Articles de revues : « Sleep apnea syndrom »

1

Mojon, Daniel. « Eye diseases associated with sleep apnea syndrome ». Therapeutische Umschau 58, n^o 1 (1 janvier 2001) : 57–60. http://dx.doi.org/10.1024/0040-5930.58.1.57.

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Beim Schlafapnoe Syndrom treten während dem Schlaf rezidivierend komplette oder partielle Obstruktionen der oberen Luftwege auf. Die Erkrankung gilt als Risikofaktor für verschiedene kardiovaskuläre und zerebrovaskuläre Erkrankungen. Diverse Augenkrankheiten wurden mit dem Schlafapnoe Syndrom assoziiert. An der Bindehaut zeigt sich gehäuft eine chronische Konjunktivitis im Rahmen eines «Floppy Eyelid»-Syndromes oder einer undichten Maske, die zur therapeutischen Überdruckbeatmung verwendet wird. Die Augenlider können eine Oberlidptose, ein Unterlidektropium, eine Blepharochalase oder eine Trichiasis aufweisen. An der Hornhaut finden sich gehäuft infektiöse Keratitiden, trockene Augen, rezidivierende Erosionen, ein Keratokonus und progressive Endothelschädigungen. Diverse Optikusneuropathien scheinen ebenfalls gehäuft beim Schlafapnoe Syndrom aufzutreten.

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Moráň, M., Z. Kadaňka, J. Siegelová et B. Fišer. « P462 Sleep apnea syndrom and cardiovascular diseases ». Electroencephalography and Clinical Neurophysiology 99, n^o 4 (octobre 1996) : 381. http://dx.doi.org/10.1016/0013-4694(96)88637-8.

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Ullmer et Solèr. « From snoring to sleep apnea syndrome – clinical spectrum ». Therapeutische Umschau 57, n^o 7 (1 juillet 2000) : 430–34. http://dx.doi.org/10.1024/0040-5930.57.7.430.

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Durchschnittlich 40% der Erwachsenen im Alter von 30 bis 60 Jahren schnarchen regelmäßig. 2% derFrauen und 4% der Männer weisen zusätzlich Atemstörungen im Schlaf auf. Anatomisch enge Rachenverhältnisse oder eine Hypotonie der dilatierenden Pharynxmuskeln begünstigen einen Kollaps. Zwischen einfachem und krank machendem Schnarchen bestehen fließende Übergänge. Während gewohnheitsmäßiges Schnarchen im Wesentlichen eine Geräuschbelästigung darstellt, führen Atemwegsobstruktionen im Schlaf zu Weckreaktionen und einem nicht mehr erholsamen Schlaf. Die daraus resultierende Tagesmüdigkeit vermindert das Leistungsvermögen, schafft berufliche und soziale Probleme und birgt Unfallrisiken. Daneben fördern diese Weckreaktionen die Entwicklung kardiovaskulärer Erkrankungen. Liegt ein obstruktives Schlafapnoe Syndrom vor, sind pulsoximetrisch fassbare repetitive Entsättigungen im Schlaf charakteristisch. Eine Quantifizierung der Apnoen sowie Hypopnoen ist mittels respiratorischer Polygraphie möglich. Eine Widerstandserhöhung in den oberen Atemwegen mit nur partieller Pharynxobstruktion (UARS = Upper Airway Resistance Syndrome) führt nicht zu Sauerstoffabfällen, kann aber Weckreaktionen auslösen und zu ähnlichen Symptomen wie das obstruktive Schlafapnoe Syndrom führen. Zum Nachweis eines UARS ist daher eine Polysomnographie notwendig, welche auch EEG-, EOG- und EMG-Ableitungen zur Beurteilung von Schlafarchitektur und Schlaffragmentation einschließt.

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Laube et Bloch. « Traffic accidents related to sleep apnea ». Therapeutische Umschau 57, n^o 7 (1 juillet 2000) : 435–38. http://dx.doi.org/10.1024/0040-5930.57.7.435.

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Einnicken am Steuer ist eine häufige und verhütbare, aber bisher noch zu wenig beachtete Ursache von Verkehrsunfällen. Eine Hypersomnie mit unfreiwilligem Einschlafen am Steuer in gefährlichen Situationen wird durch akuten oder chronischen Schlafmangel, durch die Schlafqualität beeinträchtigendes Verhalten und krankhafte Schlafstörungen begünstigt. Eine häufige Erkrankung, die sich typischerweise mit vermehrter Einschlafneigung manifestiert, ist das obstruktive Schlafapnoe Syndrom. Betroffene Patienten haben ein deutlich erhöhtes Risiko für Unfälle im Straßenverkehr. Die Früherkennung, Abklärung und Behandlung betroffener Fahrzeuglenker sowie eine gezielte Aufklärung der Öffentlichkeit über das Risiko des Einnickens am Steuer können wesentlich zur Verhütung solcher Unfälle beitragen.

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Song, Seung Il, et Ho Kyung Lee. « Surgical Management of Obsructive Slepp Apnea Syndrom : latest tendency ». Journal of The Korean Dental Association 52, n^o 10 (31 octobre 2014) : 602–14. http://dx.doi.org/10.22974/jkda.2014.52.10.002.

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Obstructive sleep apnea syndrom(OSAS) is defined by total or partial collapse of the upper airway during sleep. In the presence of specific anatomic features, OSAS is potentially amenable to surgical treatment. Initially, the only treatment available for these patients was a tracheotomy that bypassed the obstruction and resulted in a 100% cure. However, this was not readily accepted by most patients, and surgical methods other than tracheotomy were developed to successfully maintain adequate upper airway patency during sleep by comparing to postoperative polysomnography(AHI,RDI etc). In this paper, I would like to provide an overview of some of the multilevel surgical techniques available for treating OSAS as well as the necessary preoperative considerations.

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Hudecova, Jana, Petr Hosek, Bretislav Gal, Ondrej Trcka, Tomas Kostlivy, Jaroslav Betka, Martina Baneckova et Gabriela Krakorova. « Obstructive sleep apnea syndrome and high-risk pregnancy ». Kontakt 21, n^o 4 (13 décembre 2019) : 374–79. http://dx.doi.org/10.32725/kont.2019.043.

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Miljkovic, Tatjana, Vanja Drljevic-Todic, Teodora Pantic, Lazar Velicki, Aleksandar Lazarevic et Golub Samardzija. « Cardiac lipoma causing obstructive sleep apnea : A case report ». Medical review 73, n^o 1-2 (2020) : 55–58. http://dx.doi.org/10.2298/mpns2002055m.

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Introduction. Cardiac lipomas are rare benign cardiac tumors. The symptoms they cause and the diagnosis depend on their size and location. Case Report. We report the case of a 69-year-old male, whose main symptom was progressive dyspnea on exertion and in the supine position. The diagnosis of a large subepicardial lipoma in the wall of the right atrium, causing superior vena cava compression and consecutive obstructive sleep apnea syndrom, was made using different imaging techniques. The patient underwent open heart surgery, and the tumor was extracted with no intraoperative and postoperative complications. During a 1-year follow up, he remained asymptomatic, with no clinical signs of obstructive sleep apnea after the surgery. Conclusion. When it comes to the diagnosis and treatment of obstructive sleep apnea, cardiac tumors should be considered.

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Siegelová, J., B. Fišer, Z. Kadaňka, M. Moráň, J. Dušek, M. Al-Kubati, G. Cornelissen et F. Halberg. « M102 Sleep apnea syndrom and 24-h blood pressure ». Electroencephalography and Clinical Neurophysiology 99, n^o 4 (octobre 1996) : 393. http://dx.doi.org/10.1016/0013-4694(96)88682-2.

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Mariette Rakotoson, Nicko Sergio Rabarijaona, Tojomamy Herinjaka Ralaizafindraibe, Florian Adèlis Andriniaina, Tahina Ratsirarisoa, Ndimby Nomenjanahary Andrinjakarivony, Marie Olga Rasoanirina, Patrick Maholisoa Randrianandraina et Henri Martial Randrianarimanarivo. « Obstructive Sleep Apnea Syndrome (OSAS) management in Dento-Facial Orthopedic ». Magna Scientia Advanced Research and Reviews 7, n^o 1 (28 février 2023) : 035–41. http://dx.doi.org/10.30574/msarr.2023.7.1.0023.

