RESULTS: 80% of Marfan children presented an AHI>1 and a diagnosis of OSA. MG presented statistically significant lower values of palatal surface area (662.68 mm 2 ; P 3 ; P 2 and 3756.6 mm 3, respectively). [ncbi.nlm.nih.gov]

• Fatigue

  However, the effect on fatigue as major complaint in chronic fatigue patients without excessive daytime sleepiness, is not fully understood nor explored. [ncbi.nlm.nih.gov]

  RSIA requires a railroad to consider the need to include in its fatigue management plan “opportunities for identification, diagnosis, and treatment of any medical condition that may affect alertness or fatigue, including sleep disorders.” ( Id. at section [federalregister.gov]

  Complications may include: Daytime fatigue and sleepiness. The repeated awakenings associated with obstructive sleep apnea make normal, restorative sleep impossible. [mayoclinic.org]

  “We strongly believe that DOT should immediately reconsider the decision in order to help avoid future fatigue-related tragedies,” the letter states. [safetyandhealthmagazine.com]

• Weight Gain

  We report a patient with anti-muscle kinase receptor MG with severe OSA and hypoventilation that resolved upon successful treatment of MG despite a 60-lb weight gain. [ncbi.nlm.nih.gov]

  This may be due to allergies and seasonal weight gain (many people get heavier in the winter). [tuck.com]

  […] loss or poor weight gain) Excessive daytime sleepiness [stanfordhealthcare.org]

• Nocturnal Awakening

  These patients may complain of nocturnal awakenings with shortness of breath or air hunger, awakening headaches, and excessive sleepiness. [clinicaladvisor.com]

  Frequent nocturnal awakening in early life is associated with nonatopic asthma in children. Eur Respir J. 34, 1288–95 (2009). 19. Shen, T. C. et al. [nature.com]

  Patients often complain of snoring, Gasping or choking, frequent nocturnal awakenings, early morning headaches, poor concentration and coordination, anxiety, irritability, and insomnia, yet many patients are unaware of these symptoms and disease onset [intechopen.com]

• Coronary Atherosclerosis

  Association of obstructive sleep apnoea with subclinical coronary atherosclerosis. Atherosclerosis. 2013 ; 231 :191–197. doi: 10.1016/j.atherosclerosis.2013.09.011. Crossref Medline Google Scholar 7. [circ.ahajournals.org]

  Nocturnal oxygen desaturation correlates with the severity of coronary atherosclerosis in coronary artery disease. Chest 2003 ;124: 936 - 941 38. Becker HF, Jerrentrup A, Ploch T, et al. [doi.org]

• Myxedema

  Associated conditions include obesity; acromegaly; myxedema; micrognathia; myotonic dystrophy; adenotonsilar dystrophy; and neuromuscular diseases. [icd9data.com]

• Sleep Apnea

  Overview Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep. There are several types of sleep apnea, but the most common is obstructive sleep apnea. [mayoclinic.org]

  […] to obstuctive sleep apnea Acute respiratory failure from obstuctive sleep apnea Adult obstructive sleep apnea Complex sleep apnea Obstructive sleep apnea Obstructive sleep apnea of adult Obstructive sleep apnea of child Obstructive sleep apnea syndrome [icd9data.com]

  About one half of patients who have essential hypertension have obstructive sleep apnea, and about one half of patients who have obstructive sleep apnea have essential hypertension. [ncbi.nlm.nih.gov]

  Instead hypertension, obesity and age were associated with sleep apnea in females. It is, thus, possible that sleep apnea has not been observed as a public heath problem in females, as they have other signs of sleep apnea than males. [doi.org]

• Snoring

  Eligibility: (1) Patients: controls, snoring or OSA patients (2) Intervention: neuromuscular evaluation of the palate and/or uvula (3) Comparison: differences between controls, snoring and OSA patients (4) Outcomes: neuromuscular outcomes (5) Study design [ncbi.nlm.nih.gov]

