Strategies to increase effective management in patients presenting for gynecologic surgery are needed. [ncbi.nlm.nih.gov]

• Fatigue

  However, the effect on fatigue as major complaint in chronic fatigue patients without excessive daytime sleepiness, is not fully understood nor explored. [ncbi.nlm.nih.gov]

  RSIA requires a railroad to consider the need to include in its fatigue management plan “opportunities for identification, diagnosis, and treatment of any medical condition that may affect alertness or fatigue, including sleep disorders.” ( Id. at section [federalregister.gov]

  However, it is important to acknowledge the difference between daytime sleepiness and fatigue. [docsopinion.com]

  “We strongly believe that DOT should immediately reconsider the decision in order to help avoid future fatigue-related tragedies,” the letter states. [safetyandhealthmagazine.com]

  Complications may include: Daytime fatigue and sleepiness. The repeated awakenings associated with obstructive sleep apnea make normal, restorative sleep impossible. [mayoclinic.org]

• Surgical Procedure

  Twenty-three patients (35.4%) underwent at least one additional surgical procedure after T&A; 5 (7.7%) patients had ≥ two additional procedures. [ncbi.nlm.nih.gov]

  Surgery may be a good alternative for some patients, but it’s important to keep in mind that no surgical procedure is universally successful. [myoms.org]

• Congestive Heart Failure

  Pregnant women with a diagnosis of obstructive sleep apnea at delivery were at significantly increased risk of having cardiomyopathy, congestive heart failure, pulmonary embolism, and in-hospital death. [ncbi.nlm.nih.gov]

  Heart disorders. People with irregular heartbeats (atrial fibrillation) or whose heart muscles don't pump enough blood for the body's needs (congestive heart failure) are at greater risk of central sleep apnea. [mayoclinic.org]

  Recommendations are as follows: 1) A diagnosis of OSAS must be established by an acceptable method. 2) APAP titration and APAP treatment are not currently recommended for patients with congestive heart failure, significant lung disease (e.g., chronic [doi.org]

• Weight Gain

  We report a patient with anti-muscle kinase receptor MG with severe OSA and hypoventilation that resolved upon successful treatment of MG despite a 60-lb weight gain. [ncbi.nlm.nih.gov]

  This may be due to allergies and seasonal weight gain (many people get heavier in the winter). [tuck.com]

  […] loss or poor weight gain) Excessive daytime sleepiness [stanfordhealthcare.org]

  Symptoms of OSA include: Odd positions during sleep with head propped up or off the bed Loud and continuous snoring Weight loss or poor weight gain Stopping breathing at night for a short period − followed by snorting and gasping or completely waking [cincinnatichildrens.org]

• Swelling

  This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or tonsillitis that temporarily produces very enlarged tonsils. [sciencedaily.com]

  Cigarette smoking worsens swelling in the upper airway, making apnea (and snoring) worse. Some patients with mild sleep apnea or heavy snoring have fewer breathing problems when they are lying on their sides instead of their backs. [sleepfoundation.org]

  […] reading, or watching TV Feel sleepy while driving or even fall asleep while driving Have hard-to-treat headaches Other problems that may occur include: Depression Hyperactive behavior, especially in children Difficult to treat high blood pressure Leg swelling [nlm.nih.gov]

  Symptoms may also be the result of a respiratory infection, congestion, throat swelling, etc. Obstructive Sleep Apnea (OSA) Symptoms Infographic Causes of Obstructive Sleep Apnea In children, enlarged tonsils or adenoids most often cause OSA. [sleepassociation.org]

• Sleep Apnea

  The cardinal symptoms of sleep apnea include the "3 S ’s": S noring, S leepiness, and S ignificant-other report of sleep apnea episodes. [emedicine.medscape.com]

  Obstructive Sleep Apnea in Children Menu What is obstructive sleep apnea? Obstructive sleep apnea (OSA) is a condition in which there are brief pauses in your child's breathing pattern during sleep. [my.clevelandclinic.org]

  Obstructive sleep apnea Other names Obstructive sleep apnoea Obstructive sleep apnea: As soft tissue falls to the back of the throat, it impedes the passage of air (blue arrows) through the trachea. [en.wikipedia.org]

• Snoring

  Eligibility: (1) Patients: controls, snoring or OSA patients (2) Intervention: neuromuscular evaluation of the palate and/or uvula (3) Comparison: differences between controls, snoring and OSA patients (4) Outcomes: neuromuscular outcomes (5) Study design [ncbi.nlm.nih.gov]

