Peretz Lavie | Technion Israel Institute of Technology (original) (raw)
Papers by Peretz Lavie
Background: Obstructive sleep apnea (OSA) is associated with endothelial dysfunction. In the curr... more Background: Obstructive sleep apnea (OSA) is associated with endothelial dysfunction. In the current study, we assessed the effect of long-term modified Herbst mandibular advancement splint (MAS) treatment on OSA, oxidative stress markers, and on endothelial function (EF). Methods: A total of 16 subjects participated (11 men and 5 women; mean [؎ SD] age, 54.0 ؎ 8.3 years; mean body mass index, 28.0 ؎ 3.1 kg/m 2), 12 of whom completed the 1-year evaluation. Apnea severity, levels of oxidative stress markers, and EF were assessed after 3 months and 1 year of receiving treatment. For comparison, 6 untreated patients underwent two evaluations 9 months apart, and 10 non-OSA individuals were assessed once as a reference group. The results are presented as the mean ؎ SD. Results: The mean apnea-hypopnea index (AHI) decreased significantly from 29.7 ؎ 18.5 events/h before treatment to 17.7 ؎ 11.1 events/h after 3 months of treatment and 19.6 ؎ 11.5 events/h after 1 year of treatment (p < 0.005 for both). The mean Epworth sleepiness scale score decreased significantly from 12.4 ؎ 6.0 before treatment to 10.2 ؎ 6.6 after 3 months of treatment and 7.8 ؎ 3.8 after 1 year of treatment (p < 0.001 for both). The mean EF improved significantly from 1.77 ؎ 0.4 before treatment to 2.1 ؎ 0.4 after 3 months of treatment (p < 0.05) and 2.0 ؎ 0.3 after 1 year of treatment (p ؍ 0.055), which were similar to the values of the reference group. Thiobarbituric acid-reactive substance (TBARS) levels decreased from 18.8 ؎ 6.2 nmol malondialdehyde (MDA)/mL before treatment to 15.8 ؎ 3.9 MDA/mL after 3 months of treatment (p ؍ 0.09) and 15.5 ؎ 3.2 nmol MDA/mL after 1 year of treatment (p < 0.05). There was a correlation between the improvement in AHI and in EF or TBARS levels (r ؍ 0.55; p ؍ 0.05). The untreated control group remained unchanged. Conclusions: The Herbst MAS may be a moderately effective long-term treatment for patients with OSA. EF improved to levels that were not significantly different than reference levels, even though apneic events were not completely eliminated. We think that these data are encouraging and that they justify the performance of larger randomized controlled studies.
Sleep, 1995
Changes in sleep-wake patterns are among the hallmarks of biological aging. Previously, we report... more Changes in sleep-wake patterns are among the hallmarks of biological aging. Previously, we reported that impaired melatonin secretion is associated with sleep disorders in old age. In this study we investigated the effects of melatonin replacement therapy on melatonin-deficient elderly insomniacs. The study comprised a runningin, no-treatment period and four experimental periods. During the second, third and fourth periods, subjects were administered tablets for 7 consecutive days, 2 hours before desired bedtime. The tablets were either 2 mg melatonin administered as sustained-release or fast-release formulations, or an identical-looking placebo. The fifth period, which concluded the study. was a 2-month period of daily administration of I mg sustained-release melatonin 2 hours before desired bedtime. During each of these five experimental periods, sleep-wake patterns were monitored by wrist-worn actigraphs. Analysis of the first three I-week periods revealed that a I-week treatment with 2 mg sustained-release melatonin was effective for sleep maintenance (i.e. sleep efficiency and activity level) of elderly insomniacs. while sleep initiation was improved by the fast-release melatonin treatment. Sleep maintenance and initiation were further improved following the 2-month I-mg sustained-release melatonin treatment, indicating that tolerance had not developed. After cessation of treatment, sleep quality deteriorated. Our findings suggest that for melatonin-deficient elderly insomniacs. melatonin replacement therapy may be beneficial in the initiation and maintenance of sleep.
Sleep, 1997
... Or filter your current search. Haimov I, Find all citations by this author (default). Or filt... more ... Or filter your current search. Haimov I, Find all citations by this author (default). Or filter your current search. Lavie P. Sleep Laboratory, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Find all citations in this journal (default). ...
