OBJECTIVE: To study the clinical features of sleep-disordered breathing (SDB) in children with neuromuscular disease (NMD). METHODS: A retrospective analysis was performed on the medical data of 18 children who were diagnosed with NMD and underwent polysomnography (PSG) (NMD group). Eleven children without NMD who had abnormal sleeping habit and normal sleep structure on PSG were enrolled as the control group. The two groups were compared in terms of the daily and nocturnal symptoms of SDB, incidence rate of obstructive sleep apnea (OSA), pulmonary function, end-tidal partial pressure of carbon dioxide (PetCO RESULTS: In the NMD group, 16 children (89%) had related daily and nocturnal symptoms of SDB, and the youngest age was 1 year at the onset of such symptoms. Compared with the control group, the NMD group had significant reductions in total sleep time and sleep efficiency ( CONCLUSIONS There is a high proportion of children with SDB among the children with NMD, and SDB can be observed in the early stage of NMD, which results in the damage of sleep structure and the reduction in sleep efficiency. Respiratory events are mainly obstructive events, and oxygen reduction events are mainly observed during REM sleep.
Child ; Humans ; Neuromuscular Diseases/complications* ; Polysomnography ; Retrospective Studies ; Sleep ; Sleep Apnea Syndromes/etiology*

Humans ; Child ; Sleep Apnea Syndromes/complications* ; Medulla Oblongata/pathology* ; Neoplasms/complications*

Humans ; Palate, Soft ; surgery ; Postoperative Complications ; prevention & control ; Sleep Apnea Syndromes ; surgery ; Uvula ; surgery

OBJECTIVETo investigate the risk factors contributing to the development of obstructive sleep apnea hypopnea syndrome (OSAHS) and sleep hypopnea (SH) in patients with growth hormone-secreting pituitary adenoma (GHPA).

METHODSA total of 85 patients with GHPA recruited strictly according to the inclusion and exclusion criteria underwent sleep monitoring overnight. Clinical manifestations, laboratory data and magnet resonance images were collected for analysis of the risk factors of GHPA and SH using binary logistic regression analysis.

RESULTSThe prevalence rate of OSAHS was 62.4% (53/85), and that of SH was 75.3% (64/85) in the recruited patients with GHPA. Regression analysis showed that age (OR=1.107) and BMI (OR=1.166) were the risk factors for OSAHS, and BMI (OR=1.334) was the risk factor of SH.

CONCLUSIONAgeing and an increased BMI are independent risk factors for OSAHS and SH in patients with GHPA. Preoperative sleep monitoring should be routinely conducted to ensure early diagnosis of OSAHS and SH, and patients with GHPA should be advised to control their body weight to lower the mortality associated with the respiratory system.

Age Factors ; Body Mass Index ; Growth Hormone-Secreting Pituitary Adenoma ; complications ; Humans ; Polysomnography ; Prevalence ; Risk Factors ; Sleep ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

OBJECTIVEThe investigate the prevalence of sleep-disordered breathing (SDB) and evaluate its impact on left ventricular remodeling in adult patients with chronic heart failure (CHF).

METHODSAmbulatory sleep recording for 8 h was performed using Embletta PDS (Medcare, Iceland) in 74 patients with CHF, and the left ventricular ejection fraction (LVEF), internal end-diastolic diameter (LVIDd) and left ventricular mass weight (LVMW) were measured using M-mode and two-dimensional echocardiography.

RESULTSThe incidence of SDB defined as an apnea-hypopnea index (AHI, namely the number of apnea-hypopnea events per hour during sleep) no less than 10 was 62.16% in these CHF patients (77.78% in male and 37.93% in female patients). Of the 74 patients 31.1% had mainly obstructive sleep apnea (OSA) and 17.6% had central sleep apnea (CSA). There was a moderate inverse correlation between LVEF and AHI (P=0.004, r=-0.366). LVIDd in patients with CHF and SDB was significantly greater than that in patients with isolated CHF (46.67+/-7.29 vs 55.70+/-11.87 mm, P=0.001). The left ventricular myocardial weight was also greater in patients with CHF and SDB than in patients with isolated CHF (208.58+/-64.19 vs 291.03+/-121.54, P=0.001).

CONCLUSIONOur results suggest a higher prevalence of SDB in patients with CHF than in general population, and the prevalence is even higher in patients with severe CHF in relation to left ventricular remodeling. SDB contributes to the progression of CHF and further cardiac decline by a vicious cycle.

Adult ; Aged ; China ; epidemiology ; Echocardiography ; Female ; Heart Failure ; complications ; physiopathology ; Humans ; Male ; Middle Aged ; Polysomnography ; Prevalence ; Sleep Apnea Syndromes ; complications ; epidemiology ; Sleep Apnea, Central ; complications ; epidemiology ; Sleep Apnea, Obstructive ; complications ; epidemiology ; Ventricular Remodeling ; physiology

Airway Obstruction ; complications ; surgery ; Continuous Positive Airway Pressure ; Humans ; Infant ; Male ; Sleep Apnea Syndromes ; etiology ; therapy ; Sleep Apnea, Obstructive ; etiology ; therapy ; Treatment Outcome