  Snoring Snoring is a common feature of OSA. However, although 80 to 90 percent of people with OSA report snoring, many people who snore don’t have OSA. [docsopinion.com]

  Generally all people with obstructive sleep apnoea snore. 2 But not all people who snore have sleep apnoea (see "Snoring alone is not a good predictor"). [bpac.org.nz]

  Be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence. [mayoclinic.org]

  Some scientific evidence suggests that snoring for years at a time can lead to the development of lesions in the throat, just as the vibrations from snoring can lead to nerve or neuron lesions all around the body. [sleepassociation.org]

• Loud Snoring

  SDB can range from frequent loud snoring to Obstructive Sleep Apnea (OSA) a condition involving repeated episodes of partial or complete blockage of the airway during sleep. [bmc.org]

  Be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence. [mayoclinic.org]

  Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though. [nlm.nih.gov]

  OSA related symptoms included loud snoring, apneas, awakenings with gasping breaths, enuresis, and daytime sleepiness. [ncbi.nlm.nih.gov]

• Nasal Congestion

  Chronic nasal congestion. Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways. Smoking. [mayoclinic.org]

  General measures in treating obstructive sleep apnea include losing excessive weight, avoiding alcohol and sedatives, sleeping on one side, and medications to relieve nasal congestion. [medicinenet.com]

  Have a deviated septum or other nasal congestion issues. Prognosis Prognosis for those who have sleep apnea is positive. [baptisthealth.com]

• Nausea

  Patients may also be reluctant to use CPAP, because of discomfort, nausea or pain [ 77 ]. With better control of post-operative pain and nausea/vomiting, it may improve the compliance with CPAP among OSA patients [ 71 ]. [err.ersjournals.com]

  Gamm Learn More in these related Britannica articles: human nervous system: Vestibulocochlear nerve (CN VIII or 8) …in eye movement disorders (nystagmus), unsteady gait with a tendency to fall toward the side of the lesion, nausea, and vertigo. [britannica.com]

  If it is more persistent, nystagmus may contribute to dizziness or nausea, and also vision problems, as the person affected is unable to hold a steady gaze. Combined with balance issues, nystagmus can contribute to falls. [mstrust.org.uk]

  Domperidone (normally used to suppress vomiting and nausea) and decongestants pseudoephedrine or phenylephrine may help open airways to reduce sleep apnea symptoms. [tuck.com]

  Because of the motion of the eyes, people with this condition can develop nausea and vertigo. This type of nystagmus, usually temporary, also can occur in people with Meniere's disease (an inner ear disorder) or when water settles into one ear. [allaboutvision.com]

• Vomiting

  Moreover, there is no significant risk of post-operative nausea and vomiting with the use of post-operative CPAP [ 78 ]. [err.ersjournals.com]

  Domperidone (normally used to suppress vomiting and nausea) and decongestants pseudoephedrine or phenylephrine may help open airways to reduce sleep apnea symptoms. [tuck.com]

  Another important characteristic that usually makes difference between acquired and benign forms is that acquired nystagmus is usually combined with other neurological signs like nausea, vomiting, headache, vertigo or tinnitus. [intechopen.com]

  Ask about dizziness and loss of balance, nausea and vomiting. Related systemic symptoms - particularly with regard to the nervous system - are highly relevant. Use of prescribed or non-prescribed drugs is important, particularly anticonvulsants. [patient.info]

  Because of the involvement of the vestibular system, patients often present with symptoms of inner ear disease such as vertigo, nausea, vomiting, oscillopsia, tinnitus, and sometimes even hearing loss. [eyewiki.aao.org]

• Mouth Breathing

  Subjective assessments of clinical symptoms/signs, including snoring visual analog scale (VAS), nasal obstruction, and mouth breathing, were recorded. [ncbi.nlm.nih.gov]

  Loud or noisy breathing, snoring, or mouth breathing during sleep Brief pauses in breathing during sleep or difficulty breathing during sleep Restless sleep (i.e., lots of tossing and turning) Sweating heavily during sleep Bedwetting Sleeping in odd positions [my.clevelandclinic.org]

  Common symptoms of obstructive sleep apnea in children may include: Snoring Daytime cognitive and behavior problems, including problems paying attention, easy distractibility, aggressive behavior and hyperactivity Mouth breathing Enlarged tonsils and [stanfordhealthcare.org]

