Sleep & breathing = Schlaf & Atmung
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The aims of the present study are to determine whether there is an obstructive sleep apnea (OSA) subgroup presenting with sawtooth sign on the spirometric flow-volume curve, and to identify the clinical importance of the sawtooth sign in these patients. ⋯ As an OSA subgroup, the OSA patients with sawtooth sign may have more frequent and longer duration of obstructive apneas, longer duration time of oxygen desaturation, and greater risk for the coronary artery disease.
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This study aims to use clinical scales in a standardized fashion in evaluating the frequency of a high and narrow hard palate and/or small and retroplaced mandible in children with polysomnographically demonstrated sleep-disordered breathing (SDB). ⋯ Non-obese children with SDB had different initial clinical complaints based on age. Independently of age, facial anatomic structures limiting nasal breathing and those considered to be risk factors for SDB were commonly seen in the total group. Clinical assessment of craniofacial features considered as risk factors for SDB and more particularly a Mallampati scale score of 3 or 4 can be useful in identifying children who may be more at risk for limited response to adenotonsillectomy, suggesting a subsequent need for post-surgery polysomnography.
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Comparative Study
Incidence of sleep bruxism among children in Itanhandu, Brazil.
Sleep bruxism (SB) in children may be related to headaches and causes extensive damage of primary teeth. This paper evaluates the incidence of SB in children from Itanhandu, MG, Brazil. ⋯ Restless behavior was positively correlated with SB, although no correlation was found between SB and medication or duration of breastfeeding.
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The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) is limited by poor compliance often related to pressure intolerance. Mandibular advancement devices (MADs) are proven alternative therapy although not universally effective. A combination of nasal CPAP and MAD may provide another option for CPAP-intolerant patients with incomplete response to MAD. ⋯ Combination therapy of MAD and nasal CPAP is effective in normalizing respiratory disturbances of sleep apnea in selected OSA patients who are intolerant to CPAP.
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Randomized Controlled Trial Multicenter Study Comparative Study
A 2-week, polysomnographic, safety study of sodium oxybate in obstructive sleep apnea syndrome.
Sodium oxybate (SXB) is approved for cataplexy and excessive daytime sleepiness in narcolepsy. Obstructive sleep apnea syndrome (OSAS) affects ∼9-50% of narcoleptics. Effects of 2-week SXB administration on apnea-hypopnea index (AHI), oxygen saturation (SaO(2)), and sleep architecture were investigated in OSAS patients. ⋯ Short-term use of 4.5 g/night SXB did not generate respiratory depressant effects in OSAS patients as measured by AHI, obstructive apnea events, central apneas, and SaO2. Extended use of SXB in higher therapeutic doses in OSAS has not been studied, and merits caution.