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Introduction: Obstructive Syndrom Apnea (OSA) has a worldwide incidence of 0.3 to 5%, predominantly in men. This pathology causes an obstruction of the upper airway with a significant risk of asphyxia and sudden death. The objective of our study was to report the case of a patient with OSA treated in Dento-Facial Orthopedics. Observation: This was a 41-year-old man with risk factors for OSA, dento-arch dysmorphosis, and maxillo-mandibular bone deformity. The nasofibroscopy revealed a narrowed oropharynx, an airway obstruction in the supine position. The polysomnography concluded to the diagnosis of OSA in its severe form with 45 apneas in one night, an oxygen saturation of 85%. The treatment consisted of a mandibular advancement prosthesis. Discussion: OSA is a serious pathology under-diagnosed in Madagascar. Repeated apneas and hypopneas are associated with significant decreases in oxygen partial pressure. The most reliable and widely used test in the world is polysomnography. Treatment of OSA with positive pressure allows the increase of the pressure inside the pharynx. Mandibular advancement prostheses allow for promandibulia. These therapeutic devices improve the quality of life of our patient. By traction system, the device allows a mandibular protrusion during sleep. Conclusion: The treatment of OSA consists of a multidisciplinary management including Dento-Facial Orthopedics and dental prosthesis.

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Pertiwi, Aniesa Nur Laily, Nada Rajbiana et Rida Hayati. « OROPHARINGEAL EXERCISE UNTUK MEMPERBAIKI JALAN NAFAS AKIBAT OBSTRUCTIVE SLEEP APNEA SYNDROM PADA KONDISI STROKE ». FISIO MU : Physiotherapy Evidences 1, n^o 1 (26 décembre 2019) : 21–28. http://dx.doi.org/10.23917/fisiomu.v1i1.9395.

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ABSTRAKObstructive Sleep Apnea Syndrome (OSAS) merupakan faktor resiko terjadinya stroke berulang hingga kematian. OSAS adalah sindrom obstruksi total atau parsial jalan napas yang menyebabkan gangguan nafas saat tidur. Peningkatan derajat OSAS berhubungan dengan peningkatan kematian. Oleh karena itu OSAS harus diberikan pengananan yang tepat. Penelitian menunjukkan Oropharingeal Exercise dipercaya dapat memperbaiki jalan nafas akibat OSAS pada kondisi stroke. Orofarigeal Exercise merupakan metode alternatif pada pasien stroke yang menderita OSAS dengan melakukan latihan isotonic dan isometric saluran nafas bagian atas untuk meningkatkan mobilitas dan tonisitas otot-otot pernafasan bagian atas sehingga membuka jalan nafas dan meningkatkan fungsi serta kinerja saluran pernapasan. Oleh karena itu Oropharingeal Exercise dapat digunakan sebagai terapi alternatif untuk memperbaiki jalan nafas akibat OSAS pada kondisi stroke.Keywords : Obstructve Sleep Apnea Syndrome, Stroke, Oropharingeal Exercise

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Thurnheer. « Role of general practitioners in diagnosing the sleep apnea/hypopnea syndrome ». Therapeutische Umschau 57, n^o 7 (1 juillet 2000) : 439–43. http://dx.doi.org/10.1024/0040-5930.57.7.439.

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Das obstruktive Schlafapnoe Syndrom ist eine häufige, wahrscheinlich zu selten diagnostizierte und unterbehandelte Erkrankung. Hausärzte werden in der Regel als erste von den Patienten kontaktiert. Sowohl Abklärung als auch die meisten therapeutischen Maßnahmen sind aufwendig und bedürfen einer kompetenten, geduldigen und motivierenden Führung durch die behandelnden Ärzte. Die Anamnese hilft, eine für das obstruktive Schlafapnoe Syndrom typischerweise vermehrte Tagesschläfrigkeit (Hypersomnie) von einfacher Tagesmüdigkeit, wie sie auch bei Ein- und Durchschlafstörungen vorkommt, abzugrenzen. Die klinische Untersuchung unterstützt die Vorselektion von Patienten für weiterführende Abklärungen. Anatomische Engnisse in den Atemwegen müssen ausgeschlossen werden. Oft ist ein multidisziplinäres Vorgehen mit Einbezug von Pneumologen, HNO-Spezialisten, Kieferorthopäden und Neurologen nötig. Die apparative Diagnostik zielt darauf, periodische Atempausen und repetitive Aufwachreaktionen nachzuweisen. Bei diagnostischer Unsicherheit und entsprechendem Leidensdruck lässt sich meist ein Therapieversuch rechtfertigen. Die ventilatorische Unterstützung durch kontinuierlichen positiven Druck, appliziert durch eine Nasenmaske, ist die erfolgsversprechendste und nebenwirkungsärmste Behandlung. Motivation und engmaschige Betreuung besonders zu Beginn der Therapie sind essentiell. Masken und Überdruckgeräte unterstehen einer rasanten technischen Entwicklung und werden stets angenehmer und besser verträglich.

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Yakovleva, N. F., A. V. Yakovlev, S. V. Ponomarev, A. K. Snegirkova, I. M. Felikov et Ye A. Baymaeva. « Dynamics of cardiovascular risk factors in patients with obstructive sleep apnoe syndrom undergoing CPAP-therapy ». Patologiya krovoobrashcheniya i kardiokhirurgiya 17, n^o 2 (10 octobre 2015) : 41. http://dx.doi.org/10.21688/1681-3472-2013-4-41-43.

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The aim of the study was to investigate the intensity of a number of risk factors resulting in cardiovascular complications, such as body mass index (BMI), level of mean arterial pressure (MAP), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and also ECG data (heart rate variability and ventricular ectopic activity) depending on the severity of obstructive respiratory disturbances during sleep. 76 patients with obstructive sleep apnea syndrome (OSAS) were included in the study. 38 patients with a severe form of OSAS underwent prolonged apparatus treatment which included generating positive pressure in their upper airways. After 4-month treatment the patients of this group underwent another examination to estimate all the parameters studied. Examination of patients with OSAS revealed that a number of indices (BMI, LVMI and MAP) showing the intensity of basic modified cardiovascular risk factors, such as obesity and arterial hypertension, correlate to the level of obstructive respiratory disturbances during sleep, which was estimated according to apnea-hypopnea index (AHI). Twenty-four-hour ECG monitoring of patients with OSAS showed a tendency for a decrease in heart rate variability and an increase in ventricular ectopic activity in patients with more apparent obstructive respiratory disturbances during sleep and with negative disease dynamics against the background of CPAP therapy.

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Mascarenhas, R., et R. Kruschewsky. « Prevalence of sleep apnea in Schaaf-Yang syndrom : a sistematic review ». Sleep Medicine 115 (février 2024) : 125. http://dx.doi.org/10.1016/j.sleep.2023.11.364.

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Orth, Maritta, Sylvia Kotterba, H. W. Duchna, J. Zeeuw, G. Schultze-Werninghaus et K. Rasche. « Obstruktives Schlafapnoe-Hypopnoe-Syndrom geschlechtsspezifische Unterschiede. Obstructive Sleep Apnea Hypopnea Syndrome Gender-Specific Differences ». Somnologie 4, n^o 1 (février 2000) : 3–6. http://dx.doi.org/10.1046/j.1439-054x.2000.00113.x.

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Scherler. « Surgery in the treatment of snoring and sleep apnea ». Therapeutische Umschau 57, n^o 7 (1 juillet 2000) : 454–57. http://dx.doi.org/10.1024/0040-5930.57.7.454.

