Showing papers on "Polysomnography published in 1981"

Surgical Correction of Anatomic Abnormalities in Obstructive Sleep Apnea Syndrome: Uvulopalatopharyngoplasty:

Abstract: Excessive daytime sleepiness and loud snoring are the major symptoms of obstructive sleep apnea, often leading to serious medical complications if unrecognized and untreated. Tracheostomy has been the only effective treatment in most adult cases. This paper reports on a new surgical approach to treat obstructive sleep apnea by uvulopalatopharyngoplasty designed to enlarge the potential airspace in the oropharynx. Twelve patients underwent this operation. In nine there was relief of symptoms and in eight there was objective improvement in nocturnal respiration and sleep pattern, demonstrated by polysomnography.

Sleep Habits and Sleep Disturbances in Industrial Workers in Israel: Main Findings and Some Characteristics of Workers Complaining of Excessive Daytime Sleepiness

Abstract: Detailed data about sleep habits, sleep complaints, life style, work, past and present health were obtained from 1,502 industrial workers. In agreement with previous studies, one-third of the workers reported having problems with sleep. A relatively large percentage of workers complained of excessive daytime somnolence (EDS), which was unrelated to sex, age, education, and area of origin. Compared to the total population, workers complaining EDS had signficantly more pre- and postsleep complaints, midsleep disturbing phenomena, and work accidents, and they were less satisfied with their work. They also had a significantly higher prevalence of asthma, high blood pressure, headaches, and arthritis and ulcers, and they consumed significantly more medications. Based on the cluster of pre- and postsleep complaints of workers complaining of EDS, and on preliminary results from the second phase of this project (which includes laboratory polysomnographic recordings), it is suggested that in most cases, various forms of breathing disorders in sleep are responsible for EDS.

Disorders of excessive daytime somnolence: polygraphic and clinical data for 100 patients.

Abstract: A consecutive series of 100 sleep apnea free patients with the complaint of excessive daytime somnolence (EDS) were evaluated; data from medical histories, physical examination, personality inventories, and polysomnography [nocturnal polysomnography (NPSG) and daytime multiple sleep latency testing (MSLT)] were tabulated. Significant differences were found between narcoleptic and non-narcoleptic patients in a number of parameters, including EDS severity, mean sleep latency on MSLT, sleep latency on NPSG, latency to REM sleep at night, number of REM sleep at night, number of REM sleep segments throughout the night, the total number of nocturnal myoclonic jerks (as well as the number occurring per hour of NREM and REM sleep), and the number of arousals and wake periods preceded by a myoclonic jerk. Significant differences in sleep latency during MSLT and NPSG testing were found between different EDS diagnostic groups of non-narcoleptic patients. The majority of patients in the MSLT group with long sleep latencies were in the diagnostic groups of EDS associated with psychophysiological and/or psychiatric problems or with drug abuse; patients with a diagnosis of idiopathic central nervous system hypersomnia or EDS associated with disturbed nocturnal sleep formed the majority of the MSLT group with short sleep latencies. The non-narcoleptic patients in a MSLT group with short sleep latencies had significantly shorter sleep latencies at night, more sleep cycles, higher sleep efficiency, and earlier REM sleep than patients with long sleep latencies.

Diurnal Rhythm of Plasma Immunoreactive β-Endorphin and Its Relationship to Sleep Stages and Plasma Rhythms of Cortisol and Prolactin*

Abstract: To determine the diurnal rhythm of plasma beta-endorphin (beta-End), 10 healthy male volunteers between the ages of 20 and 32 yr were studied in a sleep laboratory setting for a 24-h period. Blood samples were taken through an indwelling catheter at 0800, 1000, 1400, 1800, 2200, 2300, and 2400 h and then half-hourly until 0730 h, and they were then assayed for total beta-End-like immunoreactivity (ir beta-End), PRL, and cortisol. Subjects were habituated by spending the night before the study in the sleep laboratory with an indwelling catheter and electrodes for sleep recording in place. There was a clear diurnal variation of ir beta-End, with lowest levels between 2200 and 0330 h and highest levels between 0400 and 1000 h. There was no evidence for direct entrainment with sleep stage. There was a close correlation with cortisol levels, suggesting a similar secretory pattern for beta-End and PRL in only 5 of the subjects. Because the beta-End antiserum used has a cross-reactivity of 30% with beta-lipotropin gel permeation chromatography was done on extracts of plasma taken at 1400, 2400, 0400, and 0730 h for each subject. The peak in the beta-End elution position showed a clear diurnal variation similar to that of ir beta-End.

Comparisons of home sleep recordings and polysomnograms in older adults with sleep disorders.

Abstract: A major problem with studying the prevalence of sleep disorders is the high cost. We tested a portable home recording system which can decrease the cost of screening sleep recordings. Twenty-four senior volunteers and 12 patients referred to our sleep disorders clinic were studied for two nights. On one night, recordings were done in the laboratory with a traditional polysomnogram and the portable home recorder. On another night, portable home recorders were used in the subjects' homes. Of 36 subjects, 42% had sleep apnea and 39% had nocturnal myoclonus. Intermethod correlations were highly significant for sleep apnea index, nocturnal myoclonus index, total sleep period (TSP), total sleep time (TST), and wake time after sleep onset (WASO). The portable home recorder detected sleep apnea on 100% of nights during which sleep apnea was diagnosed by polysomnogram. The labor-saving and cost-saving benefits of home recordings as well as the increased comfort, privacy, and convenience will make the portable home recording the preferred method for many research and clinical applications.

Age, sleep and irregular workhours: A field study with electroencephalographic recordings, catecholamine excretion and self-ratings.

Abstract: Day sleep (after night work) and night sleep (after day work) were studied in two groups of locomotive engineers aged 25-35 and 50-60 a, respectively. All recordings were made in the homes of the subjects. For both groups day sleep was reduced by approximately 3.3 h, mainly affecting rapid eye movement sleep and stage 2 sleep. Diuresis and the excretion of noradrenaline were increased during day sleep. The ratings of sleepiness were higher after night work than after day work. Several indices of disturbed daytime sleep correlated significantly with catecholamine excretion. The age groups differed mainly in that the older subjects had relatively more stage shifts, awakenings, stage 1 sleep, a higher diuresis, and a higher noradrenaline excretion during day sleep. It was concluded that night work is detrimental to sleep and that negative effects are exacerbated by increasing age.

Differentiating psychological characteristics of patients with sleep apnea and narcolepsy.

Abstract: Fifty male subjects were group-matched for age and socioeconomic status. Twenty of the subjects were diagnosed as having sleep apnea and 20 were diagnosed as having narcolepsy on the basis of sleep studies. The remaining 10 subjects served as normal controls. Differences among the groups were evaluated on the bases of two psychological instruments designed to assess personality characteristics and mood states. The findings suggest that narcoleptics and apneics both present discriminatively different psychological profiles than do normals. Moreover, personality characteristics of these two groups are distinguishable from one another. Apneics tend to be individuals with hypochondriacal and hysterical characteristics, whereas narcoleptics are more easily characterized by anxiety and social introversion. Both severity of psychological disturbance (mean Minnesota Multiphasic Personality Inventory elevations) and personality pattern (two-point codes) distinguish the groups. Key Words: Sleep apnea-Narcolepsy-Psychological profiles.

Evaluation and diagnosis of persistent insomnia.

Abstract: The authors placed 84 patients who complained of insomnia into 10 diagnostic categories on the basis of medical, psychiatric, and polysomnographic evaluations. Only half the patients had objectively defined difficulty inducing or maintaining sleep when compared with 20 normal control subjects. However, all but 16 patients showed polysomnographic evidence of some sleep disorder. Diagnostic categories within the insomnia groups could be distinguished from one another by polysomnography. Patients in only 3 of the 10 diagnostic categories showed evidence of psychological distress on the MMPI; patients in the other 7 categories displayed few psychological symptoms. These results have implications for the treatment of insomnia.

Hypersomnia associated with alveolar hypoventilation in myotonic dystrophy

Abstract: Myotonic dystrophy was recently discovered in a 38-year-old man complaining of excessive daytime sleep for 18 years Pulmonary function tests showed alveolar hypoventilation resulting from defective central respiratory control Polysomnography revealed a low sleep apneic index insufficient to account for the hypersomnia Sleep cycles were normal, without REM excess or REM onset A similar membrane abnormality in muscle and brainstem neurons could account for the myotonia, hypersomnia, and alveolar hypoventilation

Polysomnography: Some Difficult Questions

Abstract: Excerpt Syndromes associated with hypersomnia and sleep apnea are well established (1). Breathing may cease during light sleep and rapid-eye-movement sleep because of upper airway obstruction, cent...