1/10. narcolepsy and other non-SAS hypersomnia in sleep breathing disorders clinic.Four of the 708 snorers (0.56%), referred to our sleep breathing disorders clinic for the past 2 years were diagnosed as having narcolepsy-cataplexy. Detecting HLA DRB1*1501/DQB1*0602 positive was informative for differentiating genuine narcolepsy from non-sleep apnea syndrome (non-SAS) hypersomnia in our clinic. A non-SAS obese boy, diagnosed as having essential hypersomnia syndrome, was found to be HLA DRB1*1502/DQB1*0601 positive. His hypocretin concentration was 206 pg/mL in the cerebrospinal fluid.- - - - - - - - - - ranking = 1keywords = hypersomnia (Clic here for more details about this article) |
2/10. Marked episodic elevation of cerebrospinal fluid pressure during nocturnal sleep in patients with sleep apnea hypersomnia syndrome.The CSF pressure was measured continuously at the lumbar level during nocturnal sleep in 3 patients with sleep apnea hypersomnia syndrome. Nocturnal sleep was very unstable with frequent episodes of obstructive sleep apnea. When the patients were awake and relaxed in the supine position, their CSF pressure was stable and within the normal range. Episodic marked elevations of CSF pressure occurred frequently during sleep, and each elevation was preceded and accompanied by an episode of sleep apnea or hypopnea. Significant correlations were found between the duration of apneic episodes and increase of CSF pressure, and between decrease of SaO2 or TcPO2 and increase of CSF pressure. The duration of sleep apnea was longer, increase of CSF pressure was greater, and decreases of SaO2 and TcPO2 were more marked during REM sleep than during NREM sleep. It is suggested that the frequent marked episodic elevations of CSF pressure are caused by an increase in the intracranial vascular volume occurring mainly in response to transient hypercapnia and hypoxia, which are induced by pulmonary hypoventilation during the episodes of sleep apnea.- - - - - - - - - - ranking = 0.83333333333333keywords = hypersomnia (Clic here for more details about this article) |
3/10. Evaluation of the sleepy crewmember: USAFSAM experience and a suggested clinical approach.From 1958 to 1986, 27 crewmembers with suspected sleep disorders were referred to the USAF School of aerospace medicine. The presenting complaint in most cases was excessive daytime sleepiness (EDS). Prior to 1984, evaluations included neurologic and psychiatric testing, screening laboratory studies, and awake and asleep electroencephalography. polysomnography and sleep latency studies were included after 1984. In the majority of cases, the etiology of the complaint could not be determined. The prevalence of EDS is estimated to be between 0.3% and 4.0% of the adult population. Major causes cited in the world literature include the sleep apnea syndromes, narcolepsy, parasomnias interrupting sleep, hypersomnia secondary to systemic or affective disorders, and essential hypersomnia. Current sleep lab techniques and human leukocyte antigen (HLA) typing are reported to make the diagnosis in up to 90% of sleep disorders. Evaluation of EDS should begin with a history emphasizing sleep habits, work schedules, daytime naps, and presence of vegetative signs. A sleep diary will allow a more accurate estimate of the quantity of nocturnal sleep. This diary may reveal poor sleep hygiene or insomnia. polysomnography and/or multiple sleep latency determination can then be used to diagnose sleep apnea, parasomnias, and narcolepsy.- - - - - - - - - - ranking = 0.33333333333333keywords = hypersomnia (Clic here for more details about this article) |
4/10. 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.- - - - - - - - - - ranking = 0.66666666666667keywords = hypersomnia (Clic here for more details about this article) |
5/10. Severe adult hypersomnia--sleep apnea syndrome in craniofacial dysostosis.polysomnography and blood gas measurements during sleep in a young man with craniofacial dysostosis, who presented with an extremely severe sleep apnea syndrome, are reported. tracheostomy relieved all his complaints permanently, namely hypersomnia, deteriorated intellectual performance, automatic behaviour with hypnagogic hallucinations and snoring. Laboratory results also returned to normal. The polygraphic data of night sleep (and daytime naps) before and after surgery suggest that hypersomnia was primarily caused by severe nighttime oxygen desaturations and that the hypnagogic hallucinations were caused by apnea-induced chronic REM sleep deprivation. Furthermore, the periodic variation of central respiratory drive, which was also abolished after surgery, is interpreted as the cause of apnea-induced fluctuations between sleep stages in this case.- - - - - - - - - - ranking = 1keywords = hypersomnia (Clic here for more details about this article) |