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60% der Männer und 40% der Frauen in der Altersgruppe um 60 bis 65 Jahre schnarchen [1]. Damit ist die Nachfrage nach einer Therapie dieses häufigen Problems hoch. In den Abklärungsprozess gehören die Suche nach einem obstruktiven Schlafapnoe Syndrom und die klinische Untersuchung von Nase, Nasennebenhöhlen, Naso- und Oropharynx, Mundhöhle sowie des Larynx. Klagt der Patient über eine chronisch behinderte Nasenatmung oder ist im Rahmen eines obstruktiven Schlafapnoesyndromes die Anpassung einer CPAP-Maske aufgrund einer Nasenobstruktion erschwert, können operative Eingriffe an der äußeren Nase oder am Nasennebenhöhlensystem erfolgreich sein. Bei pathologischen Veränderungen des Gaumensegels, der Uvula oder bei übergroßen Tonsillen werden heute neben den traditionellen Operationsmethoden auch der CO2-Laser und Radiofrequenzgeräte eingesetzt. Ein weit nach dorsal ausladender Zungengrund, eine Makroglossie oder eine Dysgnathie können mittels Eingriffen an Zungenbasis, Zungenbein oder Unterkiefer erfolgreich angegangen werden.

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Fritsch et Bloch. « Nonsurgical alternatives to nasal CPAP in the treatment of the sleep apnea syndrome ». Therapeutische Umschau 57, n^o 7 (1 juillet 2000) : 449–53. http://dx.doi.org/10.1024/0040-5930.57.7.449.

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Der Leidensdruck und andere subjektive Faktoren spielen bei der Wahl der Behandlung des obstruktiven Schlafapnoe Syndroms eine wichtige Rolle. Die bewährte Überdruckbeatmung ist zwar wirksam, wird aber nicht von allen Patienten toleriert oder akzeptiert. Verhaltensmaßnahmen wie systematisches Lagetraining, Vermeiden von abendlichem Alkoholkonsum und Schlafmitteln genügen oft nicht zur befriedigenden Reduktion der Atemstörungen und des Scharchgeräusches. Abnehmbare Kieferorthopädische Apparaturen zur Schlafapnoebehandlung bieten in solchen Situationen eine wertvolle therapeutische Alternative. Die nachts auf die Zahnreihen aufgesetzten Spangen bewirken durch Vorverlagerung des Unterkiefers eine Lumenerweiterung der oberen Atemwege. Damit werden Schnarchen, Atemstörungen und Symptome des Schlafapnoe Symptomes wirksam reduziert. Die individuelle Anpassung der kieferorthopädischen Apparaturen erfolgt in enger Zusammenarbeit zwischen Pneumologen und Kieferorthopäden. Dies trägt zur Vermeidung von unerwünschten Veränderungen der Zahnstellung und von Kiefergelenksbeschwerden bei der Langzeitanwendung bei. Der Erfolg der Kieferspangentherapie beim Schlafapnoe Syndrom beruht vor allem auf der Handlichkeit und der einfachen und diskreten Anwendung.

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Jalbert, F., C. Dekeister, R. Lopez, F. Boutault et J. R. Paoli. « O.208 Effectiveness of bimaxillary advancement for severe obstructive sleep apnea syndrom ». Journal of Cranio-Maxillofacial Surgery 34 (septembre 2006) : 59. http://dx.doi.org/10.1016/s1010-5182(06)60235-7.

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J. Buechner, Nikolaus, Walter Zidek, Martina Esser, Michael Haske et and Bernd M. Sanner. « Obstructive Sleep Apnea Syndrome. Effects of Therapy on Dyslipidemia. Obstruktives Schlafapnoe Syndrom. Einfluss einer Therapie auf Fettstoffwechselstorungen ». Somnologie 5, n^o 3 (septembre 2001) : 97–102. http://dx.doi.org/10.1046/j.1439-054x.2001.01159.x.

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Predescu, Iasmina-Alexandra, Andreea Mihaela Kis, Dana Emanuela Pitic, Stefania Dinu, Mariana Pacurar, Eugen Bud, Ramona Amina Popovici et Malina Popa. « MOUTH BREATHING SYNDROM-AN INTERDISCIPLINARY APPROACH ». Romanian Journal of Oral Rehabilitation 16, n^o 4 (20 décembre 2024) : 385–401. https://doi.org/10.62610/rjor.2024.4.16.38.

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Aim of the study Mouth breathing syndrome (MBS) is a multifactorial condition where the patient breathes predominantly through the mouth instead of the nose, leading to negative consequences on facial development, oral and general health. Because of its complexity, MBS therapy requires close collaboration between different specialities. MBS is not just a respiratory problem; it also affects cranio-facial development, oral health, sleep and even some systemic functions of the body. An interdisciplinary approach ensures a complete evaluation and holistic treatment of the patient, addressing not only the symptoms but also the underlying causes of MBS. Collaboration between specialists allows an individualized treatment, adapted to the specific needs of each patient preventing long-term complications. Involvement of both patient and family in the oral rehabilitation process, supported by the interdisciplinary medical team, is crucial for the success and maintenance of long-term results. Materials and methods The research undertaken aimed to identify the opportunities, challenges and barriers existing in the interdisciplinary approach to complete MBS rehabilitation. The study took into account the responses of 720 specialists from various fields of medicine involved in MBS therapy. Results Dentistry has only 14.5% of recommendation because it is the most represented among the specializations present in the study. Most often, the dentist recommends an ENT specialty or orthodontics. At the top of most frequent symptomatology was sleep disorders, with only 14 doctors specialised in somnology as classified itself as the newest type of the specialty. The most frequent symptomatology (484 responses) is speep apnea followed by 432 answers of orthodontic issues and with close values of dry mouth and halitosis. Conclusions Through collaboration between otolaryngologists, orthodontists, dentists, speech therapists, allergists and other specialists, optimal results can be achieved, improving the general health, craniofacial development and quality of life of patients.

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Duchna, Hans-Werner, Maritta Orth, Justus de Zeeuw, Hartwig Neumann, Gerhard Schultze-Werninghaus et Kurt Rasche. « The Impact of Nasal Obstruction on Obstructive Sleep Apnea Syndrome. Einfluss nasaler Obstruktionen auf das obstruktive Schlafapnoe-Syndrom ». Somnologie 5, n^o 2 (mai 2001) : 53–57. http://dx.doi.org/10.1046/j.1439-054x.2001.01152.x.

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Koseoglu, Sabri, Kursat Ozcan, Aykut Ikinciogullari, Mehmet Cetin, Erol Yildirim et Huseyin Dere. « Relationship Between Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio and Obstructive Sleep Apnea Syndrom ». Advances in Clinical and Experimental Medicine 24, n^o 4 (2015) : 623–27. http://dx.doi.org/10.17219/acem/58969.

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Kalhous, J. « Effect of Surgical Therapy of Obstructive Sleep Apnea Syndrom in Patient Treated by Positive Airway Pressure ». Sleep Medicine 100 (décembre 2022) : S248—S249. http://dx.doi.org/10.1016/j.sleep.2022.05.668.

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Tripuraneni, Naga S., Raj Karunakara, Satish Chada, Maria Zaleska, Jahanara Begum, Samir Fahmy et Albert E. Heurich. « Utility of Impulse Oscillometry in Continuous Airway Pressure Titration for Patients With Sleep Apnea/Hypopnea Syndrom ». Chest 124, n^o 4 (janvier 2003) : 227S. http://dx.doi.org/10.1378/chest.124.4_meetingabstracts.227s-b.

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STARKOVA, LARISA N., et NATALIA A. PICHTILEVA. « PATHOMORPHOLOGICAL CHANGES OF THE UPPER RESPIRATORY TRACT IN PATIENTS SUFFERING FROM SNORING AND OBSTRUCTIVE SLEEP APNEA SYNDROM ». Bulletin of Contemporary Clinical Medicine 16, n^o 3 (juin 2023) : 84–89. http://dx.doi.org/10.20969/vskm.2023.16(3).84-89.