  Snoring alone had no impact on mortality in any of the age groups ( Table 2 ). [doi.org]

  Be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence. [mayoclinic.org]

  Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though. [nlm.nih.gov]

• Loud Snoring

  SDB can range from frequent loud snoring to Obstructive Sleep Apnea (OSA) a condition involving repeated episodes of partial or complete blockage of the airway during sleep. [bmc.org]

  Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though. [nlm.nih.gov]

  OSA related symptoms included loud snoring, apneas, awakenings with gasping breaths, enuresis, and daytime sleepiness. [ncbi.nlm.nih.gov]

  Be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence. [mayoclinic.org]

• Nasal Congestion

  Chronic nasal congestion. Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways. Smoking. [mayoclinic.org]

  This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or tonsillitis that temporarily produces very enlarged tonsils. [sciencedaily.com]

  congestion – OSA occurs more often in people with nasal congestion, such as a deviated septum, where the tissue in the nose that divides the two nostrils is bent to one side, or nasal polyps, which may be a result of the airways being narrowed Treating [nhs.uk]

  Have a deviated septum or other nasal congestion issues. Prognosis Prognosis for those who have sleep apnea is positive. [baptisthealth.com]

• Mouth Breathing

  Subjective assessments of clinical symptoms/signs, including snoring visual analog scale (VAS), nasal obstruction, and mouth breathing, were recorded. [ncbi.nlm.nih.gov]

  Common symptoms of obstructive sleep apnea in children may include: Snoring Daytime cognitive and behavior problems, including problems paying attention, easy distractibility, aggressive behavior and hyperactivity Mouth breathing Enlarged tonsils and [stanfordhealthcare.org]

  Loud or noisy breathing, snoring, or mouth breathing during sleep Brief pauses in breathing during sleep or difficulty breathing during sleep Restless sleep (i.e., lots of tossing and turning) Sweating heavily during sleep Bedwetting Sleeping in odd positions [my.clevelandclinic.org]

  Obstructive sleep-disordered breathing is common in children. Snoring, mouth breathing, and obstructive sleep apnea (OSA) often prompt parents to seek medical attention for their children. [aafp.org]

• Hypertension

  We aimed to clarify the association between OSA and hypertension, including essential and medication-resistant hypertension. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. [ncbi.nlm.nih.gov]

  Odds ratios for apnoea-hypopnoea index, body mass index, sex, age, and hypertension Fig 1. [doi.org]

• Tachycardia

  The combination of hypoxaemia and partial arousal with each apnoea or hypopnoea is accompanied by a surge of adrenergic activity with consequent tachycardia and transient systemic hypertension. [academic.oup.com]

  Activation of the sympathetic nervous system, by both hypoxia and arousal, may induce tachycardia and peripheral vasoconstriction, further increasing ventricular afterload (67). [onlinejacc.org]

  Heart rates often change during apneic episodes, with relative bradycardia occurring during airway obstruction followed by tachycardia during arousals. Specific cranio-facial and oropharyngeal features also predispose a person to develop OSA. [todaysgeriatricmedicine.com]

  Cardiovascular Disease in Obstructive Sleep Apnea • Vagal stimulation causes bradycardia • Bradycardia and hypoxia provoke serious cardiac rhythm disturbances i.e. premature beats asystole, ventricular tachycardia, cardiac arrest. 26. [slideshare.net]

  […] suggested an increased risk for coronary artery disease/myocardial ischemia, 13, 14 cerebrovascular accidents, 15, 16 and cardiomyopathy. 15, 17 Brady- and tachyarrhythmias may occur with increased frequency in patients with SDB, 18, 19 and ventricular tachycardia [clinical.diabetesjournals.org]

• Mood Swings

  “We're talking about car accidents in the daytime, lost productivity at work, mood swings, waking up feeling groggy and falling asleep in class.” [hopkinsmedicine.org]

  People with obstructive sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia). [mayoclinic.org]

  They include: breathing stopping and starting making gasping, snorting or choking noises waking up a lot loud snoring During the day, you may also: feel very tired find it hard to concentrate have mood swings have a headache when you wake up Information [nhs.uk]

  These include: Excess sweating Heat intolerance Warm skin Excessive hunger Weight loss Mood swings Panic attack Irritability Hyperactivity Restlessness Nervousness Abnormal heart rhythm Fast heart rate Palpitations Fatigue Insomnia Irregular menstruation [verywell.com]

• Sexual Dysfunction

  There are many sexual dysfunctions in men that seem to be linked such as erectile dysfunction (ED), low dyadic, and solitary sexual desire, which share many risk factors. [transbiomedicine.com]

  dysfunction Headaches People with central sleep apnea more often report recurrent awakenings or insomnia, although they may also experience a choking or gasping sensation upon awakening. [my.clevelandclinic.org]

  Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling [sleepfoundation.org]

  These include: Sensitivity to cold Constipation Dry skin Brittle nails Hair loss Unexplained weight gain High cholesterol Irritability Sexual dysfunction Slow heart rate Irregular uterine bleeding It is important to note that not all of these symptoms [verywell.com]

• Headache

  A 36-year-old active duty male with migraine headaches presented for evaluation of poorly controlled hypertension. [ncbi.nlm.nih.gov]

  There is a strong association between OSA and headache. In particular, there is a “sleep apnea headache” described as a recurrent morning headache, with resolution after effective treatment of sleep apnea. [link.springer.com]

  If left untreated, OSA can cause daytime sleepiness, poor sleep quality, high blood pressure, increased blood sugar levels (as in diabetes), heart disease, cerebrovascular disease, depression, memory problems, sexual difficulties, weight gain and headaches [hospitals.jefferson.edu]

• Irritability

  Irritability/personality change. Nocturia. Decreased libido. Symptoms such as personality change, episodes of apnoea, irritability and restlessness at night may be better elicited by taking a history from a partner. [patient.info]

  Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness may be due to other disorders, such as narcolepsy. [mayoclinic.org]

  The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely. [mayoclinic.com]

  OSA can cause children to be tired, irritable or hyperactive during the day and to perform below their potential at school. [childrenshospital.org]

• Morning Headache

  A 64-year-old woman was referred to the department of otolaryngology because of daytime sleepiness and morning headaches. The patient refused polysomnographic evaluation because of claustrophobia. [ncbi.nlm.nih.gov]

  Symptoms include snoring and sometimes restless sleep, nocturnal sweating, and morning headache. Complications of OSA may include learning or behavioral disturbances, growth disturbance, cor pulmonale, and pulmonary hypertension. [merckmanuals.com]

  People with obstructive sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia). [mayoclinic.org]

• Somnolence

  Neither patient exhibited daytime somnolence, although both were subsequently found to have severe obstructive sleep apnea. [ncbi.nlm.nih.gov]

• Sleep Disturbance

  Daytime sleepiness (Epworth scale from 0 (no daytime sleepiness) to 24), sleep quality (Pittsburgh quality of sleep index from 0 (excellent sleep quality) to 21), partner rating of sleep disturbance (visual analogue scale from 0 (not disturbed) to 10) [ncbi.nlm.nih.gov]

  In addition, the partners of participants in the didgeridoo group were much less disturbed in their sleep. [doi.org]

  The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems. OSA affects approximately 20 million Americans. [holyname.org]

Side effects of prolonged tongue-lip adhesion and optimal workup and treatment of persistent OSA in the setting of a tongue-lip adhesion. Pierre Robin sequence (PRS), persistent obstructive sleep apnea (OSA), and tongue-lip adhesion (TLA). [ncbi.nlm.nih.gov]

