1/51. 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 = sleep (Clic here for more details about this article) |
2/51. Hypersomnia following uvulopalatopharyngoplasty for snoring.This report describes three cases who underwent uvulopalatopharyngoplasty for severe snoring and who subsequently developed progressive excessive daytime sleepiness. All three cases were shown to have sleep fragmentation as a result of non-apnoeic episodic upper airway narrowing. These cases raise the possibility that increased upper airway resistance during sleep may be exacerbated or even caused by uvulopalatopharyngoplasty. Ideally, sleep-disordered breathing should be carefully excluded before this surgery is offered as treatment for severe snoring.- - - - - - - - - - ranking = 0.33333333333333keywords = sleep (Clic here for more details about this article) |
3/51. 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 = 0.41666666666667keywords = sleep (Clic here for more details about this article) |
4/51. Detection of insomnia in primary care.Insomnia is a widespread condition with diverse presentations. Detection and diagnosis of insomnia present a particular challenge to the primary care physician. patients seldom identify their sleep habits as the source of the complaints for which they are seeking treatment. Insomnia may be the result of many different medical or psychiatric illnesses or the side effects of medications or legal or illegal recreational drugs. Insomnia has a serious impact on daily activities and can cause serious or fatal injuries. With ever-increasing competition with sleep from 24-hour television broadcasts from hundreds of channels and the internet, as well as more traditional distractions of late-night movies, clubs, and bars, we have become a society that sleeps 25% less than our ancestors did a century ago. We have no evidence, however, that we require less sleep than they did. This article presents strategies for detecting and diagnosing insomnia.- - - - - - - - - - ranking = 0.33333333333333keywords = sleep (Clic here for more details about this article) |
5/51. Le Fort III distraction osteogenesis of midface-retrusion in a case of Hajdu Cheny syndrome.Le Fort III maxillary distraction osteogenesis using the RED system and advancement genioplasty was successfully performed for the midfacial retrusion and to eliminate severe snoring during sleep in a rare case of Hajdu Cheny syndrome. This syndrome is characterized by slowly progressive systemic osseous dysplasia, exhibiting craniofacial disfigurements and other skeletal deformity, but no description is found in a plastic surgical treatment up to now. A rare entity of this syndrome is also presented.- - - - - - - - - - ranking = 0.083333333333333keywords = sleep (Clic here for more details about this article) |
6/51. Rapid eye movement-localized apnea in a female patient with chronic insomnia.A middle-aged female patient with chronic insomnia showed rapid eye movement (REM)- localized obstructive sleep apnea. She visited the sleep disorders Clinic and complained of insomnia with loud snoring. Once, in the past, her sleep complaints had disappeared after weight reduction but, 6 months later, she complained of excessive daytime sleepiness. Overnight polysomnography revealed REM-localized apnea. Careful follow up is strongly recommended for a female patient with chronic insomnia who shows REM-localized apnea.- - - - - - - - - - ranking = 0.25keywords = sleep (Clic here for more details about this article) |
7/51. 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 = 0.66666666666667keywords = sleep (Clic here for more details about this article) |
8/51. Sexsomnia--a new parasomnia?OBJECTIVE: To describe a distinct parasomnia involving sexual behaviour, which we have named sexsomnia. METHOD: We have used a case series as a basis for the description of sexsomina. RESULTS: Eleven patients with distinct behaviours of the sexual nature during sleep are described. The features in common with other nonrapid eye movement arousal parasomnias, such as sleepwalking are documented. Some patients had simply been referred to a tertiary sleep clinic for investigation of unrelated sleep problems. A small number had been involved in medicolegal issues. Sexsomnia has some distinct features that separate it from sleepwalking. The automatic arousal is more prominent, motor activities are relatively restricted and specific, and some form of dream mentation is often present. CONCLUSIONS: A significant number of patients with this unusual parasomnia behaviour were identified only after specific questions were asked, suggesting that the behaviour is more common than previously thought.- - - - - - - - - - ranking = 0.41666666666667keywords = sleep (Clic here for more details about this article) |
9/51. Three-piece oral appliance with herbst attachments for persistent vegetative state patient with sleep-disordered breathing.PURPOSE: persistent vegetative state is a form of wakefulness without awareness. This report describes a dental appliance for the treatment of sleep breathing disorders in this condition. The device can be easily inserted and removed by the patient's family or nurse. MATERIALS AND methods: A 19-year-old woman had been in a persistent vegetative state since having hypoxic-ischemic encephalopathy because of cardiopulmonary arrest. Although she exhibited a sleep-wake cycle and normal respiration, she had sleep apnea and snoring, and produced snoring-like sounds even in an awake state. A three-piece device with Herbst attachments was fabricated to treat the symptoms. Overnight sleep studies were carried out to evaluate the effectiveness of the appliance. RESULTS: The device could be handled by the patient's family. snoring was satisfactorily reduced after insertion of the device. Sleep apnea, desaturation, and minimal oxygen saturation were markedly improved. CONCLUSION: If the family of a persistent vegetative state patient wishes to treat sleep-disordered breathing, the appliance may be helpful as an alternative to relieve the symptoms. The device could be applied for sleep apnea patients who experience difficulties using other types of oral appliances.- - - - - - - - - - ranking = 0.83333333333333keywords = sleep (Clic here for more details about this article) |
10/51. Obstructive sleep apnoea/hypopnoea as the initial presentation of relapsing polychondritis.Relapsing polychondritis (RP) is a relatively rare rheumatological condition, which can affect the upper airway and prove potentially life threatening. We report the first case of RP presenting initially as the obstructive sleep apnoea/hypopnoea syndrome, discuss management and review the extant literature.- - - - - - - - - - ranking = 0.41666666666667keywords = sleep (Clic here for more details about this article) |
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