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ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ84 ВЕСТНИК СОВРЕМЕННОЙ КЛИНИЧЕСКОЙ МЕДИЦИНЫ 2023 Том 16, вып. 3 ©Л.Н.Старкова, Н.А. Пихтилева, 2023 УДК 616.211/.22-008.4-091 DOI: 10.20969/VSKM.2023.16(3).84-89 ПАТОМОРФОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ ВЕРХНИХ ДЫХАТЕЛЬНЫХ ПУТЕЙ У ПАЦИЕНТОВ, СТРАДАЮЩИХ ХРАПОМ И СИНДРОМОМ ОБСТРУКТИВНОГО АПНОЭ СНА СТАРКОВА ЛАРИСА НИКОЛАЕВНА, ORCID ID:0000-0001-8945-2529, SPIN-код автора: 9826-8347, Web of Science Researcherld CAJ-1638-2022, к.м.н., доцент, доцент кафедры хирургической стоматологии и челюст- но-лицевой хирургии с курсом ЛОР- болезней, Федеральное Государственное Бюджетное образовательное учреждение высшего образования «Рязанский Государственный Медицинский Университет им. ак. И.П. Павло- ва» Минздрава России, Россия, Рязань, 390000, ул. Высоковольтная д.9, e-mail: starkovalarisa12235@ gmail.com ПИХТИЛЕВА НАТАЛЬЯ АЛЕКСЕЕВНА, ORCID ID: 0000-0003-1253-9719, SPIN 5895-4781, Web of Science Researcherld CAJ-1847-2022 ассистент кафедры хирургической стоматологии и челюстно-лицевой хирур- гии с курсом ЛОР- болезней, Федеральное Государственное Бюджетное образовательное учреждение выс- шего образования «Рязанский Государственный Медицинский Университет им. ак. И.П Павлова» Минздрава России, г. Рязань, Россия, 390000, ул. Высоковольтная, сот 89209616078, д.9 e-mail:pixtileva@gmail.com Реферат. Введение. Наиболее частой причиной храпа с периодическими остановками дыхания во сне счита- ют обструкцию глотки на уровне мягкого неба. Подобные изменения в мягком небе могут возникать, как вто- ричный воспалительный процесс при заболеваниях глотки и носа. Цель исследования состоит в изучении гистологических изменений в мягких тканях верхних дыхательных путей, у пациентов с храпом и синдромом об- структивного апноэ сна. Материалы и методы. Проведены патоморфологические исследования мягких тканей верхних дыхательных путей 57 пациентов с храпом и синдромом обструктивного апноэ сна, резецированных во время увулопалатофарингопластики. Результаты и их обсуждение. С помощью морфологических иссле- дований операционного материала, удаляемого у больных с храпом, выявлены изменения практически всех тканей верхних дыхательных путей уже в начальных стадиях заболевания. Наше исследование выявило мно- жественные патологические изменения тканей, характерные для хронического продуктивного неспецифическо- го воспаления, такие как гиперплазия лимфоидной ткани язычной и небных миндалин; многослойный плоский эпителий слизистых желез с ретенцией слизистого секрета; воспалительная инфильтрация всех исследуемых тканей с расширением и полнокровием их сосудов; гипертрофия и атрофия мышечных волокон мягкого неба с фибринозными и жировыми включениями между ними. Заключение. Сопоставление результатов клинического, антропологического и гистологического исследований позволяет говорить, что в мягком небе выявлены патоло- гические изменения, характерные для хронического продуктивного неспецифического воспаления. Ключевые слова: мягкое небо, нижние носовые раковины, гиперплазия язычной миндалины, хронический тон- зиллит. Для ссылки: Старкова Л.Н., Пихтилева Н.А. Патоморфологические изменения верхних дыхательных путей у пациентов, страдающих храпом и синдромом обструктивного апноэ сна // Вестник современной клинической медицины. – 2023. – Т.16, вып.3. – С.84-89. DOI: 10.20969/VSKM.2023.16(3).84-89. PATHOMORPHOLOGICAL CHANGES OF THE UPPER RESPIRATORY TRACT IN PATIENTS SUFFERING FROM SNORING AND OBSTRUCTIVE SLEEP APNEA SYNDROM STARKOVA LARISA N., ORCID ID: 0000-0001-8945-2529, Web of Science Researcher ID CAJ-1638-2022, C. Med. Sci. Associate Professor, Department of Surgical Dentistry, Maxillofacial Surgery with the course of otorhinolaryngology of the Ryazan State Medical University named after I.P Pavlov, Russia, Ryazan 39000, Vysokovoltnaya 9, e-mail: starkovalarisa12235@ gmail.com PICHTILEVA NATALIA A., ORCID ID: 0000-0003-1253-9719, Web of Science Researcher ID CAJ-1847-2022 Assistant Professor of the Department of Surgical Dentistry, Maxillofacial Surgery with the course of otorhinolaryngology of the Ryazan State Medical University named after I. P. Pavlov, Ryazan, Russia 39000, Vysokovoltnaya 9, com 89209616078, pixtileva@gmail Abstract. Introduction. The most common cause of snoring with periodic stops of breathing during sleep is considered to be obstruction of the pharynx at the level of the soft palate. Similar changes in the soft palate can occur as a secondary inflammatory process in diseases of the pharynx and nose. Aim. The aim of the study is to study histological changes in the soft tissues of the upper respiratory tract, in patients with snoring and obstructive sleep apnea syndrome. Material and methods. Pathomorphological studies of soft tissues of the upper respiratory tract of 57 patients with snoring and obstructive sleep apnea syndrome resected during uvulopalatopharyngoplasty were performed. Results and discussion. Morphological studies of the soft palate resected in patients with snoring revealed changes in almost all tissues of the upper respiratory tract already in the initial stages of the disease. Our research revealed multiple pathological changes characteristic of chronic productive nonspecific inflammation in the form of hyperplasia of the lymphoid tissue of the lingual and palatine tonsils, multilayered squamous epithelium, mucous glands with retention of mucosal secretions, inflammatory infiltration of all studied tissues with dilation and fullness of their vessels, hypertrophy and atrophy of the muscle fibers of the soft palate with fibrinous and fatty inclusions between them. Conclusion. Comparison of the results of clinical, anthropological and histological studies suggests that pathological changes characteristic of chronic productive nonspecific inflammation have been revealed in the soft palate: glandular hyperplasia with retention of mucosal secretions, inflammatory infiltration with vasodilation and fullness of blood vessels, hypertrophy and atrophy of muscle fibers with fibrous and fatty inclusions between them.

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Paoli, J. R., C. Dekeister, L. Lacassagne, M. Tiberge, T. Montemayor et F. Boutault. « O.205 Efficacy of oral appliance for obstructive sleep apnea syndrom : Result of a serie of 70 patients ». Journal of Cranio-Maxillofacial Surgery 34 (septembre 2006) : 58. http://dx.doi.org/10.1016/s1010-5182(06)60232-1.

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Khan, Muhammad Talha, et Rose Amy Franco. « Complex Sleep Apnea Syndrome ». Sleep Disorders 2014 (2014) : 1–6. http://dx.doi.org/10.1155/2014/798487.

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Complex sleep apnea is the term used to describe a form of sleep disordered breathing in which repeated central apneas (>5/hour) persist or emerge when obstructive events are extinguished with positive airway pressure (PAP) and for which there is not a clear cause for the central apneas such as narcotics or systolic heart failure. The driving forces in the pathophysiology are felt to be ventilator instability associated oscillation in PaCO2arterial partial pressure of Carbon Dioxide, continuous cositive airway pressure (CPAP) related increased CO2carbon dioxide elimination, and activation of airway and pulmonary stretch receptors triggering these central apneas. The prevalence ranges from 0.56% to 18% with no clear predictive characteristics as compared to simple obstructive sleep apnea. Prognosis is similar to obstructive sleep apnea. The central apnea component in most patients on followup using CPAP therap, has resolved. For those with continued central apneas on simple CPAP therapy, other treatment options include bilevel PAP, adaptive servoventilation, permissive flow limitation and/or drugs.

