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Ventilatory responses to progressive hypercapnia were analyzed in the normocapnic and hypercapnic obstructive sleep apnea patients (OSA). The rebreathing hypercapnic and hypoxic tests were performed using the computerized equipment (Lungtest, MES), according to Read's method. The ventilatory response to hypoxia was impaired in all OSA patients. Concerning the hypercapnic ventilatory response, there were no differences between the OSA patients with normal end-tidal PCO2 and controls. Nine moderately hypercapnic OSA patients showed a right shift with a normal slope of the regression curve describing the relationship between the end-tidal PCO2 and minute ventilation. In contrast, three severely hypercapnic OSA patients showed a right shift with a decreased slope of this regression curve. We conclude that awake OSA patients who developed hypercapnic ventilatory insufficiency showed an impaired hypercapnic defense reaction.
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Occurrence of obstructive sleep apnea in a group of shift worked police officers

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Shift work is an important source of health disturbances. Night work has a negative influence on some spheres: biological, working, social, and medical. Disturbances of sleeping, one group of manifestations of medical problems, can be considered as a cause of health deterioration. This study focuses on the occurrence of breathing disturbances during sleep in shift workers. Twenty one shift worked police officers (40-60 years old) were compared with an age-matched control group operating in the some environment. All subjects underwent overnight polysomnography. The polysomnographic investigation by shift workers was conducted after a day shift and normal night sleep, after an adaptational night in the sleep laboratory. Obstructive sleep apnea was found in 8 shift workers (38%) with AHI of 5.72-45.45 and in 8 control volunteers (38% of the studied group) with AHI of 5.00-25.24. All breathing parameters, as measured by polysomnography, did not differ between the two groups. Our results do not confirm the hypothesis that chronic irregular work hours promote the occurrence of obstructive sleep apnea in subjects aged 40-60 years.
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Does night work favor sleep-related accidents in police officers?

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Several studies of sleep-breathing physiology have suggested that sleep deprivation may worsen obstructive sleep apnea. The aim of the study was to determine the direct effect of night work on breathing variables during sleep in fast-rotating shift workers. Twenty one men - police officers, fast-rotating shift workers, underwent polysomnography on 2 occasions: under a normal sleeping condition after day work and after sleep deprivations after night work. Both sleep studies were conducted within 2 to 3 weeks of each other. Approximately half of the group was tested under control conditions (day work) first, with the remaining subjects tested under sleep deprivation conditions (night work) first. After a night shift the subjects did not show a significantly different apnea-hypopnea-index (AHI). However, night work significantly increased several breathing variables recorded during sleep after it: total duration of obstructive apneas (OA) during REM sleep, mean duration of OA during arousal, total duration of OA during NREM sleep, apnea index during arousal, mean length of OA during sleep period time, total duration of OA during sleep period time, mean length of OA during total sleep time, mean length of hypopnea during REM sleep, total duration of hypopnea during sleep period time and during total sleep time, maximal length of central apnea and OA, and total sleep time. Night work does not favor obstructive sleep apnea episodes during sleep, but worsens many an obstructive sleep apnea variable, as measured by polysomnography.
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Sleep disordered breathing in the elderly: comparison of women and men

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The prevalence of obstructive sleep apnea syndrome in patients up to the age of 60 is known to be two times higher in men then in women. Hormonal changes during menopause might underlie changes in this relationship in the elderly. This study was designed to detect differences in the type and frequency of sleep-disordered breathing between women and men over the age of 65 years, having the same body mass index. The study was conducted using a matched-pair approach consisting of a sample population of 40 pairs of patients over the age of 65. All patients met the following exclusion criteria: age below 65, heart failure, chronic obstructive lung disease. Polygraphy was conducted by means of a portable recorder. All measured indices were higher in men than in women. The apnea index was 2.8 ±4.1 in men and 0.6 ±1.4 in women. The apnea/hypopnea index was 10.2 ±11.4 and 4.8 ±3.9, respectively. These differences were significant (P<0.05). Significant differences also were observed when central (men 8.1 ±13.1, women 3.1 ±8.2), mixed (men 5.1 ±11.4, women 0.4 ±1.3), and obstructive (women men 8.6 ±20.1, 1.0 ±4.3) apnea indices were compared. In conclusion, the study demonstrates that elderly patients showed gender-dependent differences in the type and frequency of sleep-related breathing disorders. Men suffered from all kinds of apnea more frequently than women.
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Obstructive sleep apnea and the quality of life

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Patients suffering from obstructive sleep apnea (OSA) are unaware of clinical symptoms, such as cessation of breathing during sleep, decrease in blood oxygen levels, severe sleep fragmentation, and excessive daytime sleepiness. Equally worrying is a low level of knowledge among physicians, psychiatrists, and psychologists of the intellectual and emotional impact of OSA. The illness may lead to anxiety, depression, psychosis, and other pathological symptoms. The aim of the present study was to evaluate relationships among OSA, quality of life, and psychological performance. STAI, UMACL, the Beck Depression Inventory, the Framingham Type A Scale, the Courtauld Emotional Control Scale (CECS), the Life Orientation Test - Revised (LOT-R), and the Satisfaction With Life Scale (SWLS) were applied. The tests were used to describe the well-being and pathological symptoms, such as depression or anxiety, in a clinical group (newly-diagnosed, untreated OSA patients) in comparison with a control group (healthy volunteers). The results of the tests failed to substantiate the presence of significant differences between the clinical and control groups. We put forward a hypothesis that the rather unexpected lack of psychological differences might stem from a rapid mood improvement in OSA patients on anticipation of being diagnosed and taken care of in the hospital setting. Followed-up studies in the same patients are required to confirm this hypothesis.
Celem pracy była ocena wiedzy żywieniowej i i wybranych elementów stylu życia pacjentów otyłych z rozpoznanym OBS, leczonych w Dolnośląskim Centrum Chorób Płuc Akademii Medycznej we Wrocławiu. Ocenę stanu wiedzy żywieniowej przeprowadzono wśród 49 chorych, w tym 12 kobiet i 37 mężczyzn z rozpoznanym OBS, leczonych w Dolnośląskim Centrum Chorób Płuc we Wrocławiu. Do oceny wiedzy żywieniowej i wybranych elementów stylu życia wykorzystano autorski, standaryzowany kwestionariusz opracowany w Zakładzie Żywienia Człowieka Uniwersytetu Przyrodniczego we Wrocławiu. Zawierał on różne pytania, dotyczące m.in. rodzaju aktywności fizycznej, częstości palenia papierosów. Mimo wykazanej częściowo dobrej wiedzy żywieniowej, jej wykorzystanie przez chorych na OBS w życiu codziennym budzi wiele zastrzeżeń. Może to prawdopodobnie wynikać z nie wiązaniem wiadomości o prawidłowym żywieniu z własnym stanem zdrowia. Stwierdzona w badanej grupie chorych na OBS otyłość i niska aktywność fizyczna, świadczą o konieczności włączenia do procesu leczenia indywidualnego poradnictwa dietetycznego.
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