  Symptoms of Obstructive Sleep Apnea (OSA) are: snoring, restless/disturbed sleep, frequent partial or total wakenings and daytime mouth breathing. [ds-health.com]

• Hypertension

  Hypertension Systemic hypertension is observed in 50-70% of patients with OSA. [emedicine.medscape.com]

  Odds ratios for apnoea-hypopnoea index, body mass index, sex, age, and hypertension Fig 1. [doi.org]

  Any diabetes-related complications (retinopathy, neuropathy, nephropathy, or coronary artery disease) were present in 55.5%, and 70.2% of the participants had hypertension. [ncbi.nlm.nih.gov]

• Heart Failure

  It has been associated with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure. [ncbi.nlm.nih.gov]

  Congestive heart failure itself may contribute to the development of OSA. Patients with congestive heart failure are predisposed to periodic breathing. [doi.org]

  A 2007 follow-up study showed regression of these abnormalities after nasal CPAP. [97] Congestive heart failure OSA has not been established as a cause of heart failure, and whether it hastens death in patients with heart failure is uncertain. [emedicine.medscape.com]

• Heart Disease

  Over the next four to five years, they were followed to see how many had any heart disease events (heart attack, coronary angiography or bypass surgery) or died. [web.archive.org]

  It has been associated with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure. [ncbi.nlm.nih.gov]

  "He's the child I always knew he could be," said Claire. read more>> Sleep Apnea and Heart Disease The connection between sleep apnea and heart disease is evolving very rapidly. [sleepfoundation.org]

  The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems. OSA affects approximately 20 million Americans. [holyname.org]

• Tachycardia

  The combination of hypoxaemia and partial arousal with each apnoea or hypopnoea is accompanied by a surge of adrenergic activity with consequent tachycardia and transient systemic hypertension. [academic.oup.com]

  Activation of the sympathetic nervous system, by both hypoxia and arousal, may induce tachycardia and peripheral vasoconstriction, further increasing ventricular afterload (67). [onlinejacc.org]

  Heart rates often change during apneic episodes, with relative bradycardia occurring during airway obstruction followed by tachycardia during arousals. Specific cranio-facial and oropharyngeal features also predispose a person to develop OSA. [todaysgeriatricmedicine.com]

  Cardiovascular Disease in Obstructive Sleep Apnea • Vagal stimulation causes bradycardia • Bradycardia and hypoxia provoke serious cardiac rhythm disturbances i.e. premature beats asystole, ventricular tachycardia, cardiac arrest. 26. [slideshare.net]

  […] suggested an increased risk for coronary artery disease/myocardial ischemia, 13, 14 cerebrovascular accidents, 15, 16 and cardiomyopathy. 15, 17 Brady- and tachyarrhythmias may occur with increased frequency in patients with SDB, 18, 19 and ventricular tachycardia [clinical.diabetesjournals.org]

• Sweating

  Loud or noisy breathing, snoring, or mouth breathing during sleep Brief pauses in breathing during sleep or difficulty breathing during sleep Restless sleep (i.e., lots of tossing and turning) Sweating heavily during sleep Bedwetting Sleeping in odd positions [my.clevelandclinic.org]

  Night Sweats In the context of the difficulty regulating the body's temperature in hyperthyroidism, night sweats may occur more frequently and these may be disruptive to sleep. Menopause is commonly associated with night sweats. [verywell.com]

  Other sleep symptoms may include restless sleep, sweating at night, and observed apnea. Children may have nocturnal enuresis. [merckmanuals.com]

• Fear

  Though many people have this fear, most are able to fall asleep in the sleep lab. A full face CPAP mask is always preferred over a nasal mask. Not necessarily. [sleepapnea.com]

  These include the case of a pregnant woman who is nursing a child and her milk ceases to flow due to her pregnancy, and whose husband, who fears losing his child, does not have the means to afford a wet nurse. [dar-alifta.org]

  Sleep apnea following a pharyngeal flap: a feared complication. Plast Reconstr Surg. 1994 ; 93: 943 – 947. Google Scholar | Medline | ISI Stratoudakis, A.C. Bambace, C. Sphincter pharyngoplasty for correction of velopharyngeal incompetence. [doi.org]

  But as for he who came to you striving (for knowledge) while he fears (Allah), from him you are distracted.” (Qur’an, 80: 1-10) “There is not upon the blind any guilt or upon the lame any guilt or upon the ill any guilt [for remaining behind]. [aboutislam.net]