Sleep, 1995
During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored i... more During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored in the Technion sleep laboratories. Their age at the time of diagnosis ranged between 21 and 79 years. Fifty-seven patients (53 men and 4 women) had died by 1990, 53% due to respiratory-cardiovascular causes. The observed! expected (OlE) mortality rates, calculated for men only, revealed excess mortality of patients under 70 years old. Excess mortality was significant in the fourth and fifth decades (3.33, p < 0.002; 3.23, p < 0.0002, respectively). In patients older than 70 OlE was 0.33 (p < 0.0007). Hierarchical multivariate analysis with four fixed variables [age, body mass index (BMI), hypertension and apnea index] and four additional variables added manually one at a time (heart disease, lung disease, diabetes, apnea duration) was used to determine the predictors of death from all causes, cardiopulmonary causes and from myocardial infarction (MI). All four major variables were found to be significant predictors of mortality from all causes, in addition to lung disease and heart disease. Only age and BMI were significant predictors of cardiopulmonary deaths in addition to lung disease. Age, BMI and hypertension predicted MI deaths in addition to lung disease. These results were interpreted to suggest that SAS affects death ' indirectly, most probably by being a risk factor for hypertension. Key Words: Mortality-Sleep apnea syndrome-Age-adjusted mortality rates-Multivariate analysis-Death predictors.
Harefuah, Jan 15, 1999
Road accidents, work accidents, or other trauma can cause impotence and are frequently followed b... more Road accidents, work accidents, or other trauma can cause impotence and are frequently followed by insurance claims. During 1990-97 we examined 230 males with such a complaint. All underwent full polysomnographic recordings in the sleep laboratory for 2 nights, during the course of which NPT (nocturnal penile tumescence) was examined with special equipment. It was assessed by an experienced technician following planned awakenings from REM sleep. In 75 of the 230 subjects (33%), satisfactory erections were observed. In 100 (43%), who experienced at least 3 periods of REM sleep, no erections occurred. These patients were categorized as suffering from organic impotence. In the remaining 55 (24%), the results were inconclusive, with only partial erections or not enough REM sleep periods. Since a man recognized as suffering from impotence may be awarded large monthly payments for life, these examinations, in our opinion, are an important tool to prevent unjustified claims, and can save t...
In order to better the dynamics of the arousal response during sleep, in the present study we com... more In order to better the dynamics of the arousal response during sleep, in the present study we compared the cardiac and vasomotor response induced by multiple acoustic stimulation during daytime sleep. To this aim, we used a recently developed technique that allows for the non-invasive long-term monitoring of peripheral arterial tone(PAT). Our results suggest that the vasomotor system shows a more profound and sustained response to arousal than the cardiac system
Neurology, 1983
Auditory brainstem evoked potentials (ABEPs) were recorded from seven subjects with predominantly... more Auditory brainstem evoked potentials (ABEPs) were recorded from seven subjects with predominantly central sleep apnea. ABEPs were recorded during: (1) waking, (2) non-REM sleep between apneic episodes, (3) first half of apneas, and (4) second half of apneas. Latencies of vertex positive peaks III, V, and VI as well as the V-III interpeak latency difference were determined, and the effect of apnea phase on these measures were evaluated. The measures studied did not reveal chronic or acute functional abnormality of auditory brainstem, which may result from or cause apneic episodes during non-REM sleep. The normality and stability of ABEPs during apneic sleep indicate effective compensatory mechanisms in auditory brainstem. Brainstem functional changes associated with central apneas may not be reflected in the ABEP measures studied, unless they are part of a more extensive dysfunction.
