Apnea sleep

Small-conductance (SKCa) Sleep apnea Dequalinium, Tubocurarine,... 

Antiemetics and antivertigo drag s are used cautiously in patients with glaucoma or obstructive disease of the gastrointestinal or genitourinary system, those with renal or hepatic dysfunction, and in older men with possible prostatic hypertrophy. Piromethazine is used cautiously in patients with hypertension, sleep apnea, or epilepsy. Trimethobenzamide is used cautiously in children with a viral illness because it may increase the risk of Reye s syndrome... 

Scrima L, Hartman PG, Johnson EH, et al The effects of gamma-hydroxybutyrate on the sleep of narcolepsy patients a double blind study. Sleep 13 479 90, 1990 Series F, Series 1, Cormier Y Effects of enhancing slow-wave sleep by gamma-hydroxybutyrate on obstructive sleep apnea. Am Rev Respir Dis 143 1378-1383, 1992 Shannon M Methylenedioxymethamphetamine (MDMA, ecstasy ). Pediatr Emerg Care 16 377-380, 2000... 

An MRL of 0.1 ppm was derived for intermediate inhalation exposure (15-364 days) to trichloroethylene. This MRL was based on a study by Arito et al. (1994a) in which male JCL-Wistar rats were exposed to 0, 50, 100, or 300 ppm trichloroethylene for 6 weeks, 5 days/week, 8 hours/day. A LOAEL of 50 ppm was observed for decreased wakefulness during exposure, and decreased postexposure heart rate and slow wave sleep. Another study with rats found an increase in sleep-apneic episodes and cardiac arrhythmias after exposure to trichloroethylene (Arito et al. 1993). These results corroborate similar effects observed in humans exposed to trichloroethylene, as described in the previous paragraph, as well as evidence of organic solvent-induced sleep apnea in humans (Edling et al. 1993 Monstad et al. 1987, 1992 Wise et al. 1983). 

Wise MG, Fisher JG, de la Pena AM. 1983. Trichloroethane (TCE) and central sleep apnea a case study. 

Effects noted in study and corresponding doses Decreased post-exposure heart rate and slow wave sleep were observed at 50 ppm (less serious LOAEL). Decreased wakefiilness was observed during the exposures. Disturbed heart rates and sleep patterns (sleep apnea) have been seen in human exposures to organic solvents as well. 

Systemic lupus erythematosus Scleroderma Sleep apnea Drugs ... 

Side effects associated with benzodiazepines in PD patients are similar to those observed in other disorders. Sedation, fatigue, and cognitive impairment are the most commonly reported side effects.49 Benzodiazepines should be avoided in patients with current substance abuse, a history of such, dependence, or sleep apnea. Additionally, caution should be used in older adults because they have more pronounced psychomotor and cognitive effects. 

Describe the mechanisms of the sleep disorders covered in this chapter, including insomnia, narcolepsy, restless-legs syndrome, obstructive sleep apnea, and parasomnias. 

The main therapy for obstructive sleep apnea is nasal continuous positive airway pressure (CPAP) therapy because of its effectiveness. 

Obstructive sleep apnea (OSA) is a common disorder that is often unrecognized, affecting 4% of middle-aged white men and 2% of middle-aged white women.15 In women, the frequency of OSA increases after menopause. OSA is as common or more common in African Americans and less common in Asian... 

Poor sleep architecture and fragmented sleep secondary to OSA can cause excessive daytime sleepiness (EDS) and neu-rocognitive deficits. These sequelae can affect quality of life and work performance and may be linked to occupational and motor vehicle accidents. OSA is also associated with systemic disease such as hypertension, heart failure, and stroke.21-23 OSA is likely an independent risk factor for the development of hypertension.24 Further, when hypertension is present, it is often resistant to antihypertensive therapy. Fatal and non-fatal cardiovascular events are two- to threefold higher in male patients with severe OSA.25 OSA is associated with or aggravates biomarkers for cardiovascular disease, including C-reactive protein and leptin.26,27 Patients with sleep apnea often are obese and maybe predisposed to weight gain. Hence, obesity may further contribute to cardiovascular disease in this patient population. 

FIGURE 38-1. Primary assessment and initial treatment for complaint of excessive daytime sleepiness. RLS, restless-legs syndrome NPSG, nocturnal polysomnography OSA, obstructive sleep apnea DA, dopamine agonist MSLT, multiple sleep latency test BZDRA, benzodiazepine receptor agonist SNRI, serotonin and norepinephrine reuptake inhibitor TCA, tricyclic antidepressant CPAP, continuous positive airway pressure. 

CH returns to the clinic 3 months later. The physician previously diagnosed him with obstructive sleep apnea and RLS. He received a prescription for CPAP, for OSA and ropinirole 0.5 mg at bedtime for RLS at his last visit. Via phone calls, his ropinirole dose has been increased to 3 mg at bedtime. He has received moderate relief of his RLS symptoms, but on occasion, he still awakens and cannot fall back asleep. His sleepiness and RLS symptoms are improved ESS 13/24. 

OSA obstructive sleep apnea Hening WA, Allen RP, Earley CJ, et al. Restless Legs Syndrome Task... 

Morgenthaler TI, Kapen S, Lee-Chiong T, et al. Practice parameters for the medical therapy of obstructive sleep apnea. Sleep 2006 29 1031-1035. 

Respiratory disorders and sleep apnea occur in up to 60% of patients. 

Routinely assess acromegaly complications, including blood pressure, glucose tolerance, fasting lipid profile, cardiac evaluations (if clinically indicated), colonoscopy, dual-energy x-ray absorptiometry (DEXA) scan (hypogonadal only), evaluation of residual pituitary function, and evaluation of sleep apnea. 

The etiology of enuresis is poorly understood, but there is a clear genetic link. The incidence in children from families in whom there are no members with enuresis, where one parent had enuresis as a child, and where both parents had enuresis as children are 14%, 44%, and 77%, respectively. Loci for enuresis have been located on chromosomes 12,13, and 22. Sleep disorders are not considered major contributors with the exception of sleep apnea. Enuresis occurs in all sleep stages in proportion to the time spent in each stage. However, a small proportion of individuals are not aroused from sleep by bladder distention and have uninhibited bladder contractions preceding enuresis. 

Obstructive sleep apnea Potentially Treatable by Drugs... 

Sleep apnea The temporary cessation of breathing during sleep can be caused by airway narrowing as a result of soft tissue swelling. 

---