Disease relevance of Apnea

• Thyroxine replacement therapy decreases apnea frequency, even without change in body weight [1].
• Six of the eight patients who were available for follow-up studies had persistent sleep apnea despite an euthyroid status (apnea index before thyroxine, 51 +/- 6; apnea index after thyroxine, 45 +/- 8), and CPAP therapy was continued in these patients [2].
• Indications for intubation included coma (74.6%), shock (28.6%), apnea (22.2%), and airway obstruction (3.2%) [3].
• Effects of cilazapril on hypertension, sleep, and apnea [4].
• The indications for surgery in these infants with gastroesophageal reflux were: (A) failure to thrive, (35); (B) chronic respiratory infection, (24); (C) apnea spells, (8); and (D) esophagitis [5].

Psychiatry related information on Apnea

• Main parameters analyzed through the CPAP titration procedure were respiratory events (apnea, hypopnea), the contour of inspiratory flow, the pleural pressure behavior, the thoraco-abdominal motion, oximetry, arousals, and sleep stage [6].
• Rapid eye movement sleep, apnea, and cardiac slowing influenced by phenobarbital administration in the neonate [7].
• The authors sought to determine whether unconsciousness and amnesia occur when humans develop rigidity and apnea after intravenous fentanyl (without other concomitant anesthetics) [8].
• The aim of this study was to assess the activity of the peripheral chemoreceptors in relation to sleep stages in premature neonates treated (or not) with caffeine for idiopathic apnea [9].
• However, oxygen did not reduce apneas or improve daytime hypersomnolence as well as nasal CPAP in patients with mild OSA [10].

High impact information on Apnea

• KIF1B knockout mice die at birth from apnea due to nervous system defects [11].
• CONCLUSIONS: In patients with stable heart failure, oral theophylline therapy reduced the number of episodes of apnea and hypopnea and the duration of arterial oxyhemoglobin desaturation during sleep [12].
• Some practices are contradictory to the Guidelines for the Determination of Brain Death in Children and to recommendations for apnea testing [13].
• We characterize a subgroup of patients who benefit from medroxyprogesterone therapy by reducing obstructive apneas during sleep [14].
• Apnea after intravenous diazepam [15].

Chemical compound and disease context of Apnea

• Exposure of the infected rats to ammonia exacerbated the infections, further increased the number of Monastral blue-labeled vessels and the amount of labeling per vessel, and made the rats so sensitive to capsaicin that a normally tolerable dose of 150 micrograms/kg i.v. caused fatal apnea [16].
• Attention is called to other drugs that directly or indirectly (by lowering serum cholinesterase) interact with succinylcholine chloride resulting in prolonged apnea [17].
• Since the level of serum BChE activity and the duration of succinylcholine apnea are inversely correlated, this marked decrease in activity makes individuals with the J-variant more susceptible than usual subjects to prolonged apnea from succinylcholine [18].
• Individuals who are heterozygous for the fluoride and atypical alleles experience about 30 min of apnea, rather than the usual 3-5 min, after receiving succinyldicholine [19].
• Subjects were able to maintain a voluntary apnea to a lower oxygen saturation on dopamine than on placebo (P<0.05) [20].

Biological context of Apnea

• Moreover, resting (early-night placebo heart rate) was positively correlated with proportional reduction of REM apnea index (r = 0.69, p < 0.02) [21].
• CONCLUSIONS: The changes of mean flow velocity could be interpreted as reactive adaptation processes because of CO2 and blood pressure increases corresponding to apnea [22].
• There was a significant correlation of the apnea hypopnea index with 9 PM and 6 AM systolic and diastolic blood pressure, with 9 PM platelet activation, and with 6 AM epinephrine levels mainly due to high values in the severe OSAS group [23].
• In the older group, sleep was more disturbed and respiratory events (hypopneas and apneas) were more frequent both in non-rapid eye movement (NREM) and in REM sleep [24].
• Fourteen preterm infants with apnea (body weight, 1052 +/- 44 g; gestational age, 30.2 +/- 0.5 wks; and postnatal age, 9.9 +/- 1.5 days) were studied in an effort to evaluate the effects of aminophylline on respiratory center output and respiratory reflex activity in the preterm infant with idiopathic apnea [25].

Anatomical context of Apnea

• In the newborn, theophylline stimulates the central nervous system, particularly the respiratory center, leading to decreased apnea frequency and increased ventilation [26].
• At 5 weeks of age, guide cannulae were implanted bilaterally in the medial nucleus tractus solitarius at a site that produced apnea in response to the glutamate agonist D,L-homocysteic acid [27].
• Respiratory muscle weakness is much more important than the frequency of apneas and hypopneas in determining quality of life in ALS [28].
• STUDY OBJECTIVES: Serotonin, acting in the peripheral nervous system, can exacerbate sleep-related apnea, and systemically administered serotonin antagonists reduce sleep-disordered respiration in rats and bulldogs [29].
• Because cannabinoid receptor agonists are known to inhibit the excitatory effects of serotonin on nodose ganglion cells, we examined the effects of endogenous (oleamide) and exogenous (delta9-tetrahydrocannabinol; delta9THC) cannabimimetic agents on sleep-related apnea [29].

Gene context of Apnea

• During the treatment of neonatal apnea, formula-fed infants, compared to breastfed infants, show nearly three-fold increase in clearance of caffeine, a substrate of cytochrome P450 1A (CYP1A) and in part CYP3A4 [30].
• The role played by this further increase in TNF-alpha levels after the obstructive apnea in OSAS patients remains to be established in the light of the pathogenic mechanisms of this sleep disorder [31].
• We observed that nCPAP decreased apnea, desaturation, and the circulating ICAM-1 and IL-8 levels in OSAS patients [32].
• The newborn (PO) Krox-20-/- mice, in which apneas are ten times longer than in wild-type animals, may be a valuable model for the study of life-threatening apneas during early infancy [33].
• Choline acetyltransferase mutations cause myasthenic syndrome associated with episodic apnea in humans [34].

Analytical, diagnostic and therapeutic context of Apnea

• Polysomnography, including esophageal pressure monitoring, confirmed central sleep apnea with an apnea index of 27/h. He had mild non-insulin-dependent diabetes mellitus (NIDDM) but no signs of diabetic neuropathy or other background diseases [35].
• Hormone replacement therapy increased the change in end-tidal CO2 at the apnea threshold from 2.9+/-0.4 mm Hg to 4.8+/-0.4 mm Hg (P<.001) [36].
• Replacing the regional ischaemia with 5 min perfusion with 10 microM adenosine or 65 nM N6-[2-(4-aminophenyl)ethyl]adenosine (APNEA), an adenosine A3 receptor agonist, was equally protective [37].
• Body mass index (P = 0.16), estimated creatinine clearance (P = 0.17), and apnea hypopnea index (P = 0.13) were not associated with the urine protein/creatinine ratio [38].
• Additionally, fentanyl produced immediate apnea necessitating tracheal intubation and mechanical ventilation [39].

References