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1/13. 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.
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ranking = 1
keywords = airway
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2/13. Hypersomnia with periodic breathing (an acromegalic Pickwickian).

    The syndromes of Pickwickian, Ondine's curse, and primary alveolar hypoventilation are respiratory disorders manifesting increased sleepiness and irregular respiratory rhythms. These disorders are currently grouped as hypersomnia with periodic breathing (HPB). Polygraphic techniques have lead to a reasonable hypothesis as to the pathophysiology of the multiple variants of HPB. Discernible causes of HPB have been attributed to both central and peripheral factors. Peripheral factors encompass those conditions relating to upper airway obstruction. An acromegalic person suffering the HPB syndrome secondary to laryngeal stenosis is described.
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ranking = 14.757995771139
keywords = airway obstruction, airway, obstruction
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3/13. The effect of mandibular osteotomy in three patients with hypersomnia sleep apnea.

    Hypersomnia sleep apnea (HSA) is characterized by apneic episodes during sleep and daytime hypersomnolence. patients afflicted as a result of upper airway obstruction have been treated traditionally with permanent tracheostomy. Three patients with HSA and mandibular retrognathism are presented. Each patient had a retrognathic mandible that stemmed from a different cause. Surgical advancement of their underdeveloped mandibles corrected the symptoms of HSA rapidly. The literature concerning HSA is reviewed and the advantages of mandibular surgery in selected cases are discussed.
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ranking = 14.757995771139
keywords = airway obstruction, airway, obstruction
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4/13. slit ventricle syndrome presenting with paroxysmal hypersomnia in an adult: case report.

    The slit ventricle syndrome (SVS), defined as intermittent shunt malfunction without substantial ventricular enlargement, is usually observed in shunted children with small, slitlike ventricles. This syndrome has been attributed to recurrent obstruction of the ventricular catheter, which then causes an increase of intracranial pressure. Only rarely has the SVS been reported in adults. We describe a 29-year-old woman whose shunt malfunction presented with long-lasting paroxysmal hypersomnia and was diagnosed with computed tomographic evidence of small lateral ventricles. This episodic hypersomnia presented every 2 to 3 weeks and each episode lasted 1 to 2 weeks. After revision of the ventricular catheter, her symptoms stopped and she remained well.
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ranking = 0.30988375466158
keywords = obstruction
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5/13. Breathing during sleep immediately after uvulopalatopharyngoplasty.

    Uvulopalatopharyngoplasty (UPPP) has been acclaimed in the treatment of obstructive sleep apnea (OSA). Evaluation of the effect of UPPP has usually been done 6 to 8 weeks postoperatively. Recently, a patient died suddenly at home of unknown causes 48 hours following UPPP. autopsy evaluation demonstrated no evidence of hemorrhage, aspiration, or airway edema; however, it caused us to reassess our postoperative program. Three obese patients (192%, 162% and 157% of ideal body weight) with OSA underwent polysomnography on the second postoperative night. The mean duration of the postoperative apneas was not significantly different; however, the nadir SaO2 during apnea in one patient was significantly lower postoperatively. Those individuals with awake hypercapnia nad hypoxemia who had significant sleep associated hemoglobin unsaturation preoperatively may be at greatest risk. These observations indicate that careful postoperative monitoring is warranted in this group of patients.
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ranking = 0.5
keywords = airway
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6/13. retrognathia and sleep apnea. A life-threatening condition masquerading as narcolepsy.

    The association of sleep apnea with daytime hypersomnolence without obesity, and its potentially lethal cardiopulmonary sequelae, make it crucial that this condition be distinguished from narcolepsy. A patient with retrognathia who had been diagnosed as a narcoleptic for 15 years had the primary complaint of excessive daytime sleepiness. Sleep laboratory evaluation showed severe hypoxemia and a mean of 366 upper airway obstructions per night. The patient was treated with a tracheotomy; this resulted in relief of the sleep-related upper airway obstructions, hypoxemia, and hypersomnolence.
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ranking = 29.515991542277
keywords = airway obstruction, airway, obstruction
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7/13. Hypersomnolence and intermittent upper airway obstruction. Occurrence caused by micrognathia.

    A patient with hypersomnolence, micrognathia, and respiratory insufficiency had been treated eight years for narcolepsy. Sleep apnea because of upper airway obstruction was found, and a tracheostomy was performed. Following this the hypersomnolence and respiratory insufficiency resolved. This case emphasizes the importance of carefully evaluating the condition of patients complaining of hypersomnolence to detect those with intermittent upper airway obstruction occurring during sleep.
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ranking = 88.547974626832
keywords = airway obstruction, airway, obstruction
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8/13. Hypersomnia and periodic breathing. Report of a case and review of the literature.

    A patient with hypersomnia and periodic breathing has been studied. Both airflow obstruction and an abnormally of the respiratory control mechanism were implicated in the pathogenesis of the ventilatory arrhythmia. It is suggested that the older terms "Pickwick" syndrome and primary alveolar hypoventilation are abandoned for more descriptive terms, e.g. "hypersomnia with periodic breathing".
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ranking = 0.30988375466158
keywords = obstruction
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9/13. Sleep apnea syndrome--an alternative treatment to tracheostomy.

    Two patients with obstructive sleep apnea syndrome had polygraphic recordings demonstrated upper airway obstruction and sleep with extremely short sleep latency, severely disturbed nightsleep resulting in sleep deprivation, and excessive daytime sleepiness. Radiological investigation showed the upper airway obstruction to be caused by the tongue falling back occluding the pharynx. Nasopharyngeal intubation relieved the symptoms. The patients were trained to perform this treatment themselves every night, demonstrating that this treatment is an attractive alternative to the conventional tracheotomy.
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ranking = 15.5678795258
keywords = airway obstruction, airway, obstruction
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10/13. The "chubby puffer" syndrome. Upper airway obstruction and obesity, with intermittent somnolence and cardiorespiratory embarrassment.

    Upper airway obstruction and obesity can produce cardiopulmonary distress in susceptible children. Three such children with chronic airway obstruction due to hypertrophied tonsillar and adenoidal tissue developed pronounced obesity, which in turn helped to provoke sleep alterations, cardiac signs, and abnormal arterial blood gas values. After tonsillectomy and adenoidectomy the symptoms were relieved.
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ranking = 88.547974626832
keywords = airway obstruction, airway, obstruction
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