RE: C-PAP Research info.

[Guest guest]

There is tons more research around on sleep apnea and MSA, those were short

and to the point. We used to be able to access an article on the web

entitled:

" Sudden Death During Sleep in Multiple System Atrophy Is Related to

Unrecognized Sleep-Disordered Breathing " but the link no longer works and I

don't think I saved a text version. That article was published in the

" Lancet " medical journal. You can see a few lines from the beginning if

you go to this website(the very bottom) but you have to pay to see the whole

article.

http://www.lancetneuronet.com/journal/vol2/iss1/contents

Here is another short one I sometimes post:

PECULIAR SNORING IN PATIENTS WITH MULTIPLE SYSTEM ATROPHY: ITS SOUND SOURCE,

ACOUSTIC CHARACTERISTICS, AND DIAGNOSTIC SIGNIFICANCE

NORIYA KAKITSUBA, MD

TATSUYA SADAOKA, MD

YUKI FUJIWARA, MD

RYUICHI KANAI, MD

HIROAKI TAKAHASHI, MD

OSAKA, JAPAN

It is known that abductor paralysis (AP) of the vocal folds sometimes

occurs in patients with multiple system atrophy (MSA), and some of them have

sleep apnea and loud snoring during sleep. However, the site of obstruction

and the sound source of the snoring are still unknown. We performed

fiberscopic examinations under diazepam sedation in 8 MSA patients with AP

and analyzed the snoring sound. We found that the peculiar snoring occurred

with inspiratory vibration of the vocal folds, and there was no obstruction

in this portion. Acoustic analysis showed that the fundamental frequency of

vocal fold snoring was 260 to 330 Hz, which is different from that of

ordinary soft palate snoring. Recognition of vocal fold snoring is important

in the early diagnosis of MSA and sleep-related breathing disorders. (Ann

Otol Rhinol Laryngol 1997:380-384.)

And another good one:

Sleep 1996 Jul;19(6):479-84

Sleep-related breathing disorders in patients with multiple system atrophy

and

vocal fold palsy.

Sadaoka T, Kakitsuba N, Fujiwara Y, Kanai R, Takahashi H.

Department of Otolaryngology, Osaka Medical College, Japan.

We performed sleep studies in eight patients with multiple system atrophy

(MSA)

and three patients with peripheral bilateral vocal fold palsy (PBVFP) and

investigated stenosis of the upper airway tract during sleep in MSA patients

with vocal fold palsy. Among the eight MSA patients in this study, five had

definite glottic snoring and two others were suspected of having glottic

snoring. Of the PBVFP patients, two had glottic snoring. Three of 11

patients

died, and two of the three deaths occurred during sleep. Glottic snoring

indicated a high degree of negative esophageal pressure. High negative

esophageal pressure demonstrates severe narrowing of the upper airway tract.

Therefore, glottic snoring should be considered a risk factor for sudden

death

in sleep. Repeated laryngoscopic examination is useful in evaluating the

progressive process of vocal fold palsy while awake, but this examination

performed only while awake is not enough to evaluate narrowing of the upper

airway during sleep. Sleep studies that include the measurement of

esophageal

pressure can be very useful in evaluating the severity of narrowing in the

upper

airway tract. It is suspected that sudden nocturnal death in MSA patients is

caused not only by abnormal respiration resulting from impairment of the

respiratory center, but also by glottic obstruction caused by sputum or by

edema

of the vocal folds. We recommend treatment of respiratory disorders when

loud

laryngeal snoring occurs in patients with MSA, even if they do not complain

of

dyspnea while awake.

PMID: 8865505

And yet another... The research is very clear ... sleep apnea is VERY

SERIOUS!!!

J Neurol Sci 1998 Jan 8;153(2):192-202

Disorders of excessive daytime sleepiness--an update.

El-Ad B, Korczyn AD.

Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel.

Disorders of excessive daytime sleepiness (EDS) constitute a major health

hazard, since impaired alertness may lead to accidents and poor quality of

life,

and some of them are associated with increased cardiovascular morbidity and

mortality. Many disorders of EDS are neurological diseases (e.g. narcolepsy

and

periodic limb movements in sleep, PLMS). The largest group of disorders

causing

EDS consists of sleep-related disturbances of breathing, where

neuroregulatory

mechanisms play a major role in pathophysiology. Many patients with

neurodegenerative and neuromuscular diseases suffer from sleep disturbances

associated with EDS. Therefore, neurologists must be acquainted with the

differential diagnosis of EDS and the major categories of sleep disorders

causing it. The present update focuses on major sleep disorders causing EDS,

and

approaches the topic from the neurologist's perspective. Rather than being

an

extensive review, this update includes recent data on epidemiology,

pathophysiology, diagnosis and treatment of obstructive sleep apnea and

related

conditions (increased upper airway resistance syndrome, central sleep

apnea), as

well as of narcolepsy and PLMS. Also included are recent data concerning EDS

in

neurodegenerative (Alzheimer's disease, Parkinson's disease, multiple system

atrophy) and neuromuscular disorders.

PMID: 9511878

C-PAP Research info.

Thanks Pam for finding the research.

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