  After phentermine was banned in the UK following the fears regarding heart damage, the only two weight-loss drugs that were available included Orlistat and methylcellulose. ★ ★ ★ ★ ★ Nies ħasbu I ma setgħux jagħmlu dan imma I mitlufa 44 £ fi 3 xhur tqabbil [fckfat.com]

• Mood Swings

  “We're talking about car accidents in the daytime, lost productivity at work, mood swings, waking up feeling groggy and falling asleep in class.” [hopkinsmedicine.org]

  People with obstructive sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia). [mayoclinic.org]

  They include: breathing stopping and starting making gasping, snorting or choking noises waking up a lot loud snoring During the day, you may also: feel very tired find it hard to concentrate have mood swings have a headache when you wake up Information [nhs.uk]

  These include: Excess sweating Heat intolerance Warm skin Excessive hunger Weight loss Mood swings Panic attack Irritability Hyperactivity Restlessness Nervousness Abnormal heart rhythm Fast heart rate Palpitations Fatigue Insomnia Irregular menstruation [verywell.com]

• Headache

  A 36-year-old active duty male with migraine headaches presented for evaluation of poorly controlled hypertension. [ncbi.nlm.nih.gov]

  There is a strong association between OSA and headache. In particular, there is a “sleep apnea headache” described as a recurrent morning headache, with resolution after effective treatment of sleep apnea. [link.springer.com]

  […] odd positions (e.g. neck hyperextended) Inattentiveness and lack of focus at school Excessive daytime sleepiness (e.g., child regularly falls asleep in school) Poor academic performance Irritable mood, aggressiveness, other behavioral problems Morning headaches [my.clevelandclinic.org]

  If left untreated, OSA can cause daytime sleepiness, poor sleep quality, high blood pressure, increased blood sugar levels (as in diabetes), heart disease, cerebrovascular disease, depression, memory problems, sexual difficulties, weight gain and headaches [hospitals.jefferson.edu]

• Irritability

  OSA can cause children to be tired, irritable or hyperactive during the day and to perform below their potential at school. [childrenshospital.org]

  Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness may be due to other disorders, such as narcolepsy. [mayoclinic.org]

  […] and turning) Sweating heavily during sleep Bedwetting Sleeping in odd positions (e.g. neck hyperextended) Inattentiveness and lack of focus at school Excessive daytime sleepiness (e.g., child regularly falls asleep in school) Poor academic performance Irritable [my.clevelandclinic.org]

  Irritability/personality change. Nocturia. Decreased libido. Symptoms such as personality change, episodes of apnoea, irritability and restlessness at night may be better elicited by taking a history from a partner. [patient.info]

  The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely. [mayoclinic.com]

• Morning Headache

  headaches Cleveland Clinic News & More Cleveland Clinic News & More [my.clevelandclinic.org]

  A 64-year-old woman was referred to the department of otolaryngology because of daytime sleepiness and morning headaches. The patient refused polysomnographic evaluation because of claustrophobia. [ncbi.nlm.nih.gov]

  Typical symptoms include snoring, not feeling refreshed on waking, day-time sleepiness, altered mood and morning headaches. [southerncross.co.nz]

  In many cases it leads to debilitating daytime sleepiness, morning headaches, depression, and a general sense of unwellness. [sleepapnea.org]

• Somnolence

  Neither patient exhibited daytime somnolence, although both were subsequently found to have severe obstructive sleep apnea. [ncbi.nlm.nih.gov]

• Sleep Disturbance

  Daytime sleepiness (Epworth scale from 0 (no daytime sleepiness) to 24), sleep quality (Pittsburgh quality of sleep index from 0 (excellent sleep quality) to 21), partner rating of sleep disturbance (visual analogue scale from 0 (not disturbed) to 10) [ncbi.nlm.nih.gov]

  In addition, the partners of participants in the didgeridoo group were much less disturbed in their sleep. [doi.org]

  The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems. OSA affects approximately 20 million Americans. [holyname.org]

• Sexual Dysfunction

  There are many sexual dysfunctions in men that seem to be linked such as erectile dysfunction (ED), low dyadic, and solitary sexual desire, which share many risk factors. [transbiomedicine.com]

  dysfunction Headaches People with central sleep apnea more often report recurrent awakenings or insomnia, although they may also experience a choking or gasping sensation upon awakening. [my.clevelandclinic.org]

  Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling [sleepfoundation.org]

  These include: Sensitivity to cold Constipation Dry skin Brittle nails Hair loss Unexplained weight gain High cholesterol Irritability Sexual dysfunction Slow heart rate Irregular uterine bleeding It is important to note that not all of these symptoms [verywell.com]

Side effects of prolonged tongue-lip adhesion and optimal workup and treatment of persistent OSA in the setting of a tongue-lip adhesion. Pierre Robin sequence (PRS), persistent obstructive sleep apnea (OSA), and tongue-lip adhesion (TLA). [ncbi.nlm.nih.gov]

Workup • An overnight sleep study,or polysomnography: In-laboratory measurement of sleep architecture and electroencephalographic (EEG) arousals, eye movements, chin movements, airflow, respiratory effort, oximetry, electrocardiographic (ECG) tracings [slideshare.net]

It is necessary for this kind of nystagmus to perform a complete neurological and endocrinological workup. [intechopen.com]

• Hypercapnia

  Six months later, severe hypoxemia without hypercapnia was noted. Contrast transthoracic echocardiography showed right-to-left shunt through a patent foramen ovale. [ncbi.nlm.nih.gov]

  Neural responses to hypoxia and hypercapnia have not been well studied in children with obstructive sleep apnea and underlying syndromes. [emedicine.com]

  References: [5] [3] Pathophysiology Obstruction of the upper airways → apnea → ↓ partial pressure of oxygen in arterial blood ( PaO 2 ), ↑ partial pressure of carbon dioxide in arterial blood ( PaCO 2, also known as hypercapnia ) → ↑ Hypoxic pulmonary [amboss.com]

  The respiratory pauses may induce hypercapnia or hypoxia. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur. [icd9data.com]

  This is called “hypercapnia.” Adults with OSA often have fragmented sleep. They tend to wake up briefly after their breathing stops. Children with OSA often do not wake up in response to pauses in breathing. [sleepeducation.org]

Treatment of OSA usually improves well-being and reduces the risk of associated disorders. However, many people with OSA don’t receive treatment because they are not properly diagnosed. [docsopinion.com]

Patients should be encouraged to persevere with treatment for at least four weeks, as treatment acceptance often improves over time. [bpac.org.nz]

and for treatment of OSA should be low. [emedicine.medscape.com]

We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure. [ncbi.nlm.nih.gov]

Prognosis Prognosis for those who have sleep apnea is positive. There are treatments that can alleviate symptoms and lead to better sleep, including, dental appliances, therapies and CPAP machines. [baptisthealth.com]

For patients who respond to CPAP, the short-term prognosis is excellent. [patient.info]

KEYWORDS: Continuous positive airway pressure/methods; heart diseases/epidemiology/etiology; heart failure/complications/therapy; prevalence; risk factors; sleep apnea syndromes/classification/physiopathology; sleep apnea, obstructive/complications/prevention [ncbi.nlm.nih.gov]

Etiology Obstruction of the upper airways due to the collapse of the pharyngeal muscles during sleep Risk factors Obesity, especially around the neck (short, wide “ bull neck ”) Structural abnormalities that impair respiratory flow : tonsillar hyperplasia [amboss.com]

This finding suggests that the etiology of OSA in children may result from a complex interplay between adenotonsillar hypertrophy and loss of neuromuscular tone. [aafp.org]

The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults. Correspondence and requests for reprints should be addressed to Naresh M. [doi.org]

The prevalence of OSA has increased in epidemiological studies over time. [ncbi.nlm.nih.gov]

We believe that this case exemplifies the relevant pathophysiological interdependence between obesity, metabolic syndrome and OSAS. [ncbi.nlm.nih.gov]

The potential for some of the specific pathophysiological causes of OSA to drive some of the key symptoms and consequences of OSA is also highlighted. [dovepress.com]

A ‘Positioner’ preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. [doi.org]

KEYWORDS: Continuous positive airway pressure/methods; heart diseases/epidemiology/etiology; heart failure/complications/therapy; prevalence; risk factors; sleep apnea syndromes/classification/physiopathology; sleep apnea, obstructive/complications/prevention [ncbi.nlm.nih.gov]

CPAP machines increase air pressure in the throat to prevent sleep apnea's effect of closing off the upper airway and interrupting breathing. [hub.jhu.edu]