Abductor vocal fold palsy in the Shy-Drager syndrome presenting with snoring and sleep apnoea

1996 ◽  
Vol 110 (7) ◽  
pp. 681-682 ◽  
Author(s):  
Fergus McBrien ◽  
Paul D. R. Spraggs ◽  
John P. Harcourt ◽  
Charles B. Croft
Keyword(s):  
Vocal Fold ◽  
Sleep Apnoea ◽  
Elderly Male ◽  
Rare Presentation ◽  
Sleep Related Breathing Disorders ◽  
Sound Recordings ◽  
Breathing Disorders ◽  
Vocal Fold Palsy

AbstractThe case of an elderly male with Shy-Drager syndrome is presented. His presentation to the Sleep Clinic for assessment of snoring illustrates bilateral abductor vocal fold palsy as a rare presentation of the syndrome. This case emphasizes the need for thorough investigation of all patients with sleep-related breathing disorders with video and sound recordings prior to anaesthesia and surgery.

scholarly journals Sleep-Related Breathing Disorders in Patients With Multiple System Atrophy and Vocal Fold Palsy

SLEEP ◽  
1996 ◽  
Vol 19 (6) ◽  
pp. 479-484 ◽  
Author(s):  
Tatsuya Sadaoka ◽  
Noriya Kakitsuba ◽  
Yuki Fujiwara ◽  
Ryuichi Kanai ◽  
Hiroaki Takahashi
Keyword(s):  
Multiple System Atrophy ◽  
Vocal Fold ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Vocal Fold Palsy

Day-case tonsillectomy for children in Glasgow: the impact of changing indications and deprivation

2013 ◽  
Vol 127 (4) ◽  
pp. 392-398 ◽  
Author(s):  
W A Clement
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Day Surgery ◽  
Sleep Apnoea ◽  
Day Case ◽  
Sleep Related Breathing Disorders ◽  
Number Of Children ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Same Day Discharge ◽  
The Impact

AbstractObjective:To determine the number of children undergoing tonsillectomy that could have this performed as a day surgery procedure.Methods:This paper reports a prospective cohort study, which entailed a comparison of children's eligibility for day-case surgery between 2001 and 2011 and an assessment of the Scottish Index of Multiple Deprivation scores.Results:In total, 148 children were enrolled. In 2011, 60 children (42 per cent) were eligible for surgery with same day discharge compared with 27 per cent in 2001. The percentage of children undergoing tonsillectomy for sleep-related breathing disorders or obstructive sleep apnoea hypopnoea syndrome increased from 26 per cent to 55 per cent.Conclusion:Eligibility for tonsillectomy with same day discharge has increased. This appears to be related to an increase in the number of children who are able to fulfil the social criteria for same day discharge. The results indicate an association between deprivation and tonsillectomy, particularly surgery carried out for the symptoms of sleep-related breathing disorders or obstructive sleep apnoea hypopnoea syndrome. There has been a significant increase in the percentage of children undergoing tonsillectomy for the indication of sleep-related breathing disorders or obstructive sleep apnoea hypopnoea syndrome.

Sleep-related breathing disorders and pulmonary hypertension

2020 ◽  
Vol 57 (1) ◽  
pp. 2002258
Author(s):  
Yochai Adir ◽  
Marc Humbert ◽  
Ari Chaouat
Keyword(s):  
Pulmonary Hypertension ◽  
Sleep Apnoea ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Pulmonary Haemodynamics ◽  
Pulmonary Arterial ◽  
Central Apnoea

Sleep-related breathing disorders (SBDs) include obstructive apnoea, central apnoea and sleep-related hypoventilation. These nocturnal events have the potential to increase pulmonary arterial pressure (PAP) during sleep but also in the waking state. “Pure” obstructive sleep apnoea syndrome (OSAS) is responsible for a small increase in PAP whose clinical impact has not been demonstrated. By contrast, in obesity hypoventilation syndrome (OHS) or overlap syndrome (the association of chronic obstructive pulmonary disease (COPD) with obstructive sleep apnoea (OSA)), nocturnal respiratory events contribute to the development of pulmonary hypertension (PH), which is often severe. In the latter circumstances, treatment of SBDs is essential in order to improve pulmonary haemodynamics.Patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) are at risk of developing SBDs. Obstructive and central apnoea, as well as a worsening of ventilation–perfusion mismatch, can be observed during sleep. There should be a strong suspicion of SBDs in such a patient population; however, the precise indications for sleep studies and the type of recording remain to be specified. The diagnosis of OSAS in patients with PAH or CTEPH should encourage treatment with continuous positive airway pressure (CPAP). The presence of isolated nocturnal hypoxaemia should also prompt the initiation of long-term oxygen therapy. These treatments are likely to avoid worsening of PH; however, it is prudent not to treat central apnoea and Cheyne–Stokes respiration (CSR) with adaptive servo-ventilation in patients with chronic right-heart failure because of a potential risk of serious adverse effects from such treatment.In this review we will consider the current knowledge of the consequences of SBDs on pulmonary haemodynamics in patients with and without chronic respiratory disease (group 3 of the clinical classification of PH) and the effect of treatments of respiratory events during sleep on PH. The prevalence and consequences of SBDs in PAH and CTEPH (groups 1 and 4 of the clinical classification of PH, respectively), as well as therapeutic options, will also be discussed.

Peculiar Snoring in Patients with Multiple System Atrophy: Its Sound Source, Acoustic Characteristics, and Diagnostic Significance

1997 ◽  
Vol 106 (5) ◽  
pp. 380-384 ◽  
Author(s):  
Tatsuya Sadaoka ◽  
Ryuichi Kanai ◽  
Noriya Kakitsuba ◽  
Yuki Fujiwara ◽  
Hiroaki Takahashi
Keyword(s):  
Multiple System Atrophy ◽  
Sound Source ◽  
Vocal Fold ◽  
Acoustic Analysis ◽  
Vocal Folds ◽  
Diagnostic Significance ◽  
Sleep Related Breathing Disorders ◽  
Acoustic Characteristics ◽  
Breathing Disorders ◽  
Abductor Paralysis

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.

scholarly journals The nose, snoring and obstructive sleep apnoea

2011 ◽  
Vol 49 (3) ◽  
pp. 259-263
Author(s):  
B. Kotecha
Keyword(s):  
Nasal Obstruction ◽  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Nasal Surgery ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Nasal Pathology

Snoring and obstructive sleep apnoea are both due to multilevel anatomical obstruction, and the nose and nasal pathology both contribute in many cases. This paper addresses some of the issues surrounding the problem and briefly discusses the role of medication and nasal dilators and in more detail the implication of nasal surgery in various aspects of sleep related breathing disorders (SRBD). Nasal obstruction leads to mouth breathing, which destabilises the upper airway and aggravates SRBD.

Sleep-related breathing disorders: classification and diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1062-1065
Author(s):  
Melissa C. Lipford ◽  
Virend K. Somers
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
Cardiac Patients ◽  
Separate Entity ◽  
Sleep Related Breathing Disorders ◽  
Clinical Screening ◽  
Breathing Disorders ◽  
Obstructive Sleep

Sleep-related breathing disorders encapsulate multiple respiratory abnormalities which occur during sleep. The most common disorders within this category are obstructive sleep apnoea, central sleep apnoea, and sleep-related hypoventilation. This chapter defines each of these conditions as a separate entity; however, in clinical practice there is overlap between the disorders and patients may have combinations of disease. Untreated sleep-related breathing disorders serve as risk factors for cardiovascular and cerebrovascular disease, and these diseases are commonly co-morbid in cardiac patients. Identification and treatment in the cardiac patient population is extremely important; yet many patients remain undiagnosed. This chapter discusses clinical screening tools as well as definitive diagnostic studies for these respiratory disorders. The definitions in this chapter will pertain only to adult patients.

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