During the past two decades tremendous efforts have been made by the medical community, especially in the fields of forensic medicine and pediatrics, to better understand the etiology, epidemiology and pathophysiology of SIDS. There have been many SIDS reports from developed countries, but few from developing Asian countries. Despite a recent significant decrease in the incidence of SIDS in many developed countries, SIDS continues to be the most common cause of post-neonatal infant death in these countries. This article analyzes the SIDS data (1990-2006) from the Office of the Chief Medical Examiner for the State of Maryland, USA, along with review of the literature with regard to the history, epidemiological and pathophysiological characteristics of SIDS, as well as the recent advances in SIDS research. The changing trends in the diagnosis of SIDS and current challenges to its forensic investigation are also discussed.
Arrhythmias, Cardiac/complications* ; Forensic Medicine ; Humans ; Infant ; Risk Factors ; Sleep Apnea Syndromes/complications* ; Sudden Infant Death/etiology* ; United States/epidemiology*

INTRODUCTIONSleep problems are a prominent feature in children with attention deficit hyperactivity disorder (ADHD). Unlike existing studies that focused on extreme samples (i.e. normal vs. ADHD), our study investigated the associations of sleep-related behaviours and ADHD features in nonclinical Chinese preschoolers.

METHODSAll participants were recruited via advertisements and screened for eligibility through a telephone interview prior to an onsite visit. The maternal reports of the Conners' Parent Rating Scale (CPRS) and Pediatric Sleep Questionnaire (PSQ) were acquired from 110 Chinese preschoolers aged six years. Regression models were used to examine the association between CPRS and PSQ scores.

RESULTSThe results obtained from regression models on the CPRS and PSQ scores of the 110 participants showed that none of the sleep-related behavioural measures (i.e. sleep-related breathing disorder [SRBD], snoring, daytime sleepiness, restless legs syndrome) was associated with inattention in our sample. However, worse SRBD was associated with higher hyperactivity.

CONCLUSIONOur study underpins the importance of understanding the relationship between sleep-related behaviours and ADHD characteristics before the usual age of clinical diagnosis in children with ADHD.

Attention Deficit Disorder with Hyperactivity ; complications ; Child ; Child, Preschool ; China ; Humans ; Male ; Regression Analysis ; Severity of Illness Index ; Sleep ; Sleep Apnea Syndromes ; complications ; Snoring ; Surveys and Questionnaires

This study was attempted to observe the rate of oxygen desaturation after full oxygenation in six parturients scheduled for Cesarean sections and six patients scheduled for transabdominal hysterectomies. We calculated the mean rate of fall of arterial saturation (slope of desaturation: less than SaO2 (t2)-SaO2(t1) greater than/t2-t1) and changes in arterial blood gases were observed. All subjects were denitrogenated then a single isolated apnea was carried out. The mean time to obtain 90% saturation was longer in the nonpregnant group (7.5 min vs 3.6 min in parturients). The mean slope of desaturation was steeper in the parturients (-3.34) than the nonpregnant group (-1.52). As far as the oxygen reserve is concerned, the parturients had a lesser margin of safety than the nonpregnant women. It was concluded that the lower the thoracic gas volume (parturients), the lower the alveolar O2 stores and, the more rapidly these stores are depleted.
Adult ; Arteries ; Blood ; Blood Gas Analysis ; Female ; Humans ; Obstetric Labor Complications/*blood ; Oxygen/*blood ; Pregnancy ; Sleep Apnea Syndromes/*blood

BACKGROUND AND OBJECTIVES: Laser-assisted uvulopalatoplasty (LAUP) and laser uvulopalatopharyngoplasty (Laser-UPPP) are well established and highly successful operation in the treatment of snoring and obstructive sleep apnea (OSA). But, most reports are based on short-term follow-up results. This study was performed to evaluate the patient's satisfaction rate after long-term postoperative follow-up, and to investigate prognostic factors of good surgical outcome, time of recurrence, and sequelae. MATERIALS AND METHOD: 102 patients were operated by LAUP (n=77) and Laser-UPPP (n=25) between Jul,1993 and Dec,1996. These patients were followed up more than 2 years (mean 3.1 years). The degree of snoring and apnea related symptoms were evaluated using questionnaires preoperatively and postoperatively. RESULTS: In 95 (93%) of 102 patients, symptoms were satisfationally reduced in 6 months of surgery. After 2 years the success rate dropped to 68% (70 of 102 patients. In the dissatisfied group 32 patients, most failures occurred between 6 and 12 months after surgery. Prognostic factors of good surgical outcomes were lower preoperative body mass index value, absence of postoperative weight gain, and combined nasal surgery. There was no major postoperative complication, but temporary sequalae ocurred as nasal regurgitation (8.8%), hypernasality (5.9%), pharyngeal foreign body sensation (13.7%), postoperative bleeding (6.9%), and long-lasting pain over 3 weeks (12.7%). CONCLUSION: Long-term follow-up more than 18 months is mandatory to evaluate postoperative results of LAUP and Laser-UPPP. To achieve good postoperative outcomes in the treatment of snoring or OSA, perioperative weight reduction should be recommended, and nasal surgery should be considered in patients with nasal obstruction.
Apnea ; Body Mass Index ; Follow-Up Studies ; Foreign Bodies ; Hemorrhage ; Humans ; Nasal Obstruction ; Nasal Surgical Procedures ; Postoperative Complications ; Surveys and Questionnaires ; Recurrence ; Sensation ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Snoring* ; Weight Gain ; Weight Loss