6/10. Micrognathia, obstructive sleep apnoea and cor pulmonale--a case for tracheostomy.A patient with congenital micrognathia, hypersomnia and severe pulmonary hypertension which resulted in sudden death during sleep is described. Hypersomnolence is a well-recognized manifestation of the pickwickian syndrome. A less recognized but similar disorder may affect patients with congenital or acquired micrognathia. The pathogenesis of this syndrome and obstructive sleep apnoea are reviewed. tracheostomy timeously performed may be life-saving and the value of early resort to this apparently drastic procedure in a high-risk patient is emphasized.- - - - - - - - - - ranking = 0.16666666666667keywords = hypersomnia (Clic here for more details about this article) |
7/10. Sleep apnea precipitated by pharyngeal surgery in a patient with myotonic dystrophy.A patient was seen for evaluation of excessive daytime sleepiness, which was exacerbated following complications secondary to surgical reconstruction of the pharynx for a submucous cleft palate. She underwent recordings in the sleep laboratory and was found to have sleep apnea. Also, a thorough clinical and laboratory assessment established the diagnosis of myotonic dystrophy. Following tracheostomy, both the patient's sleep apnea and daytime hypersomnia were eliminated. Our case demonstrates that surgical procedures involving the upper airway should be approached with considerable caution in patients with myotonic dystrophy and only after the presence of associated sleep apnea has been carefully excluded. An original finding is the suggestion of a decrease in the number of T-cell lymphocytes in a patient with myotonic dystrophy.- - - - - - - - - - ranking = 0.16666666666667keywords = hypersomnia (Clic here for more details about this article) |
8/10. Therapeutic effects of tracheostomy in two cases of hypersomnia with respiratory disturbance during sleep.Recently the association of hypersomnia and respiratory insufficiency without lesion in the respiratory organ has attracted attention of many investigators. Obese patients with such a condition have been called the Pickwickian syndrome. In this report, two non-obese patients with a similar condition were presented, one with micrognathia and frequent apneic episodes during sleep, and the other with laryngeal stenosis due to paralysis of the bilateral laryngeal nerves and chronic laryngitis. tracheostomy had a prompt and long-lasting therapeutic effect to make their sleep stable and also to relieve their excessive daytime sleepiness. These findings suggest that the obstruction or stenosis of the upper airway during sleep disturbed their nocturnal sleep, and that their excessive daytime sleepiness was a phenomenon compensating for their disturbed nocturnal sleep.- - - - - - - - - - ranking = 0.83333333333333keywords = hypersomnia (Clic here for more details about this article) |
9/10. Central sleep apnoea syndrome with upper airway collapse.We report on an 83 yr old man with hypersomnia and central sleep apnoea (CSA). He had several possible causes for CSA, including a central nervous system lesion, hypocapnia and anatomical narrowing of the airway at the hypopharyngeal level. We postulate that reduced central respiratory drive occurring in conjunction with upper airway narrowing may have led to central apnoeas. These in turn could have facilitated a complete passive hypopharyngeal collapse at the end of each apnoea, as visualized by somnofluoroscopy. The CSA could also have been favoured by respiratory instability due to chronic hypocapnia.- - - - - - - - - - ranking = 0.16666666666667keywords = hypersomnia (Clic here for more details about this article) |
10/10. Nocturnal arterial oxygen desaturation secondary to a sphenoidal meningioma.We report the case of a nonobese and nonsmoking 51-year-old man with nocturnal arterial oxygen desaturation that returned to normal after sphenoidal meningioma resection. He presented an important daytime hypersomnia and episodes of nocturnal apnea, without snoring. His arterial blood gases, mechanical properties of the respiratory system pulmonary diffusing capacity and chemosensitivity were normal. The most frequent causes of nocturnal hypoxemia are examined.- - - - - - - - - - ranking = 0.16666666666667keywords = hypersomnia (Clic here for more details about this article) |
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