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. 1981 Nov;44(11):970–982. doi: 10.1136/jnnp.44.11.970

Primary sleep apnoea syndrome.

S Chokroverty, J T Sharp
PMCID: PMC491200  PMID: 7334397

Abstract

Polygraphic study in 18 men with the sleep apnoea syndrome showed central, upper airway obstructive, and mixed apnoeas. Fifty per cent of the total apnoea time was central, 33% was obstructive, and 17% was mixed. Apnoeic episodes were accompanied by oxygen desaturation, relative bradycardia and hypotonia of orofacial muscles innervated by ponto-medullary neurons. During regular breathing these muscles revealed tonic and phasic inspiratory EMG activities. The data suggest that the primary sleep apnoea syndrome results from a dysfunction of the central control of breathing.

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Selected References

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  1. AUCHINCLOSS J. H., Jr, COOK E., RENZETTI A. D. Clinical and physiological aspects of a case of obesity, polycythemia and alveolar hypoventilation. J Clin Invest. 1955 Oct;34(10):1537–1545. doi: 10.1172/JCI103206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BERGOFSKY E. H., TURINO G. M., FISHMAN A. P. Cardiorespiratory failure in kyphoscoliosis. Medicine (Baltimore) 1959 Sep;38:263–317. doi: 10.1097/00005792-195909000-00004. [DOI] [PubMed] [Google Scholar]
  3. BICKELMANN A. G., BURWELL C. S., ROBIN E. D., WHALEY R. D. Extreme obesity associated with alveolar hypoventilation; a Pickwickian syndrome. Am J Med. 1956 Nov;21(5):811–818. doi: 10.1016/0002-9343(56)90094-8. [DOI] [PubMed] [Google Scholar]
  4. Berger A. J., Mitchell R. A., Severinghaus J. W. Regulation of respiration (first of three parts). N Engl J Med. 1977 Jul 14;297(2):92–97. doi: 10.1056/NEJM197707142970206. [DOI] [PubMed] [Google Scholar]
  5. Block A. J., Boysen P. G., Wynne J. W., Hunt L. A. Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. N Engl J Med. 1979 Mar 8;300(10):513–517. doi: 10.1056/NEJM197903083001001. [DOI] [PubMed] [Google Scholar]
  6. Bremer F. Cerebral hypnogenic centers. Ann Neurol. 1977 Jul;2(1):1–6. doi: 10.1002/ana.410020102. [DOI] [PubMed] [Google Scholar]
  7. Chokroverty S., Barrocas M., Barron K. D., Sharp J. T. Hypoventilation syndrome and obesity: A polygraphic study. Trans Am Neurol Assoc. 1969;94:240–242. [PubMed] [Google Scholar]
  8. Chokroverty S. Phasic tongue movements in human rapid eye-movement sleep. Neurology. 1980 Jun;30(6):665–668. doi: 10.1212/wnl.30.6.665. [DOI] [PubMed] [Google Scholar]
  9. Clark R. W., Schmidt H. S., Malarkey W. B. Disordered growth hormone and prolactin secretion in primary disorders of sleep. Neurology. 1979 Jun;29(6):855–861. doi: 10.1212/wnl.29.6.855. [DOI] [PubMed] [Google Scholar]
  10. Devereaux M. W., Keane J. R., Davis R. L. Automatic respiratory failure associated with infarction of the medulla. Report of two cases with pathologic study of one. Arch Neurol. 1973 Jul;29(1):46–52. doi: 10.1001/archneur.1973.00490250064007. [DOI] [PubMed] [Google Scholar]
  11. FADELL E. J., RICHMAN A. D., WARD W. W., HENDON J. R. Fatty infiltration of respiratory muscles in the Pick-wickian syndrome. N Engl J Med. 1962 Apr 26;266:861–863. doi: 10.1056/NEJM196204262661704. [DOI] [PubMed] [Google Scholar]
  12. Gastaut H., Tassinari C. A., Duron B. Polygraphic study of the episodic diurnal and nocturnal (hypnic and respiratory) manifestations of the Pickwick syndrome. Brain Res. 1966 Feb;1(2):167–186. doi: 10.1016/0006-8993(66)90117-x. [DOI] [PubMed] [Google Scholar]
  13. Guilleminault C., Hill M. W., Simmons F. B., Dement W. C. Obstructive sleep apnea: electromyographic and fiberoptic studies. Exp Neurol. 1978 Oct;62(1):48–67. doi: 10.1016/0014-4886(78)90040-7. [DOI] [PubMed] [Google Scholar]
  14. Guilleminault C., Tilkian A., Dement W. C. The sleep apnea syndromes. Annu Rev Med. 1976;27:465–484. doi: 10.1146/annurev.me.27.020176.002341. [DOI] [PubMed] [Google Scholar]
  15. Gulleminault C., Lehrman A. T., Forno L., Dement W. C. Sleep apnoea syndrome: states of sleep and autonomic dysfunction. J Neurol Neurosurg Psychiatry. 1977 Jul;40(7):718–725. doi: 10.1136/jnnp.40.7.718. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Krieger A. J., Rosomoff H. L. Sleep-induced apnea. 1. A respiratory and autonomic dysfunction syndrome following bilateral percutaneous cervical cordotomy. J Neurosurg. 1974 Feb;40(2):168–180. doi: 10.3171/jns.1974.40.2.0168. [DOI] [PubMed] [Google Scholar]
  17. Laffont F., Autret A., Minz M., Beillevaire T., Cathala H. P., Castaigne P. Sleep respiratory arrhythmias in control subjects, narcoleptics and non-cataplectic hypersomniacs. Electroencephalogr Clin Neurophysiol. 1978 Jun;44(6):697–705. doi: 10.1016/0013-4694(78)90204-3. [DOI] [PubMed] [Google Scholar]
  18. Levin A. B. A simple test of cardiac function based upon the heart rate changes induced by the Valsalva maneuver. Am J Cardiol. 1966 Jul;18(1):90–99. doi: 10.1016/0002-9149(66)90200-1. [DOI] [PubMed] [Google Scholar]
  19. Lourenço R. V. Diaphragm activity in obesity. J Clin Invest. 1969 Sep;48(9):1609–1614. doi: 10.1172/JCI106126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Martin R. J., Pennock B. E., Orr W. C., Sanders M. H., Rogers R. M. Respiratory mechanics and timing during sleep in occlusive sleep apnea. J Appl Physiol Respir Environ Exerc Physiol. 1980 Mar;48(3):432–437. doi: 10.1152/jappl.1980.48.3.432. [DOI] [PubMed] [Google Scholar]
  21. Meyer J. S., Sakai F., Karacan I., Derman S., Yamamoto M. Sleep apnea, narcolepsy, and dreaming: regional cerebral hemodynamics. Ann Neurol. 1980 May;7(5):479–485. doi: 10.1002/ana.410070515. [DOI] [PubMed] [Google Scholar]
  22. Mitchell R. A., Berger A. J. Neural regulation of respiration. Am Rev Respir Dis. 1975 Feb;111(2):206–224. doi: 10.1164/arrd.1975.111.2.206. [DOI] [PubMed] [Google Scholar]
  23. Miura M., Reis D. J. The role of the solitary and paramedian reticular nuclei in mediating cardiovascular reflex responses from carotid baro- and chemoreceptors. J Physiol. 1972 Jun;223(2):525–548. doi: 10.1113/jphysiol.1972.sp009861. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Orem J., Montplaisir J., Dement W. C. Changes in the activity of respiratory neurons during sleep. Brain Res. 1974 Dec 27;82(2):309–315. doi: 10.1016/0006-8993(74)90611-8. [DOI] [PubMed] [Google Scholar]
  25. Orr W. C., Martin R. J., Imes N. K., Rogers R. M., Stahl M. L. Hypersomnolent and nonhypersomnolent patients with upper airway obstruction during sleep. Chest. 1979 Apr;75(4):418–422. doi: 10.1378/chest.75.4.418. [DOI] [PubMed] [Google Scholar]
  26. Phillipson E. A. Control of breathing during sleep. Am Rev Respir Dis. 1978 Nov;118(5):909–939. doi: 10.1164/arrd.1978.118.5.909. [DOI] [PubMed] [Google Scholar]
  27. Phillipson E. A., Sullivan C. E. Arousal: the forgotten response to respiratory stimuli. Am Rev Respir Dis. 1978 Nov;118(5):807–809. doi: 10.1164/arrd.1978.118.5.807. [DOI] [PubMed] [Google Scholar]
  28. Remmers J. E., deGroot W. J., Sauerland E. K., Anch A. M. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol Respir Environ Exerc Physiol. 1978 Jun;44(6):931–938. doi: 10.1152/jappl.1978.44.6.931. [DOI] [PubMed] [Google Scholar]
  29. Sauerland E. K., Harper R. M. The human tongue during sleep: electromyographic activity of the genioglossus muscle. Exp Neurol. 1976 Apr;51(1):160–170. doi: 10.1016/0014-4886(76)90061-3. [DOI] [PubMed] [Google Scholar]
  30. Sharp J. T., Barrocas M., Chokroverty S. The cardiorespiratory effects of obesity. Clin Chest Med. 1980 Jan;1(1):103–118. [PubMed] [Google Scholar]
  31. Sharp J. T., Druz W. S., Foster J. R., Wicks M. S., Chokroverty S. Use of the respiratory magnetometer in diagnosis and classification of sleep apnea. Chest. 1980 Mar;77(3):350–353. doi: 10.1378/chest.77.3.350. [DOI] [PubMed] [Google Scholar]
  32. Strohl K. P., Saunders N. A., Feldman N. T., Hallett M. Obstructive sleep apnea in family members. N Engl J Med. 1978 Nov 2;299(18):969–973. doi: 10.1056/NEJM197811022991801. [DOI] [PubMed] [Google Scholar]
  33. Wynne J. W., Block A. J., Hemenway J., Hunt L. A., Shaw D., Flick M. R. Disordered breathing and oxygen desaturation during sleep in patients with chronic obstructive pulmonary disease. Chest. 1978 Feb;73(2 Suppl):301–303. doi: 10.1378/chest.73.2_supplement.301-a. [DOI] [PubMed] [Google Scholar]
  34. Zwillich C. W., Sutton F. D., Pierson D. J., Greagh E. M., Weil J. V. Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome. Am J Med. 1975 Sep;59(3):343–348. doi: 10.1016/0002-9343(75)90392-7. [DOI] [PubMed] [Google Scholar]

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