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Isayeva, G. S., et O. O. Buryakovska. « Connection between severity of sleep disorders, lipid parametres, and antropometric characteristics in patients with hypertension and metabolic syndrom ». Ukrainian Journal of Cardiology 27, n^o 2 (11 juin 2020) : 25–33. http://dx.doi.org/10.31928/1608-635x-2020.2.2533.

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The aim – to assess correlations between insomnia, excessive daytime sleepiness (EDS) and levels of lipids, anthropometric parameters and cardiovascular risks in patients with hypertension and metabolic syndrom. Materials and methods. 118 patients with hypertension over 45 years of age were enrolled to this study. The Framingham Risk Score was used to evaluate cardiovascular risks and cardiovascular age. Body mass index, muscular strength, and physical activity (the number of steps per day) were assessed. Total cholesterol, triacylglycerols (TAGs), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose and glycated hemoglobin levels were determined. Insomnia was diagnosed in accordance with the International Classification of Sleep Disorders – Third Edition (ICSD-3). EDS was assessed by the Epworth Sleepiness Scale. To detect obstructive sleep apnea, a portable monitoring. Results and discussion. Insomnia was diagnosed in 48 (40.7 %) out of the 118 patients examined. No correlation between insomnia and either metabolic indices or arterial pressure was found. However, levels of systolic arterial pressure, HDL cholesterol, waist circumference, and body mass index were shown to differ depending on the severity of EDS. Analysis of cardiovascular age using the Framingham Risk Score revealed that patients with severe ESD were characterized by a greater cardiovascular age. In group 1 according to the Epworth Sleepiness Scale, it reached 48.0 [45.5–56.7] years, while in groups 2 and 3 this parameter was 57.0 [48.7–63.0] and 72.0 [68.0–80.0] years, respectively (ANOVA test, F=63,4; p=0.001). Conclusions. Thus, evaluation of the impact of sleep disorders on metabolic parameters and arterial hypertension allowed us to reveal that not insomnia itself but EDS as its manifestation is of huge importance. Our findings when using the Epworth Sleepiness Scale suggest that patients with moderate and severe EDS have higher levels of systolic arterial pressure, body mass index, waist circumference, lower HDL cholesterol, and greater cardiovascular age according to the Framingham Risk Score. The presence of insomnia was associated only with low level of high density cholesterol.

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Suto, Y., et Y. Inoue. « Sleep Apnea Syndrome ». Acta Radiologica 37, n^o 1P1 (janvier 1996) : 315–20. http://dx.doi.org/10.1177/02841851960371p166.

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Purpose: We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). Subjects and Methods: A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO2 value during sleep. Results: Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. Conclusion: Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS.

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Rani, Seema, Alexandra Cohen, Abigail Strang et Aaron Chidekel. « 1220 Polysomnography in Children with Joubert Syndrome ». SLEEP 47, Supplement_1 (20 avril 2024) : A520. http://dx.doi.org/10.1093/sleep/zsae067.01220.

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Abstract Introduction Joubert syndrome is autosomal recessive, clinically and genetically heterogeneous with multiorgan involvement. Classic breathing symptoms include episodes of hyperpnea followed by apnea and periodic breathing. Gas exchange abnormalities include hyperventilation with low CO2s and intermittent desaturations. Purpose of this abstract is to report prolonged survival, describe the PSG findings and treatment modalities in 2 cases. Report of case(s) 8-year-old female with Joubert syndrome, global developmental delay, hydrocephalus, hypotonia, cortical blindness presented for initial evaluation of sleep apnea. PSG revealed primarily central sleep apnea with upper airway resistance with snoring with arousal and few episodes of obstructive and mixed apnea and hypopnea. Gas exchange demonstrated episodic, brief desaturations, associated with central apneas. Repeat PSG at 13 years showed intermittent hyperpnea followed by apnea, low ETCO2s with self-limiting desaturations and periodic breathing. Gas exchange revealed low ETCO2 and desaturations. She was treated with clinical observation. PSG at age 20 year demonstrated intermittent hyperpnea followed by episodes of prolonged central apneas, with low ETCO2s and desaturations, and few obstructive hypopneas. Most central apneas associated with self-limiting desaturations, with significant number associated with oxygen saturation below 90%. Gas exchange demonstrated low ETCO2s and episodic desaturations. Supplemental oxygen was prescribed. 20-month-old female with diagnosed Joubert syndrome, cleft lip, polydactyly, hypotonia, dysphagia, and developmental delay presented for loud snoring and gasping during sleep and apneas while awake. Sibling with Joubert Syndrome and a tracheostomy had died. Presented for a second opinion for tracheostomy due to PSG at OSH demonstrating OSAHS with AHI of 18.2, OAI of 3.9 and CAI of 14.3, minimal hypoxemia, normal ETCO2 and SaO2 nadir was 75%. Repeat sleep study done at our center; AHI of 27.7 and OAI of 0.83. ETCO2 was normal, SpO2 nadir was 75% and minimal hypoxemia. Overall PSG demonstrated primarily central apneas with a few obstructive apneas and hypopneas and minimal O2 desaturations. Subsequently underwent BLPAP titration study and treated with non-invasive modality. Conclusion PSG in Joubert syndrome demonstrated intermittent hyperpnea and prolonged central apneas with low ETCO2's and brief desaturations. All events were predominantly present in REM sleep. Patients did well with low respiratory support and did not require tracheostomy. Support (if any)

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Anne, Pratibha, Rupa Koothirezhi, Ugorji Okorie, Minh Tam Ho, Brittany Monceaux, Cesar Liendo, Sheila Asghar et Oleg Chernyshev. « 833 Evolution of sleep disordered breathing types in heart failure ». Sleep 44, Supplement_2 (1 mai 2021) : A324—A325. http://dx.doi.org/10.1093/sleep/zsab072.830.

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Abstract Introduction Central sleep apnea is commonly seen in patients with heart failure. Here we present a case demonstrating shifting of predominant apneic events from central to obstructive type after placement of left ventricular assist device (LVAD) in end stage heart failure patient. Report of case(s) Case Presentation: 66 year-old African American male has past medical history of chronic congestive heart failure diabetes, hypertension, paroxysmal atrial fibrillation, anemia, hypothyroidism, chronic kidney disease and sleep apnea. Prior to his LVAD placement, his left ventricular ejection fraction (EF) was <10%. Patient was diagnosed with central sleep apnea with AHI of 58 (with 92% of apneic events being central events), oxygen nadir of 74%. Subsequently, patient had LVAD placed for symptomatic heart failure and repeat polysomnogram repeated at six month demonstrated an improved AHI of 45.8 with predominantly obstructive and mixed apneic events, with only 12.5% being central events. Conclusion This case report highlights not only the improvement of the sleep apnea in CHF treated with LVAD but also shows the shift of apneic events from predominantly central to obstructive type post LVAD. Support (if any) 1. Henein MY, Westaby S, Poole-Wilson PA, Cowie MR, Simonds AK. Resolution of central sleep apnoea following implantation of a left ventricular assist device. Int J Cardiol. 2010 Feb 4;138(3):317–9. PMID: 18752859. 2. Köhnlein T, Welte T, Tan LB, Elliott MW. Central sleep apnoea syndrome in patients with chronic heart disease: a critical review of the current literature. Thorax. 2002 Jun;57(6):547–54. PMID: 12037232 3. Monda C, Scala O, Paolillo S, Savarese G, Cecere M, D’Amore C, Parente A, Musella F, Mosca S, Filardi PP. Apnee notturne e scompenso cardiaco: fisiopatologia, diagnosi e terapia [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy]. G Ital Cardiol (Rome). 2010 Nov;11(11):815–22. Italian. PMID: 21348318.

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Biermann, Eckhard. « Nasale CPAP-Therapie beim obstruktiven Schlafapnoe-Syndrom : Verbessert funktionelle Rhinochirurgie die Compliance?. Nasal CPAP Therapy in Obstructive Sleep Apnea Syndrome : Does functional Rhinosurgery Improve Compliance ? » Somnologie 5, n^o 2 (mai 2001) : 59–64. http://dx.doi.org/10.1046/j.1439-054x.2001.01147.x.

