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4 results

  • Association between multimorbidity and undiagnosed obstructive sleep apnea severity and their impact on quality of life in men over 40 years old

  • G. Ruel, S. A. Martin, J.-F. Lévesque, G. A. Wittert, R. J. Adams, S. L. Appleton, Z. Shi, A. W. Taylor
  • Journal:
    Global Health, Epidemiology and Genomics / Volume 3 / 2018
    Published online by Cambridge University Press:
    04 June 2018, e10
    • Article
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  • Background.

    Multimorbidity is common but little is known about its relationship with obstructive sleep apnea (OSA).

    Methods.

    Men Androgen Inflammation Lifestyle Environment and Stress Study participants underwent polysomnography. Chronic diseases (CDs) were determined by biomedical measurement (diabetes, dyslipidaemia, hypertension, obesity), or self-report (depression, asthma, cardiovascular disease, arthritis). Associations between CD count, multimorbidity, apnea-hyponea index (AHI) and OSA severity and quality-of-life (QoL; mental & physical component scores), were determined using multinomial regression analyses, after adjustment for age.

    Results.

    Of the 743 men participating in the study, overall 58% had multimorbidity (2+ CDs), and 52% had OSA (11% severe). About 70% of those with multimorbidity had undiagnosed OSA. Multimorbidity was associated with AHI and undiagnosed OSA. Elevated CD count was associated with higher AHI value and increased OSA severity.

    Conclusion.

    We demonstrate an independent association between the presence of OSA and multimorbidity in this representative sample of community-based men. This effect was strongest in men with moderate to severe OSA and three or more CDs, and appeared to produce a greater reduction in QoL when both conditions were present together.

  • Chapter 35 - Posterior cerebral artery

  • from Section 2 - Vascular topographic syndromes
  • Edited by Louis R. Caplan, Jan van Gijn
  • Book:
    Stroke Syndromes, 3ed
    Published online:
    05 August 2012
    Print publication:
    12 July 2012, pp 405-418

  • Summary

    The study of respiratory dysfunction following a cerebrovascular event may permit localization of the neuroanatomical lesion. In addition, some respiratory dysfunctions are related to the etiology and the prognosis of stroke. This chapter reviews current knowledge regarding these associations. Unilateral hemispheric ischemic strokes appear to affect respiratory function to a modest degree. In contrast to cerebral hemispheric involvement, brainstem strokes may induce a more typical respiratory pattern, allowing more precise correlation between structure and function. Patients with severe obstructive sleep apnea (OSA) syndrome may develop ischemic stroke more frequently, as OSA syndrome with an apnea-hypopnea index (AHI) >30 was associated with stroke in an elderly population. The adverse effects of central hyperventilation may be related to arterial vasoconstriction induced by hypocapnia, leading to decrease in cerebral blood flow but also inducing impairment in cerebral autoregulation and cerebral arterial compliance.

  • Case 35 - Repetitive arm movements

  • from Part VII - Sleep-related movement disorders
  • Edited by Antonio Culebras
  • Book:
    Case Studies in Sleep Neurology
    Published online:
    10 November 2010
    Print publication:
    23 September 2010, pp 248-254

  • Summary

    This chapter presents the case of a 24-year-old woman who presented with 5-year history of hallucinations during night, occurring three to four times a week. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. The polysomnography (PSG) study has revealed sleep latency of 11 minutes and REM sleep latency of 99 minutes. Sleep efficiency was 81% with normal distribution of sleep stages. Her apnea-hypopnea index (AHI) was 3 per hour and periodic limb movement (PLM) index was 4 per hour. The patient is awake from stage N2 sleep at 2.05am without any obvious precipitating cause. She describes seeing a woman standing by her bed. The EEG showed an alpha rhythm commencing immediately on waking and persisting for several minutes, and a review of the EEG recorded over the rest of the night showed no potentially epileptogenic activity.

  • Case 9 - Extreme dreams

  • from Part IV - Parasomnias
  • Edited by Antonio Culebras
  • Book:
    Case Studies in Sleep Neurology
    Published online:
    10 November 2010
    Print publication:
    23 September 2010, pp 59-66

  • Summary

    This chapter presents the clinical history, examination, and the results of the procedures performed on a patient who was a 14-year-old young woman who, according to her parents, has had problems sleeping for several years. The results of the studies showed that the patient had a total of 144 sleep-related respiratory events, with an apnea-hypopnea index (AHI) of 22.47 per hour. There were 140 central apneas and four hypopneas, with 126 events occurring in NREM sleep. The diagnosis was Chiari 1 malformation with associated central sleep apnea. The patient also had a syrinx from C3 through the thoracic cord. Treatment of Chiari 1 malformation involves suboccipital decompression (posterior fossa craniectomy), with or without upper cervical laminectomy. In this case too, the patient underwent suboccipital decompression, and remained in the hospital for 4 days, with some immediate post-operative sleep-related apneas but subsequent significant improvement of sleep.