European Respiratory Journal, 2011
The European Sleep Apnoea Database (ESADA) reflects a network of 22 sleep disorder centres in Eur... more The European Sleep Apnoea Database (ESADA) reflects a network of 22 sleep disorder centres in Europe enabled by a COST action B26 programme. This ongoing project aims to describe differences in standard clinical care of patients with obstructive sleep apnoea (OSA) and to establish a resource for genetic research in this disorder. Patients with suspected OSA are consecutively included and followed up according to local clinical standards. Anthropometrics, medical history, medication, daytime symptoms and sleep data (polysomnography or cardiorespiratory polygraphy) are recorded in a structured web-based report form. 5,103 patients (1,426 females, mean¡SD age 51.8¡12.6 yrs, 79.4% with apnoea/hypopnoea index (AHI) o5 events?h-1) were included from March 15, 2007 to August 1, 2009. Morbid obesity (body mass index o35 kg?m-2) was present in 21.1% of males and 28.6% of females. Cardiovascular, metabolic and pulmonary comorbidities were frequent (49.1%, 32.9% and 14.2%, respectively). Patients investigated with a polygraphic method had a lower AHI than those undergoing polysomnography (23.2¡23.5 versus 29.1¡26.3 events?h-1 , p,0.0001). The ESADA is a rapidly growing multicentre patient cohort that enables unique outcome research opportunities and genotyping. The first cross-sectional analysis reveals a high prevalence of cardiovascular and metabolic morbidity in patients investigated for OSA.
Sleep, 1999
SLEEP-RELATED BREATHING DISORDERS HAVE COME TO BE INCREASINGLY RECOGNIZED IN RECENT YEARS, as has... more SLEEP-RELATED BREATHING DISORDERS HAVE COME TO BE INCREASINGLY RECOGNIZED IN RECENT YEARS, as has the serious morbidity and excess mortality associated with these disorders. Estimations of the Obstructive Sleep Apnea Syndrome's (OSA) prevalence vary considerably as do its definitive criteria; however it is clear that this condition is very widespread. 1,2 It is well recognized as a major cause of morbidity with a particularly strong association with hypertension, reduced longevity, and as a contributing factor in automotive and industrial accidents. 3-5 Aside from OSAS which, as its name suggests, involves frank cessations in breathing in sleep, an allied condition, the Upper Airway Resistance Syndrome (UARS) has been more recently described. 6 In UARS frequent apneas and hypopneas do not actually occur, but the condition nevertheless results in frequent arousals and sleep fragmentation. UARS could also cause similar cardiac sequelae as OSAS, perhaps due to high levels of airways resistance. 6 The diagnosis of UARS is much more difficult due to the condition's more subtle symptomatology. 6 Upper airway patency during inspiration depends largely on the interaction between UAW anatomical and mechanical factors, on the one hand, and the forces exerted by the UAW dilating muscles that support its walls on the other. 7-9 Methods for determining the presence and severity of OSA have been directed at the combination of standard polysomnographic measurements, and measurements of the respiratory aspects of the disorder, which include monitoring of airflow at nose and mouth, and respiratory movements of the thorax and abdomen by noninvasive means. Apart from the disadvantage of being limited to the sleep laboratory, the traditional approach is likely to underestimate hypopneas and particularly UARS since respiratory parameters are not sufficiently sensitive. 10 Attempting to evaluate OSAS by monitoring blood oxygen saturation using pulse oximetry is liable to result in low specificity since minor variations in SaO 2 accompanying hypopneas and UARS may be missed. 11 A precise but not necessarily accurate way of evaluating UAW obstruction is by the invasive measurement of resistance based on the measurement of the pressure difference between two points within the airway system, together with
Life Sciences, 1981
Recent research has demonstrated rhythms in physiologic, behavioral, and endocrine processes with... more Recent research has demonstrated rhythms in physiologic, behavioral, and endocrine processes with periodicity similar to that of the sleep REM-NONREM cycles. These findings confirm that part of Kleitman's Basic Rest-Activity (BRAQ hypothesis which predicted about 1½ hour cycles in waking levels of arousal. In contrast, however, with the BRAC model, which viewed the waking rhythms as fragments of the same oscillatory system controlling the REM-NONREM cycles, the accumulated data suggest that ultradian 90-100 min rhythms are generated by a multioscillatory system. It is hypothesized that the diverse ultradian variations in behavioral, physiologic and endocrine subsystems may play a role in the adaptation of group living animals to their environment. There seem to be no common denominators for dreaming, the rate of urine flow, visual illusions, and gastric motility, but similar cycles averaging 90 or I00 minutes have been described in these and several additional physiologic and neuroendocrine functions. In exploring the mechanisms of these diverse cyclic processes, we are challenged to uncover not only their interrelationships but also their functional or adaptational significance, Early in the century, Wada (i) described a 1½-2 hour rhythmicity in periods of gastric motility, and Olmeyer et al. noticed that penile erection during sleep has a similar rhythm (2). In the late 19S0's, the cyclic recurrence of the rapid eye movement (REM) stage of sleep and its association with dreaming were recognized (3,4). Summarizing these findings, Kleitman (~ hypothesized that there was a "Basic Rest-Activity Cycle", or BRAC, which might be expressed not only by cycles of dreaming during sleep but also by cycles of arousal and behavioral activity in the waking person. Thus, a single cyclic process, perhaps related to feeding, was hypothesized as underlying a wide variety of manifestations from the neuronal to the subjective and behavioral levels. REM and NONREM sleep Cyclic alternation of REM and NONREM sleep has been observed in every mammal studied, but there is considerable doubt whether this cycle should be called a rhythm. In ~human adults, the intervals between periods of REM average rather reliably around I00 minutes, and curiously, this periodicity seems even more stable than the quantities of REM sleep which occur (6,7). On the other hand, the I00 minute periodicity is only an average, and the
Ultradian Rhythms in Physiology and Behavior, 1985
Choice Reviews Online, 2004
D74. CLINICAL PRESENTATION AND EPIDEMIOLOGY OF SLEEP DISORDERED BREATHING, 2010
Israel journal of medical sciences, 1997
Psychophysiology, 1987
... Performance Procedure Each performance trial began with a warning signal followed one second ... more ... Performance Procedure Each performance trial began with a warning signal followed one second later by either une or two "go" signals presented by ... 5) two-hand-ed "near" targets, 6) two-handed "far" targets, 7) right-handed "far" combined with left-handed "near" tar-gets, and ...
Background: Obstructive sleep apnea (OSA) is associated with endothelial dysfunction. In the curr... more Background: Obstructive sleep apnea (OSA) is associated with endothelial dysfunction. In the current study, we assessed the effect of long-term modified Herbst mandibular advancement splint (MAS) treatment on OSA, oxidative stress markers, and on endothelial function (EF). Methods: A total of 16 subjects participated (11 men and 5 women; mean [؎ SD] age, 54.0 ؎ 8.3 years; mean body mass index, 28.0 ؎ 3.1 kg/m 2), 12 of whom completed the 1-year evaluation. Apnea severity, levels of oxidative stress markers, and EF were assessed after 3 months and 1 year of receiving treatment. For comparison, 6 untreated patients underwent two evaluations 9 months apart, and 10 non-OSA individuals were assessed once as a reference group. The results are presented as the mean ؎ SD. Results: The mean apnea-hypopnea index (AHI) decreased significantly from 29.7 ؎ 18.5 events/h before treatment to 17.7 ؎ 11.1 events/h after 3 months of treatment and 19.6 ؎ 11.5 events/h after 1 year of treatment (p < 0.005 for both). The mean Epworth sleepiness scale score decreased significantly from 12.4 ؎ 6.0 before treatment to 10.2 ؎ 6.6 after 3 months of treatment and 7.8 ؎ 3.8 after 1 year of treatment (p < 0.001 for both). The mean EF improved significantly from 1.77 ؎ 0.4 before treatment to 2.1 ؎ 0.4 after 3 months of treatment (p < 0.05) and 2.0 ؎ 0.3 after 1 year of treatment (p ؍ 0.055), which were similar to the values of the reference group. Thiobarbituric acid-reactive substance (TBARS) levels decreased from 18.8 ؎ 6.2 nmol malondialdehyde (MDA)/mL before treatment to 15.8 ؎ 3.9 MDA/mL after 3 months of treatment (p ؍ 0.09) and 15.5 ؎ 3.2 nmol MDA/mL after 1 year of treatment (p < 0.05). There was a correlation between the improvement in AHI and in EF or TBARS levels (r ؍ 0.55; p ؍ 0.05). The untreated control group remained unchanged. Conclusions: The Herbst MAS may be a moderately effective long-term treatment for patients with OSA. EF improved to levels that were not significantly different than reference levels, even though apneic events were not completely eliminated. We think that these data are encouraging and that they justify the performance of larger randomized controlled studies.
Sleep, 1995
Changes in sleep-wake patterns are among the hallmarks of biological aging. Previously, we report... more Changes in sleep-wake patterns are among the hallmarks of biological aging. Previously, we reported that impaired melatonin secretion is associated with sleep disorders in old age. In this study we investigated the effects of melatonin replacement therapy on melatonin-deficient elderly insomniacs. The study comprised a runningin, no-treatment period and four experimental periods. During the second, third and fourth periods, subjects were administered tablets for 7 consecutive days, 2 hours before desired bedtime. The tablets were either 2 mg melatonin administered as sustained-release or fast-release formulations, or an identical-looking placebo. The fifth period, which concluded the study. was a 2-month period of daily administration of I mg sustained-release melatonin 2 hours before desired bedtime. During each of these five experimental periods, sleep-wake patterns were monitored by wrist-worn actigraphs. Analysis of the first three I-week periods revealed that a I-week treatment with 2 mg sustained-release melatonin was effective for sleep maintenance (i.e. sleep efficiency and activity level) of elderly insomniacs. while sleep initiation was improved by the fast-release melatonin treatment. Sleep maintenance and initiation were further improved following the 2-month I-mg sustained-release melatonin treatment, indicating that tolerance had not developed. After cessation of treatment, sleep quality deteriorated. Our findings suggest that for melatonin-deficient elderly insomniacs. melatonin replacement therapy may be beneficial in the initiation and maintenance of sleep.
Sleep, 1997
... Or filter your current search. Haimov I, Find all citations by this author (default). Or filt... more ... Or filter your current search. Haimov I, Find all citations by this author (default). Or filter your current search. Lavie P. Sleep Laboratory, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Find all citations in this journal (default). ...
Sleep, 1995
During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored i... more During 1976-1988 we diagnosed sleep apnea syndrome (SAS) in 1,620 adult men and women monitored in the Technion sleep laboratories. Their age at the time of diagnosis ranged between 21 and 79 years. Fifty-seven patients (53 men and 4 women) had died by 1990, 53% due to respiratory-cardiovascular causes. The observed! expected (OlE) mortality rates, calculated for men only, revealed excess mortality of patients under 70 years old. Excess mortality was significant in the fourth and fifth decades (3.33, p < 0.002; 3.23, p < 0.0002, respectively). In patients older than 70 OlE was 0.33 (p < 0.0007). Hierarchical multivariate analysis with four fixed variables [age, body mass index (BMI), hypertension and apnea index] and four additional variables added manually one at a time (heart disease, lung disease, diabetes, apnea duration) was used to determine the predictors of death from all causes, cardiopulmonary causes and from myocardial infarction (MI). All four major variables were found to be significant predictors of mortality from all causes, in addition to lung disease and heart disease. Only age and BMI were significant predictors of cardiopulmonary deaths in addition to lung disease. Age, BMI and hypertension predicted MI deaths in addition to lung disease. These results were interpreted to suggest that SAS affects death ' indirectly, most probably by being a risk factor for hypertension. Key Words: Mortality-Sleep apnea syndrome-Age-adjusted mortality rates-Multivariate analysis-Death predictors.
Harefuah, Jan 15, 1999
Road accidents, work accidents, or other trauma can cause impotence and are frequently followed b... more Road accidents, work accidents, or other trauma can cause impotence and are frequently followed by insurance claims. During 1990-97 we examined 230 males with such a complaint. All underwent full polysomnographic recordings in the sleep laboratory for 2 nights, during the course of which NPT (nocturnal penile tumescence) was examined with special equipment. It was assessed by an experienced technician following planned awakenings from REM sleep. In 75 of the 230 subjects (33%), satisfactory erections were observed. In 100 (43%), who experienced at least 3 periods of REM sleep, no erections occurred. These patients were categorized as suffering from organic impotence. In the remaining 55 (24%), the results were inconclusive, with only partial erections or not enough REM sleep periods. Since a man recognized as suffering from impotence may be awarded large monthly payments for life, these examinations, in our opinion, are an important tool to prevent unjustified claims, and can save t...
In order to better the dynamics of the arousal response during sleep, in the present study we com... more In order to better the dynamics of the arousal response during sleep, in the present study we compared the cardiac and vasomotor response induced by multiple acoustic stimulation during daytime sleep. To this aim, we used a recently developed technique that allows for the non-invasive long-term monitoring of peripheral arterial tone(PAT). Our results suggest that the vasomotor system shows a more profound and sustained response to arousal than the cardiac system
Neurology, 1983
Auditory brainstem evoked potentials (ABEPs) were recorded from seven subjects with predominantly... more Auditory brainstem evoked potentials (ABEPs) were recorded from seven subjects with predominantly central sleep apnea. ABEPs were recorded during: (1) waking, (2) non-REM sleep between apneic episodes, (3) first half of apneas, and (4) second half of apneas. Latencies of vertex positive peaks III, V, and VI as well as the V-III interpeak latency difference were determined, and the effect of apnea phase on these measures were evaluated. The measures studied did not reveal chronic or acute functional abnormality of auditory brainstem, which may result from or cause apneic episodes during non-REM sleep. The normality and stability of ABEPs during apneic sleep indicate effective compensatory mechanisms in auditory brainstem. Brainstem functional changes associated with central apneas may not be reflected in the ABEP measures studied, unless they are part of a more extensive dysfunction.
European Respiratory Journal, 2011
The European Sleep Apnoea Database (ESADA) reflects a network of 22 sleep disorder centres in Eur... more The European Sleep Apnoea Database (ESADA) reflects a network of 22 sleep disorder centres in Europe enabled by a COST action B26 programme. This ongoing project aims to describe differences in standard clinical care of patients with obstructive sleep apnoea (OSA) and to establish a resource for genetic research in this disorder. Patients with suspected OSA are consecutively included and followed up according to local clinical standards. Anthropometrics, medical history, medication, daytime symptoms and sleep data (polysomnography or cardiorespiratory polygraphy) are recorded in a structured web-based report form. 5,103 patients (1,426 females, mean¡SD age 51.8¡12.6 yrs, 79.4% with apnoea/hypopnoea index (AHI) o5 events?h-1) were included from March 15, 2007 to August 1, 2009. Morbid obesity (body mass index o35 kg?m-2) was present in 21.1% of males and 28.6% of females. Cardiovascular, metabolic and pulmonary comorbidities were frequent (49.1%, 32.9% and 14.2%, respectively). Patients investigated with a polygraphic method had a lower AHI than those undergoing polysomnography (23.2¡23.5 versus 29.1¡26.3 events?h-1 , p,0.0001). The ESADA is a rapidly growing multicentre patient cohort that enables unique outcome research opportunities and genotyping. The first cross-sectional analysis reveals a high prevalence of cardiovascular and metabolic morbidity in patients investigated for OSA.
Sleep, 1999
SLEEP-RELATED BREATHING DISORDERS HAVE COME TO BE INCREASINGLY RECOGNIZED IN RECENT YEARS, as has... more SLEEP-RELATED BREATHING DISORDERS HAVE COME TO BE INCREASINGLY RECOGNIZED IN RECENT YEARS, as has the serious morbidity and excess mortality associated with these disorders. Estimations of the Obstructive Sleep Apnea Syndrome's (OSA) prevalence vary considerably as do its definitive criteria; however it is clear that this condition is very widespread. 1,2 It is well recognized as a major cause of morbidity with a particularly strong association with hypertension, reduced longevity, and as a contributing factor in automotive and industrial accidents. 3-5 Aside from OSAS which, as its name suggests, involves frank cessations in breathing in sleep, an allied condition, the Upper Airway Resistance Syndrome (UARS) has been more recently described. 6 In UARS frequent apneas and hypopneas do not actually occur, but the condition nevertheless results in frequent arousals and sleep fragmentation. UARS could also cause similar cardiac sequelae as OSAS, perhaps due to high levels of airways resistance. 6 The diagnosis of UARS is much more difficult due to the condition's more subtle symptomatology. 6 Upper airway patency during inspiration depends largely on the interaction between UAW anatomical and mechanical factors, on the one hand, and the forces exerted by the UAW dilating muscles that support its walls on the other. 7-9 Methods for determining the presence and severity of OSA have been directed at the combination of standard polysomnographic measurements, and measurements of the respiratory aspects of the disorder, which include monitoring of airflow at nose and mouth, and respiratory movements of the thorax and abdomen by noninvasive means. Apart from the disadvantage of being limited to the sleep laboratory, the traditional approach is likely to underestimate hypopneas and particularly UARS since respiratory parameters are not sufficiently sensitive. 10 Attempting to evaluate OSAS by monitoring blood oxygen saturation using pulse oximetry is liable to result in low specificity since minor variations in SaO 2 accompanying hypopneas and UARS may be missed. 11 A precise but not necessarily accurate way of evaluating UAW obstruction is by the invasive measurement of resistance based on the measurement of the pressure difference between two points within the airway system, together with
Life Sciences, 1981
Recent research has demonstrated rhythms in physiologic, behavioral, and endocrine processes with... more Recent research has demonstrated rhythms in physiologic, behavioral, and endocrine processes with periodicity similar to that of the sleep REM-NONREM cycles. These findings confirm that part of Kleitman's Basic Rest-Activity (BRAQ hypothesis which predicted about 1½ hour cycles in waking levels of arousal. In contrast, however, with the BRAC model, which viewed the waking rhythms as fragments of the same oscillatory system controlling the REM-NONREM cycles, the accumulated data suggest that ultradian 90-100 min rhythms are generated by a multioscillatory system. It is hypothesized that the diverse ultradian variations in behavioral, physiologic and endocrine subsystems may play a role in the adaptation of group living animals to their environment. There seem to be no common denominators for dreaming, the rate of urine flow, visual illusions, and gastric motility, but similar cycles averaging 90 or I00 minutes have been described in these and several additional physiologic and neuroendocrine functions. In exploring the mechanisms of these diverse cyclic processes, we are challenged to uncover not only their interrelationships but also their functional or adaptational significance, Early in the century, Wada (i) described a 1½-2 hour rhythmicity in periods of gastric motility, and Olmeyer et al. noticed that penile erection during sleep has a similar rhythm (2). In the late 19S0's, the cyclic recurrence of the rapid eye movement (REM) stage of sleep and its association with dreaming were recognized (3,4). Summarizing these findings, Kleitman (~ hypothesized that there was a "Basic Rest-Activity Cycle", or BRAC, which might be expressed not only by cycles of dreaming during sleep but also by cycles of arousal and behavioral activity in the waking person. Thus, a single cyclic process, perhaps related to feeding, was hypothesized as underlying a wide variety of manifestations from the neuronal to the subjective and behavioral levels. REM and NONREM sleep Cyclic alternation of REM and NONREM sleep has been observed in every mammal studied, but there is considerable doubt whether this cycle should be called a rhythm. In ~human adults, the intervals between periods of REM average rather reliably around I00 minutes, and curiously, this periodicity seems even more stable than the quantities of REM sleep which occur (6,7). On the other hand, the I00 minute periodicity is only an average, and the
Ultradian Rhythms in Physiology and Behavior, 1985
Choice Reviews Online, 2004
D74. CLINICAL PRESENTATION AND EPIDEMIOLOGY OF SLEEP DISORDERED BREATHING, 2010
Israel journal of medical sciences, 1997
Psychophysiology, 1987
... Performance Procedure Each performance trial began with a warning signal followed one second ... more ... Performance Procedure Each performance trial began with a warning signal followed one second later by either une or two "go" signals presented by ... 5) two-hand-ed "near" targets, 6) two-handed "far" targets, 7) right-handed "far" combined with left-handed "near" tar-gets, and ...
Recent years have seen the rapid development of sleep medicine as a new medical subspecialty. It ... more Recent years have seen the rapid development of sleep medicine as a new medical subspecialty. It is estimated that at least 30% of the adult population suffer at least once from some sort of sleep disturbance. Patients with sleep disorders are frequently among the most difficult to treat and account for a high percentage of absenteeism in the workplace. Furthermore, recent evidence indicates that sleep apnea can be a major underlying factor of cardiovascular disease. This authoritative handbook covers the whole area of sleep, from the history of sleep medicine to the pathophysiology of sleep disorders, effective treatment and longterm management of the problem. The Sleep Disorders Handbook has been written for those working in specialist clinics as well as GPs, internists and nonspecialists. The editors have developed strategies for the management and aggressive treatment of sleep disorders, and they present those clearly here.
People with severe sleep apnea may struggle for breath all through the night, not breathing for a... more People with severe sleep apnea may struggle for breath all through the night, not breathing for as long as ninety seconds at a time during their sleep. This syndrome, which affects at least four percent of men and two percent of women, can cause daytime fatigue, traffic and work accidents, deteriorating cognitive abilities, and cardiovascular