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Bhandarkar, Dr Ajay M., Dr Rukma Bhandary et Dr Suraj S. Nair. « Clinical Indicators of Obstructive Sleep Apnea Syndrome ». International Journal of Scientific Research 2, n^o 12 (1 juin 2012) : 399–400. http://dx.doi.org/10.15373/22778179/dec2013/120.

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Zdravković, Marija, Ratko Lasica, Sofija Nikolić et Milica Brajković. « Cardiovascular diseases associated with obstructive sleep apnea syndrome ». Medicinska istrazivanja 57, n^o 3 (2024) : 123–27. http://dx.doi.org/10.5937/medi57-49569.

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Obstructive Sleep Apnea (OSA) is a syndrome characterized by repeated episodes of breathing cessation during sleep, which can be partial (hypopneas) or complete (apneas). Intermittent hypoxia is the fundamental pathophysiological mechanism in the development of all associated diseases with obstructive sleep apnea. OSA is linked to various forms of cardiovascular diseases, and their association is correlated with poorer health outcomes. It is present in as much as 40% to 60% of patients with pre-existing cardiovascular diseases, making the causal relationship between cardiovascular diseases and obstructive sleep apnea the focus of this article.

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Pendharkar, Seema Shantilal, Sakshi Jain et Harshad Bhagwat. « Upper airway imaging techniques for obstructive sleep apnea syndrome ». IP International Journal of Maxillofacial Imaging 10, n^o 4 (15 décembre 2024) : 153–59. https://doi.org/10.18231/j.ijmi.2024.033.

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Obstructive sleep apnea syndrome (OSAS) is a sleep disorder marked by recurrent stops in breathing during sleep or by not breathing for 10 seconds or longer despite an effort to breathe. It is brought on by a partial or total blockage of the upper airway, which results in apnea or hypopnea. Soft tissue in the back of the throat collapses and blocks the upper airway when muscles relax while you sleep. The Apnea-Hypopnea Index (AHI) is a widely used metric to quantify sleep apnea. The total number of apneas and hypopneas that happen during an hour of sleep is represented by this average. The majority of people with OSA remain undiagnosed, even with the recent advancements in sleep medicine diagnostic technologies and public awareness of the condition. The upper airway imaging methods for obstructive sleep apnea syndrome will be covered in this review.

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Badr, M. S., F. Toiber, J. B. Skatrud et J. Dempsey. « Pharyngeal narrowing/occlusion during central sleep apnea ». Journal of Applied Physiology 78, n^o 5 (1 mai 1995) : 1806–15. http://dx.doi.org/10.1152/jappl.1995.78.5.1806.

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We hypothesized that subatmospheric intraluminal pressure is not required for pharyngeal occlusion during sleep. Six normal subjects and six subjects with sleep apnea or hypopnea (SAH) were studied during non-rapid-eye-movement sleep. Pharyngeal patency was determined by using fiber-optic nasopharyngoscopy during spontaneous central sleep apnea (n = 4) and induced hypocapnic central apnea via nasal mechanical ventilation (n = 10). Complete pharyngeal occlusion occurred in 146 of 160 spontaneously occurring central apneas in patients with central sleep apnea syndrome. During induced hypocapnic central apnea, gradual progressive pharyngeal narrowing occurred. More pronounced narrowing was noted at the velopharynx relative to the oropharynx and in subjects with SAH relative to normals. Complete pharyngeal occlusion frequently occurred in subjects with SAH (31 of 44 apneas) but rarely occurred in normals (3 of 25 apneas). Resumption of inspiratory effort was associated with persistent narrowing or complete occlusion unless electroencephalogram signs of arousal were noted. Thus pharyngeal cross-sectional area is reduced during central apnea in the absence of inspiratory effort. Velopharyngeal narrowing consistently occurs during induced hypocapnic central apnea even in normal subjects. Complete pharyngeal occlusion occurs during spontaneous or induced central apnea in patients with SAH. We conclude that subatmospheric intraluminal pressure is not required for pharyngeal occlusion to occur. Pharyngeal narrowing or occlusion during central apnea may be due to passive collapse or active constriction.

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Delgado Juan, Ivonne, et Lic Isvel Perón Carmenates. « Obstructive sleep apnea syndrome ». Journal of Otolaryngology-ENT Research 15, n^o 2 (2023) : 81–85. http://dx.doi.org/10.15406/joentr.2023.15.00533.

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Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is a frequent, chronic and progressive disorder. It is associated with increased cardiovascular, neurocognitive, and metabolic morbidity, risk of accidents, poor quality of life, and increased mortality. It affects 5% of the adult population, mainly men, and 2% of children between 4 and 5 years of age. Diagnosis is based on suspicion and joint evaluation of the clinical picture with appropriate confirmatory nocturnal studies such as polysomnography. The treatment has two fundamental objectives: to eliminate the respiratory obstruction and, therefore, the breathing stops (apneas) or the hypoventilations (hypopneas) and the drops in oxygen in the blood (desaturations) in any body position or phase of sleep and ensure that the subject sleeps well, improving their sleep quality and reducing or eliminating awakenings and micro-awakenings, which are the main causes of the symptoms.

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Karabulut, Müjdat, Sinem Karabulut, Aylin Karalezli et Gülnihal Kutlu. « Effects of obstructive sleep apnea on retinal microvasculature ». International Journal of Ophthalmology 16, n^o 10 (18 octobre 2023) : 1670–75. http://dx.doi.org/10.18240/ijo.2023.10.17.

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AIM: To detect retinal microvascular variations in obstructive sleep apnea syndrome patients. METHODS: This prospective, observational case-control study included healthy controls and patients with mild, moderate, and severe obstructive sleep apnea syndrome. Vascular parameters, foveal avascular area, and flow areas in macula-centered, 6.00×6.00 mm2 scan size optical coherence tomography angiography images were compared. RESULTS: The control group had the highest whole image, parafoveal, and perifoveal vessel density among the groups in both superficial and the deep capillary plexus (all P<0.05). Rapid eye movement sleep apnoea-hypopnoea index was reversely correlated with whole (Rho=-0.195, P=0.034), parafoveal (Rho=-0.242, P=0.008), perifoveal (Rho=-0.187, P=0.045) vessel density in the superficial capillary plexus, and whole (Rho=-0.186, P=0.046), parafoveal (Rho=-0.260, P=0.004), perifoveal (Rho=-0.189, P=0.043) vessel density in the deep capillary plexus, though the mean and non-rapid eye movement sleep apnoea-hypopnoea index related with only parafoveal vessel density in the superficial capillary plexus (Rho=-0.213, P=0.020; Rho=-0.191, P=0.038) and the deep capillary plexus (Rho=-0.254, P=0.005; Rho=-0.194, P=0.035). CONCLUSION: This study shows decreased vessel density and its reverse correlation with the apnoea-hypopnoea index in patients with obstructive sleep apnea syndrome.

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Fairbanks, David W., et David N. F. Fairbanks. « Neurostimulation for Obstructive Sleep Apnea : Investigations ». Ear, Nose & ; Throat Journal 72, n^o 1 (janvier 1993) : 52–57. http://dx.doi.org/10.1177/014556139307200111.

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Neurostimulation of the upper airway muscles (accessory muscles of respiration) was accomplished in anesthetized dogs and sleeping humans by electrical stimulation of the hypoglossal nerves. Such stimulations relieved partial airway obstructions in dogs. They also aborted (shortened) obstructive sleep apnea events in humans who suffer with obstructive sleep apnea syndrome. In one subject, stimulations delivered in advance of apneic events (by automatic cycling) prevented apneas. Neurostimulation for obstructive sleep apnea may be an important concept for future research and development.

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Juraški, Romana Gjergja, Mirjana Turkalj, Davor Plavec, Boro Nogalo, Ivana Marušić, Marija Miloš, Srđan Ante Anzić, Matilda Kovač Šižgorić et Feodora Stipoljev. « Sleep phenotype in children with Down syndrome – altered sleep architecture and sleep-disordered breathing ». Paediatria Croatica 63, n^o 4 (30 décembre 2019) : 179–204. http://dx.doi.org/10.13112/pc.443.

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The aim of the study was to assess sleep architecture and breathing in sleep in children with Down syndrome. The study was conducted by using overnight video-polysomnography (V-PSG) in children with Down syndrome and age-matched children from the general population. Analysis of polysomnographic parameters revealed that compared to the norms of healthy age- and maturitymatched children from the general population, children with Down syndrome had significantly shorter sleep latency (p=0.007), shorter total sleep time (p=0.004), lower sleep efficiency (p=0.010), less NREM1 sleep phase (p=0.0002), less NREM3 sleep phase (p=0.034), less REM sleep (p=0.034) in favour of more NREM2 phase but not significantly (p=0.069), and spent more time awake after sleep onset (p=0.0002). Children with Down syndrome had significantly more obstructive sleep apnoeas and hypopnoeas per hour (higher obstructive sleep apnoeas and hypopnoeas index) (p=0.008), but less central sleep apnoea per hour (lower central apnoeas index) (p=0.041), which led to the nonsignificantly lower total apnoea-hypopnoea index (p=0.762) in children with Down syndrome. The mean and longest apnoea duration did not differ significantly between these two groups. Children with Down syndrome had a significantly lower mean and nadir oxygen saturation (p=0.008 and p=0.001, respectively). In conclusion, the majority of respiratory complications in children with Down syndrome can be prevented by raising awareness of sleep disturbances in children with Down syndrome among their parents and health care providers and by introducing early routine V-PSG in the follow up of these children. Key words: CHILD; DOWN SYNDROME; SLEEP APNEA SYNDROMES

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Lafond, Chantal, Frédéric Series et Catherine Lemière. « IMPACT OF CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) ON AIRWAY RESPONSIVENESS AND ASTHMA QUALITY OF LIFE IN SUBJECTS WITH ASTHMA AND SLEEP APNEA SYNDROM ». Chest 128, n^o 4 (octobre 2005) : 165S. http://dx.doi.org/10.1378/chest.128.4_meetingabstracts.165s-c.

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Benedek, Pálma, Gabriella Kiss, Eszter Csábi et Gábor Katona. « Postoperative monitoring of children with obstructive sleep apnea syndrome ». Orvosi Hetilap 155, n^o 18 (mai 2014) : 703–7. http://dx.doi.org/10.1556/oh.2014.29879.

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Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

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Vaartjes, Martin, Rob L. M. Strijers et Nico de Vries. « Posterior Nasal Packing and Sleep Apnea ». American Journal of Rhinology 6, n^o 2 (mars 1992) : 71–74. http://dx.doi.org/10.2500/105065892781874784.

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Posterior nasal packing has been reported to be associated with cardiorespiratory complications and, occasionally, with sudden death. To study the rate and incidence of sleep apnea, between October 1989 and September 1990 polysomnography (PSG) was performed in 10 patients who were treated for severe epistaxis with posterior nasal packing. Of these 10 patients, three had obstructive apneas, one had central apneas, and four had a combination of central and/or obstructive and mixed apneas. One patient had no apneas, and one was unable to sleep during PSG. In six patients, PSG was repeated a few months after removal of the packs. Four of these six patients no longer had apneas; one patient had a considerable decrease in number of apneas. One patient did not sleep during the second PSG, however, he had no apneas during the first PSG. This study demonstrates that posterior nasal packing can induce sleep apneas or enhance the severity of an apnea syndrome when present. This may contribute to the cardiorespiratory morbidity and sudden death that has been reported in epistaxis patients treated with posterior packing.

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Xie, Ailiang, Fiona Rankin, Ruth Rutherford et T. Douglas Bradley. « Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea ». Journal of Applied Physiology 82, n^o 3 (1 mars 1997) : 918–26. http://dx.doi.org/10.1152/jappl.1997.82.3.918.

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Xie, Ailiang, Fiona Rankin, Ruth Rutherford, and T. Douglas Bradley. Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea. J. Appl. Physiol. 82(3): 918–926, 1997.—We hypothesized that reductions in arterial [Formula: see text]([Formula: see text]) below the apnea threshold play a key role in the pathogenesis of idiopathic central sleep apnea syndrome (ICSAS). If so, we reasoned that raising[Formula: see text] would abolish apneas in these patients. Accordingly, patients with ICSAS were studied overnight on four occasions during which the fraction of end-tidal CO2 and transcutaneous[Formula: see text] were measured: during room air breathing ( N1), alternating room air and CO2 breathing ( N2), CO2 breathing all night ( N3), and addition of dead space via a face mask all night ( N4). Central apneas were invariably preceded by reductions in fraction of end-tidal CO2. Both administration of a CO2-enriched gas mixture and addition of dead space induced 1- to 3-Torr increases in transcutaneous [Formula: see text], which virtually eliminated apneas and hypopneas; they decreased from 43.7 ± 7.3 apneas and hypopneas/h on N1 to 5.8 ± 0.9 apneas and hypopneas/h during N3( P < 0.005), from 43.8 ± 6.9 apneas and hypopneas/h during room air breathing to 5.9 ± 2.5 apneas and hypopneas/h of sleep during CO2 inhalation during N2 ( P< 0.01), and to 11.6% of the room air level while the patients were breathing through added dead space during N4 ( P< 0.005). Because raising[Formula: see text] through two different means virtually eliminated central sleep apneas, we conclude that central apneas during sleep in ICSA are due to reductions in[Formula: see text] below the apnea threshold.

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Dominici, Michele, Fernando Pompeu Filho et Marleide da Mota Gomes. « Probable causal link between epilepsy and sleep apnea : case report ». Arquivos de Neuro-Psiquiatria 65, n^o 1 (mars 2007) : 164–66. http://dx.doi.org/10.1590/s0004-282x2007000100034.

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Patients with epilepsy were reported to have concomitant sleep apnea, but it has been rarely linked to the epilepsy itself. We present a case of a 28-year-old, obese man with secondary medically resistant partial complex epilepsy due to a brain trauma, with progressive snoring, and sleep agitation, apneas, and important daytime somnolence. It was noticed in the polysomnographic study that he had several sleep respiratory events, probably due both to the epileptic seizures and the sleep apnea syndrome as a co-morbidity. Apnea and epilepsy will be discussed. A careful video-EEG-polysomnography study is important in evaluating refractory epileptic patients and/or epileptic patients with snoring.

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Punjabi, Naresh M., et Vsevolod Y. Polotsky. « Disorders of glucose metabolism in sleep apnea ». Journal of Applied Physiology 99, n^o 5 (novembre 2005) : 1998–2007. http://dx.doi.org/10.1152/japplphysiol.00695.2005.

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Sleep is a complex behavioral state that occupies one-third of the human life span. Although viewed as a passive condition, sleep is a highly active and dynamic process. The sleep-related decrease in muscle tone is associated with an increase in resistance to airflow through the upper airway. Partial or complete collapse of the airway during sleep can lead to the occurrence of apneas and hypopneas during sleep that define the syndrome of sleep apnea. Sleep apnea has become pervasive in Western society, affecting ∼5% of adults in industrialized countries. Given the pandemic of obesity, the prevalence of Type 2 diabetes mellitus and metabolic syndrome has also increased dramatically over the last decade. Although the role of sleep apnea in cardiovascular disease is uncertain, there is a growing body of literature that implicates sleep apnea in the pathogenesis of altered glucose metabolism. Intermittent hypoxemia and sleep fragmentation in sleep apnea can trigger a cascade of pathophysiological events, including autonomic activation, alterations in neuroendocrine function, and release of potent proinflammatory mediators such as tumor necrosis factor-α and interleukin-6. Epidemiologic and experimental evidence linking sleep apnea and disorders of glucose metabolism is reviewed and discussed here. Although the cause-and-effect relationship remains to be determined, the available data suggest that sleep apnea is independently associated with altered glucose metabolism and may predispose to the eventual development of Type 2 diabetes mellitus.

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Kahn, A., D. Blum, E. Rebuftat, M. Sottiaux, J. Levitt, A. Bochner, M. Alexander, J. Grosswasser et M. F. Muller. « Polysomnographic Studies of Infants Who Subsequently Died of Sudden Infant Death Syndrome ». Pediatrics 82, n^o 5 (1 novembre 1988) : 721–27. http://dx.doi.org/10.1542/peds.82.5.721.

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The polygraphic findings from 11 future victims of sudden infant death syndrome (SIDS) are reported and compared with those of matched pairs of control infants. The recordings had been done to alleviate parental anxiety about sleep apnea. Four infants had siblings who were victims of SIDS. Two infants were studied 3.5 to 9.5 weeks before their deaths because of an unexplained apparent life-threatening event that had occurred during sleep. For each victim of SIDS, two control infants were selected from the 2,000 infants who had been tested in the same hospitals. They were matched for sex, gestational age, postnatal age, and weight at birth with the SIDS victims. Their polygraphic recordings had been performed within similar conditions. Each record was allocated a random code number and was analyzed without knowledge of the patient's identity by two independent scorers. Most sleep and cardiorespiratory variables studied did not differentiate SIDS victims from control infants. Only four variables significantly characterized the future SIDS victims: the maximal duration of central apneas, the number of sighs followed by a central apnea, the presence of obstructive apneas, and the presence of mixed apneas. Central apneas were longer during all sleep states in the SIDS victims compared with their matched controls, but none exceeded 14 seconds. Sighs immediately followed by an apnea were significantly less frequent in the future SIDS group. Obstructive and mixed sleep apneas were seen in eight of 11 SIDS victims and in only three of 22 control infants. They were significantly more frequent (total number of episodes: 89 in the SIDS group and three in the control group) and lasted longer in the SIDS victims than in the control group. The present data thus confirm some previous reports of an increase in obstructed breathing in infants who eventually die of SIDS. The observation of a reduced number of sighs followed by an apnea in this group raises the possibility of a lower peripheral chemoreceptor response in some of these infants. Although these observations do not establish risk predictors for infants who eventually become victims of SIDS, they add further indirect evidence for a possible sleep-related impairment of respiratory controls in some of these infants.

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Dlewati, Mohammad, et Roberta Leu. « 1214 A Case of Mixed Obstructive and Central Sleep Apnea in Jacobsen Syndrome ». SLEEP 47, Supplement_1 (20 avril 2024) : A517—A518. http://dx.doi.org/10.1093/sleep/zsae067.01214.

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Abstract Introduction Jacobsen syndrome is a rare genetic disorder due to variable deletion lengths on chromosome 11q. The estimated prevalence is only 1/100,000 births in the U.S. Clinical features are multi-system with characteristic facial features, growth and motor retardation, neurocognitive disability, cytopenias, and possible malformations in the CNS, heart, kidneys, and skeleton. Little information is available regarding their sleep and respiratory features. Report of case(s) A 3 month old girl with a history of Jacobsen syndrome presented to an outside sleep lab due to oxygen desaturations on overnight pulse oximetry. She was diagnosed prenatally due to intrauterine growth retardation. Whole genome sequencing revealed a 15.6 megabase deletion of 11q23.3q25. On polysomnography, she was found to have severe mixed obstructive and central sleep apnea (obstructive AHI 13.4 events/hour, central AHI 8.6 events/hour). She was treated with up to ½ Lpm of O2 via nasal cannula during sleep. CT imaging of the head and MRI of the brain and spine were obtained. These demonstrated absent olfactory nerves, pituitary interruption syndrome, periventricular white matter hypomyelination, lacunar skull, brachycephaly, mild congenital cervical spinal stenosis, and a “split atlas” with incomplete anterior and posterior arches of the C1 vertebra. There was no Chiari malformation and no radiographic abnormalities of the spinal cord. At 6 months of age she was started and maintained on levothyroxine and hydrocortisone for central hypothyroidism and adrenal insufficiency. Repeat polysomnogram at 15 months of age showed an obstructive AHI of 3.2 events/hour, and a central AHI of 5.6 events/hour. While most central apneas were brief (mean duration of 10.4 seconds), there were prolonged central apneas lasting as long as 20.9 seconds. Due to oxygen desaturations to the 70’s and 80’s following central apneas, oxygen supplementation in sleep was continued. Conclusion Multiple features of Jacobsen syndrome (e.g. hypotonia, craniofacial and skeletal abnormalities) increase risk for obstructive and central sleep apnea. We present a girl with Jacobsen syndrome demonstrating both obstructive and central sleep apnea from infancy into toddlerhood. This report highlights the importance of screening for sleep disordered breathing in patients with Jacobsen syndrome, and the need for further research on sleep disturbances in this population. Support (if any)

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Defabjanis, Patrizia. « Impact of nasal airway obstruction on dentofacial development and sleep disturbances in children : preliminary notes ». Journal of Clinical Pediatric Dentistry 27, n^o 2 (1 janvier 2004) : 95–100. http://dx.doi.org/10.17796/jcpd.27.2.27934221l1846711.

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Respiratory disorders in the upper respiratory tract during sleep are most often part of a continuous pathological process of long standing. Schematically, three clinical syndromes with increasing severity are described: breathing with the mouth open, snoring and sleep apneal hypopnea syndrome. Obstructive sleep apnea syndrome (OSAS) is a subtle, but severe sleep disorder of early childhood. It is often difficult to detect and may have long-term consequences, including failure to thrive, behavioral disturbances, developmental delay, and cor pulmonale.1 These conditions always include a functional maxillofacial perturbation, which may be associated with a constitutional or acquired morphological disorder. Pediatric dentists must be aware of the problems connected with mouth breathing and OSAS (obstructive sleep apnea syndrome) in children as any delay in diagnosis and treatment may cause prolonged morbidity. They also have a role in the diagnosis and co-management of these patients because the signs and symptoms may be recognizable in the dental practice. Besides the medical approach itself, the treatment sometimes is surgical, always orthopedic: the earlier it is initiated, the more effective, simple and unrestraining it is. The aim of this work is to focus attention on the early diagnosis and prevention of these pathologies. Diagnostic guidelines will be illustrated.

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Evers, Stefan, Birke Barth, Achim Frese, Ingo-W. Husstedt et Svenja Happe. « Sleep apnea in patients with cluster headache : A case-control study ». Cephalalgia 34, n^o 10 (14 juillet 2014) : 828–32. http://dx.doi.org/10.1177/0333102414544038.

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Objective Polysomnographic investigations have shown an unspecific association between cluster headache and obstructive sleep apnea syndrome. The aim of this study was to investigate this association in a cluster episode compared with a symptom free interval, and to further characterize this association. Methods We investigated 42 patients with episodic ( n = 26) or chronic ( n = 16) cluster headache by means of polygraphic screening for sleep apnea and compared the data to 28 healthy control subjects matched according to age, sex, and BMI. The patients with episodic cluster headache were screened twice, once in a cluster episode and once in a symptom free interval. Results Patients with active cluster headache showed a significantly higher respiratory distress index (8.6 ± 16.0) compared with healthy control subjects (3.4 ± 2.1; p = 0.002). More patients fulfilled the criteria for an obstructive sleep apnea syndrome (29%) than control subjects (7%; p = 0.018). Patients only, but not the control subjects, had central apneas. These differences were only significant when measured during an active cluster episode but not during a symptom free interval. Conclusion Cluster headache is associated with a sleep apnea syndrome only in the active cluster episode. The increased rate of central apneas might be a result of involvement of the hypothalamus in the pathophysiology of cluster headache. Out of five anecdotal cases treated with nasal continuous positive airway pressure, only one patient showed benefit with respect to cluster headache attack frequency.

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Csiszer Iren, Csiszer Iren, Solyom Arpad, Solyom Reka et Neagos Adriana. « The Metabolic Syndrome and its Correlations with the Obstructive Sleep Apnea Syndrome ». Indian Journal of Applied Research 3, n^o 8 (1 octobre 2011) : 50–52. http://dx.doi.org/10.15373/2249555x/aug2013/179.

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