Workup • An overnight sleep study,or polysomnography: In-laboratory measurement of sleep architecture and electroencephalographic (EEG) arousals, eye movements, chin movements, airflow, respiratory effort, oximetry, electrocardiographic (ECG) tracings [slideshare.net]

It is necessary for this kind of nystagmus to perform a complete neurological and endocrinological workup. [intechopen.com]

• Hypercapnia

  Six months later, severe hypoxemia without hypercapnia was noted. Contrast transthoracic echocardiography showed right-to-left shunt through a patent foramen ovale. [ncbi.nlm.nih.gov]

  References: [5] [3] Pathophysiology Obstruction of the upper airways → apnea → ↓ partial pressure of oxygen in arterial blood ( PaO 2 ), ↑ partial pressure of carbon dioxide in arterial blood ( PaCO 2, also known as hypercapnia ) → ↑ Hypoxic pulmonary [amboss.com]

  The respiratory pauses may induce hypercapnia or hypoxia. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. [icd9data.com]

  Neural responses to hypoxia and hypercapnia have not been well studied in children with obstructive sleep apnea and underlying syndromes. [emedicine.com]

  This is called “hypercapnia.” Adults with OSA often have fragmented sleep. They tend to wake up briefly after their breathing stops. Children with OSA often do not wake up in response to pauses in breathing. [sleepeducation.org]

Data obtained during APAP titration can be used to provide a fixed single pressure for subsequent treatment. Alternatively, APAP devices can be used in self-adjusting mode for treatment (APAP treatment). [ncbi.nlm.nih.gov]

If treatment effects or changes in SBP and DBP in each treatment group were not reported in studies, then the mean (standard deviation) values for each outcome, in each group, and at each visit were extracted and used to estimate treatment effects. [doi.org]

Controlled study of treatment schemes for RFA suggests additional improvement in outcomes with repeated treatments. [web.archive.org]

We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure. [ncbi.nlm.nih.gov]

Prognosis Prognosis for those who have sleep apnea is positive. There are treatments that can alleviate symptoms and lead to better sleep, including, dental appliances, therapies and CPAP machines. [baptisthealth.com]

For patients who respond to CPAP, the short-term prognosis is excellent. [patient.info]

KEYWORDS: Continuous positive airway pressure/methods; heart diseases/epidemiology/etiology; heart failure/complications/therapy; prevalence; risk factors; sleep apnea syndromes/classification/physiopathology; sleep apnea, obstructive/complications/prevention [ncbi.nlm.nih.gov]

Etiology Obstruction of the upper airways due to the collapse of the pharyngeal muscles during sleep Risk factors Obesity, especially around the neck (short, wide “ bull neck ”) Structural abnormalities that impair respiratory flow : tonsillar hyperplasia [amboss.com]

This finding suggests that the etiology of OSA in children may result from a complex interplay between adenotonsillar hypertrophy and loss of neuromuscular tone. [aafp.org]

The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults. Correspondence and requests for reprints should be addressed to Naresh M. [doi.org]

The prevalence of OSA has increased in epidemiological studies over time. [ncbi.nlm.nih.gov]

We believe that this case exemplifies the relevant pathophysiological interdependence between obesity, metabolic syndrome and OSAS. [ncbi.nlm.nih.gov]

The potential for some of the specific pathophysiological causes of OSA to drive some of the key symptoms and consequences of OSA is also highlighted. [dovepress.com]

Includes pathophysiology, risk factors, diagnosis, and treatment. [youtube.com]

Mandibular DO using skeletal anchorage with intermaxillary elastics is useful for preventing extrusion of the upper and lower anterior teeth, thereby preventing rotation of the mandible. [ncbi.nlm.nih.gov]

"The findings of our small study present an interesting theory on preventative measures or treatment in sleep apnoea,” Silas Daniel Raj, author of the study, said in a statement. [web.archive.org]

A ‘Positioner’ preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. [doi.org]