep apnea. Treatment with nasal continuous positive airway pressure normalized the respiratory pattern and the sleep structure, except for rapid eye movement sleep onset. Whereas upper airway obstruction and obesity may explain the respiratory disorders, as shown by their resolution with continuous positive airway pressure treatment, hypothalamic dysfunction could play a role in the disruption of the normal nonrapid eye movement/rapid eye movement sleep periodicity.- - - - - - - - - - ranking = 6keywords = pressure (Clic here for more details about this article) |
8/8. Fetal response to periodic sleep apnea: a new syndrome in obstetrics.Periodic sleep apnea, a chronic sleep deprivation state, in which marked changes in the arterial PO2 and PCO2 tensions have been recorded, is a relatively new syndrome not previously reported in pregnancy. It is characterized by episodes of apnea, prevalently obstructive, during sleep. The majority of patients with this syndrome have snored heavily for years, suggesting a causal relationship between snoring and periodic sleep apnea. The effects of prolonged snoring on alveolar ventilation and systemic pressure(s) suggest that this snoring has physiopathological implications on maternal cardio-respiratory reserve and indirectly upon the fetus, especially as there are recordable changes in fetal heart rate and also a change in the acid-base status of the fetus. The possibility that this syndrome may have an adverse effect upon the fetus is stressed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |