Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1973 Feb;36(1):15–26. doi: 10.1136/jnnp.36.1.15

Effects of tracheostomy in two cases of hypersomnia with periodic breathing

Elio Lugaresi 1,2,1, Giorgio Coccagna 1,2, Magda Mantovani 1,2, Fabrizio Brignani 1,2
PMCID: PMC494270  PMID: 4691688

Abstract

Two non-obese patients suffering from hypersomnia with periodic breathing, who presented predominantly obstructive apnoea persisting throughout sleep, underwent tracheotomy with placement of a permanent tracheal cannula. Before tracheostomy there was a serious state of alveolar hypoventilation with a marked rise in pulmonary arterial pressure which appeared during sleep. After tracheostomy breathing during sleep became regular, pulmonary arterial pressure became normal, and daytime drowsiness disappeared. These observations suggest that the obstruction of the upper air tracts during sleep represents the most important factor in the pathogenesis of hypersomnia with periodic breathing.

Full text

PDF
15

Images in this article

18Image
on p.18
22Image
on p.22
23Image
on p.23

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALEXANDER J. K., WEST J. R., WOOD J. A., RICHARDS D. W. Analysis of the respiratory response to carbon dioxide inhalation in varying clinical states of hypercapnia, anoxia, and acid-base derangement. J Clin Invest. 1955 Apr;34(4):511–532. doi: 10.1172/JCI103100. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. 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]
  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. BONVALLET M., HUGELIN A., DELL P. Sensibilité comparée du système réticulé activateur ascendant et du centre respiratoire aux gaz du sang et a l'adrénaline. J Physiol (Paris) 1955;47(4):651–654. [PubMed] [Google Scholar]
  5. CARROLL D. A peculiar type of cardiopulmonary failure associated with obesity. Am J Med. 1956 Nov;21(5):819–824. doi: 10.1016/0002-9343(56)90095-x. [DOI] [PubMed] [Google Scholar]
  6. Coccagna G., Mantovani M., Ceroni G. B., Pazzaglia P., Petrella A., Lugaresi E. Sindromi ipersonniche-ipoventilatorie. Considerazioni sui rapporti fisiopatologici e nosografici tra sindrome pickwickiana, ipoventilazione alveolare primaria e narcolessia a sonno lento. Minerva Med. 1970 Mar 17;61(22):1073–1084. [PubMed] [Google Scholar]
  7. DEMENT W., KLEITMAN N. Cyclic variations in EEG during sleep and their relation to eye movements, body motility, and dreaming. Electroencephalogr Clin Neurophysiol. 1957 Nov;9(4):673–690. doi: 10.1016/0013-4694(57)90088-3. [DOI] [PubMed] [Google Scholar]
  8. DRACHMAN D. B., GUMNIT R. J. Periodic alteration of consciousness in the "pickwickian" syndrome. Arch Neurol. 1962 Jun;6:471–477. doi: 10.1001/archneur.1962.00450240049006. [DOI] [PubMed] [Google Scholar]
  9. Fishman A. P., Goldring R. M., Turino G. M. General alveolar hypoventilation: a syndrome of respiratory and cardiac failure in patients with normal lungs. Q J Med. 1966 Apr;35(138):261–275. [PubMed] [Google Scholar]
  10. GELLHORN E. On the physiological action of carbon dioxide on cortex and hypothalamus. Electroencephalogr Clin Neurophysiol. 1953 Aug;5(3):401–413. doi: 10.1016/0013-4694(53)90083-2. [DOI] [PubMed] [Google Scholar]
  11. GOFF L. G., BARTLETT R. G., Jr Elevated end-tidal CO2 in trained underwater swimmers. J Appl Physiol. 1957 Mar;10(2):203–206. doi: 10.1152/jappl.1957.10.2.203. [DOI] [PubMed] [Google Scholar]
  12. Gastaut H., Duron B., Papy J. J., Tassinari C. A., Waltregny A. Etude polygraphique comparative du cycle nycthémérique chez les narcoleptiques, les Pickwickiens, les obèses et les insuffisants respiratoires. Rev Neurol (Paris) 1966 Sep;115(3):456–462. [PubMed] [Google Scholar]
  13. Gastaut H., Tassinari C. A., Duron B. Etude polygraphique des manifestations épisodiques (hypniques et respiratoires), diurnes et nocturnes, du syndrome de Pickwick. Rev Neurol (Paris) 1965 Jun;112(6):568–579. [PubMed] [Google Scholar]
  14. Grandjean T. Une microtechnique du cathétérisme cardiaque droit praticable au lit du malade sans contrôle radioscopique. Cardiologia. 1967;51(3):184–192. [PubMed] [Google Scholar]
  15. JUNG R., KUHLO W. NEUROPHYSIOLOGICAL STUDIES OF ABNORMAL NIGHT SLEEP AND THE PICKWICKIAN SYNDROME. Prog Brain Res. 1965;18:140–159. doi: 10.1016/s0079-6123(08)63590-6. [DOI] [PubMed] [Google Scholar]
  16. Kuhlo W., Doll E., Franck M. C. Erfolgreiche Behandlung eines Pickwick-Syndroms durch eine Dauertrachealkanüle. Dtsch Med Wochenschr. 1969 Jun 13;94(24):1286–1290. doi: 10.1055/s-0028-1111209. [DOI] [PubMed] [Google Scholar]
  17. Kuhlo W. Neurophysiologische und klinische Untersuchungen beim Pickwick-Syndrom. Arch Psychiatr Nervenkr (1970) 1968 Aug 22;211(2):170–192. doi: 10.1007/BF00344412. [DOI] [PubMed] [Google Scholar]
  18. LILLINGTON G. A., ANDERSON M. W., BRANDENBURG R. O. The cardiorespiratory syndrome of obesity. Dis Chest. 1957 Jul;32(1):1–20. doi: 10.1378/chest.32.1.1. [DOI] [PubMed] [Google Scholar]
  19. Lugaresi E., Coccagna G., Berti Ceroni G., Petrella A., Mantovani M. La "maledizione di ondine": il disturbo del respiro e del sonno nell'ipoventilazione alveolare primaria. Sist Nerv. 1968 Jan-Feb;20(1):27–37. [PubMed] [Google Scholar]
  20. Lugaresi E., Coccagna G., Mantovani M., Brignani F. Effets de la trachéotomie dans les hypersomnies avec respiration périodique. Rev Neurol (Paris) 1970 Oct;123(4):267–268. [PubMed] [Google Scholar]
  21. Lugaresi E., Coccagna G., Petrella A., Berti Ceroni G., Pazzaglia P. Il disturbo del sonno e del respiro nella sindrome pickwickinana. Sist Nerv. 1968 Jan-Feb;20(1):38–50. [PubMed] [Google Scholar]
  22. NAEYE R. L. Alveolar hypoventilation and cor pulmonale secondary to damage to the respiratory center. Am J Cardiol. 1961 Sep;8:416–419. doi: 10.1016/0002-9149(61)90161-8. [DOI] [PubMed] [Google Scholar]
  23. RODMAN T., CLOSE H. P. The primary hypoventilation syndrome. Am J Med. 1959 May;26(5):808–817. doi: 10.1016/0002-9343(59)90239-6. [DOI] [PubMed] [Google Scholar]
  24. SERIFF N. S. ALVEOLAR HYPOVENTILATION WITH NORMAL LUNGS: THE SYNDROME OF PRIMARY OR CENTRAL ALVEOLAR HYPOVENTILATION. Ann N Y Acad Sci. 1965 Mar 24;121:691–705. doi: 10.1111/j.1749-6632.1965.tb14238.x. [DOI] [PubMed] [Google Scholar]
  25. SIEKER H. O., HEYMAN A., BIRCHFIELD R. I. The effects of natural sleep and hypersomnolent states on respiratory function. Ann Intern Med. 1960 Mar;52:500–516. doi: 10.7326/0003-4819-52-3-500. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES