"At present it appears that stimulation of the self-defense systems in neural cells is a promising strategy in restricting the progression of AD. .... In this review we selectively present data that support the idea that adaptation to hypoxia is a possible non-drug means in the prevention of AD. In our opinion this strategy may provide a break-through in the clinical approach of this disease."

Recognition and management of complex sleep-disordered breathing.
Curr Opin Pulm Med. 2005 Nov;11(6):485-93.
PMID: 16217173 [PubMed - in process]

Gilmartin GS, Daly RW, Thomas RJ.

"PURPOSE OF REVIEW: The recent rapid evolution of our understanding of the mechanisms involved in control of respiration during sleep has yielded new insights to guide our care of difficult-to-treat sleep apnea patients with complex sleep-disordered breathing. This review will describe these recent advances in the literature and suggest a model for their incorporation into clinical practice......."

Relationships Between Sleep Disordered Breathing and Glucose Metabolism in Polycystic Ovary Syndrome.
J Clin Endocrinol Metab. 2005 Oct 11; [Epub ahead of print]
PMID: 16219719 [PubMed - as supplied by publisher]
Tasali E, Van Cauter E, Ehrmann DA.
of Medicine, University of Chicago, Chicago, IL.

“Context: Women with PCOS are insulin resistant and are at increased risk for sleep apnea, which in turn, may contribute to insulin resistance. ...... Conclusion: PCOS is associated with poor sleep quality, daytime sleepiness, and increased risk for OSA. Insulin levels and measures of glucose tolerance in PCOS are strongly correlated with the risk and severity of OSA.”

Association Between Sleep Apnea and Death Points to Need to Examine Treatments, Modify Devices (AScribe - USA)

"ROCHESTER, Minn., Nov. 9 (AScribe Newswire) -- In the current issue of the New England Journal of Medicine, two studies draw attention to the newly recognized association between sleep disorders and heart trouble. The relevance of these studies to patients with sleep apnea is discussed in an accompanying editorial by Virend Somers, M.D., Ph.D., a Mayo Clinic cardiologist."

Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
H. K. Yaggi and Others
N Engl J Med. 2005 Nov 10;353(19):2034-2041.
Abstract  PMID: 16282178

“Background Previous studies have suggested that the obstructive sleep apnea syndrome may be an important risk factor for stroke. It has not been determined, however, whether the syndrome is independently related to the risk of stroke or death from any cause after adjustment for other risk factors, including hypertension. ....

Conclusions The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.”

Continuous Positive Airway Pressure for Central Sleep Apnea and Heart Failure
T. D. Bradley and Others
N Engl J Med. 2005 Nov 10;353(19):2025-2033.
Abstract |  PMID: 16282177

“Background The Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure trial tested the hypothesis that continuous positive airway pressure (CPAP) would improve the survival rate without heart transplantation of patients who have central sleep apnea and heart failure. ....

Conclusions Although CPAP attenuated central sleep apnea, improved nocturnal oxygenation, increased the ejection fraction, lowered norepinephrine levels, and increased the distance walked in six minutes, it did not affect survival. Our data do not support the use of CPAP to extend life in patients who have central sleep apnea and heart failure.”

The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea.
Sleep Breath. 2005 Nov 8;:1-5 [Epub ahead of print]
PMID: 16283228 [PubMed - as supplied by publisher]
Hassaballa HA, Tulaimat A, Herdegen JJ, Mokhlesi B.
Section of Pulmonary/Critical Care Medicine, Rush University Medical Center, Chicago, IL, USA.

Deleterious Effects of Sleep-Disordered Breathing on the Heart and Vascular System.
Respiration. 2005 Nov 15; [Epub ahead of print]
PMID: 16293956 [PubMed - as supplied by publisher]
Dincer HE, O'neill W
"Pulmonary, Critical Care and Sleep Medicine, VA Southern Nevada Health Care System, Las Vegas, Nev., USA.

"Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing, affecting 5-15% of the population. It is characterized by intermittent episodes of partial or complete obstruction of the upper airway during sleep that disrupts normal ventilation and sleep architecture, and is typically associated with excessive daytime sleepiness, snoring, and witnessed apneas. Patients with obstructive sleep apnea present risk to the general public safety by causing 8-fold increase in vehicle accidents, and they may themselves also suffer from the physiologic consequences of OSA; these include hypertension, coronary artery disease, stroke, congestive heart failure, pulmonary hypertension, and cardiac arrhythmias. Of these possible cardiovascular consequences, the association between OSA and hypertension has been found to be the most convincing. Although the exact mechanism has not been understood, there is some evidence that OSA is associated with frequent apneas causing mechanical effects on intrathoracic pressure, cardiac function, and intermittent hypoxemia, which may in turn cause endothelial dysfunction and increase in sympathetic drive. Therapy with continuous positive airway pressure has been demonstrated to improve cardiopulmonary hemodynamics in patients with OSA and may reverse the endothelial cell dysfunction. Despite the availability of diagnostic measures and effective treatment, many patients with sleep-disordered breathing remain undiagnosed. Therefore, OSA continues to be a significant health risk both for affected individuals and for thegeneral public. Awareness and timely initiation of an effective treatment may prevent potential deleterious cardiovascular effects of OSA. Copyright (c) 2006 S. Karger AG, Basel."

Association of Sleep-disordered Breathing and the Occurrence of Stroke.
Am J Respir Crit Care Med. 2005 Dec 1;172(11):1447-51. Epub 2005 Sep 1.
PMID: 16141444 [PubMed - in process]

Arzt M, Young T, Finn L, Skatrud JB, Bradley TD.

"Conclusions: These data demonstrate a strong association between moderate to severe sleep-disordered breathing and prevalent stroke, independent of confounding factors. They also provide the first prospective evidence that sleep-disordered breathing precedes stroke and may contribute to the development of stroke."

Sleep Apnea Increases Stroke Risk (MedPage)

"In the four years after diagnosis people with moderate to severe sleep-disordered breathing have nearly 4.5 times the risk of stroke as do people without the condition, according to Douglas Bradley, M.D., director of Toronto General Hospital's Sleep Research Laboratory here."

"The researchers found:

      Without adjustment for other risk factors, the odds ratio for stroke among those with the worst disorder -- compared to the reference group -- was 4.31 (with a 95% confidence interval from 1.31 to 14.15) over any four-year period.

      When age and sex were accounted for, the odds ratio became 4.48 (with the 95% confidence interval from 1.31 to 15.33.)

      Both results were statistically significant at p=0.02."

Researchers link sleep apnea to risk of strokes (CTV.ca, Canada)

"We showed for the first time that if you have sleep apnea, your chance of having a stroke is four times greater than if you have no sleep apnea," Dr. Douglas Bradley, director of the Sleep Research Laboratory at the Toronto Rehabilitation Institute, told CTV News.

The researchers found that interrupted sleep increases blood pressure, which makes blood more prone to the clots that cause strokes. More than 70 per cent of stroke patients are later found to have sleep apnea."

Sleep apnea linked to higher stroke risk(United Press International)

Study links sleep disorder, stroke (Globe and Mail)

Influence of cardiac function and failure on sleep-disordered breathing: evidence for a causative role.
J Appl Physiol. 2005 Dec;99(6):2433-9. PMID: 16288101 [PubMed - in process]
Caples SM, Wolk R, Somers VK.
Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, 200 First St., SW, Rochester, MN 55905. somers.virend@mayo.edu).

"Heart failure is an increasingly common public health problem that is strongly linked to both central and obstructive sleep apnea, collectively referred to as sleep-disordered breathing. Much attention has been given to the deleterious effects of sleep-disordered breathing on the failing heart and potential mechanisms by which treatment of sleep-disordered breathing may result in improved cardiac performance and long-term outcomes. However, there is compelling evidence that cardiac dysfunction may contribute to sleep-disordered breathing. Although there is recognized overlap between pathophysiological mechanisms in central sleep apnea and obstructive sleep apnea, data supporting the role of cardiac function are certain forms of central sleep apnea are well established, whereas investigation into the relationship with obstructive sleep apnea is less mature but continues to evolve. This review will examine experimental and observational data that explore possible pathophysiological mechanisms and potential targets for therapy in heart failure and sleep-disordered breathing."

‘Silent’ nighttime acid reflux symptoms can cause poor sleep and sleep apnea October 31, 2005

"HONOLULU — Patients with sleep complaints but no heartburn symptoms suffered episodes of nighttime acid reflux according to research presented at the 70th Annual Scientific Meeting of the American College of Gastroenterology. In a separate study, researchers found that symptoms of gastroesophageal reflux (GER) are common and frequently severe in patients with obstructive sleep apnea."

Most GERD symptoms are not due to acid reflux in patients with very low 24-hour acid contact times.
Dig Dis Sci. 2004 Aug;49(7-8):1084-7.
PMID: 15387325 [PubMed - indexed for MEDLINE]

Green BT, O'Connor JB.

"In patients with very low total acid contact times, only 12% of symptoms (typical or atypical) are associated with acid reflux, compared to 86% in patients with very high acid contact times. Younger females are overrepresented in the very low reflux, low SI group."

Causal relationship suggested between reflux and sleep apnea

"The results of a recent study to be presented at the 68th Annual Scientific Meeting of the American College of Gastroenterology suggest that gastroesophageal reflux (GER) of any sort -- not just acid reflux -- may contribute to sleep apnea arousals.   Causal relationship suggested between reflux and sleep apneaOctober 14, 2003 BALTIMORE - The results of ... of Gastroenterology suggest that gastroesophageal reflux (GER) of any sort -- not just acid reflux..."

Marked improvement in nocturnal gastroesophageal reflux in a large cohort of patients with obstructive sleep apnea treated with continuous positive airway pressure.
Arch Intern Med. 2003 Jan 13;163(1):41-5.
PMID: 12523915 [PubMed - indexed for MEDLINE]
Green BT, Broughton WA, O'Connor JB.

"CONCLUSIONS: Nocturnal GER is common in patients with OSA. Treatment with nasal CPAP decreases the frequency of nGER symptoms by 48%. Higher nasal CPAP pressures are associated with greater improvement in nGER."

Predictors of heartburn during sleep in a large prospective cohort study.
Chest. 2005 May;127(5):1658-66.
PMID: 15888843 [PubMed - indexed for MEDLINE]

Fass R, Quan SF, O'Connor GT, Ervin A, Iber C.

"CONCLUSIONS: Heartburn during sleep is very common in the general population. Reports of this type of symptom of GERD are strongly associated with increased BMI, carbonated soft drink consumption, snoring and daytime sleepiness, insomnia, hypertension, asthma, and usage of benzodiazepines. Overall, heartburn during sleep may be associated with sleep complaints and excessive daytime sleepiness."

Sleep and the Aerodigestive Complications of Gastroesophageal Reflux (RT Article) William C. Orr, PhD

"Conclusions
There is considerable evidence linking nighttime reflux with severe esophageal damage, respiratory complications, and decrements in quality of life. Sleep disturbances that occur with nocturnal reflux may have serious consequences for the general well-being of patients and their ability to perform well at work or in other roles the next day....."

Correlation between Symptoms and Laryngeal Signs in Laryngopharyngeal Reflux.
Laryngoscope. 2005 Nov;115(11):1947-1952.
PMID: 16319603 [PubMed - as supplied by publisher]
Qadeer MA, Swoger J, Milstein C, Hicks DM, Ponsky J, Richter JE, Abelson TI, Vaezi MF.

"RESULTS:: Twenty-five of 72 (35%) patients remained unresponsive after 4 months of aggressive acid suppressive therapy. Ten (40%) patients agreed to undergo surgical fundoplication (mean age = 50, male = 4). The most common laryngeal symptoms were sore throat (40%), hoarseness (30%), and cough (20%), whereas the most common signs were medial arytenoid wall erythema/edema (60%), interarytenoid erythema (50%), and arytenoid complex erythema/edema (50%). At 1 year postfundoplication, laryngeal symptoms improved in only 1 of 10 (10%) patient, whereas signs improved in 8 of 10 (80%) patients. CONCLUSIONS:: There appears to be poor correlation between signs and symptoms of LPR, particularly when monitoring therapeutic outcomes. In patients unresponsive to twice-daily proton-pump inhibitor therapy for 4 months, further aggressive therapy is unlikely to bring additional symptomatic benefit."

A nightmare for your body - Los Angeles Times

New studies link obstructive sleep apnea to risks such as brain damage and diabetes. Still, the disorder is often ignored.

"Some people first suspect they have obstructive sleep apnea when their significant other complains about excessive snoring, or tells them they stop breathing many times during the night.

Others figure it out when their daytime sleepiness gets so bad they fall asleep at meetings or have a car accident."

Snoring Related to Obesity, Excessive Daytime Sleepiness, and Chronic Fatigue (AAOHNS)

Many studies have clearly showed that self perception of snoring poorly correlated, and observer perception only moderately correlated, with mean, maximum loudness, and snoring index. Two researchers set out to introduce an objective method of measuring snoring. (American Academy of Otolaryngology Head and Neck Surgery Foundation Annual Meeting & OTO EXPO)

Sleep Apnea Not Detrimental to Some Young Air Force Personnel (AAOHNS)

A new study finds that young Air Force men and NFL players have some similar qualities. They exercise regularly, often at body-building, they develop muscle mass in the arms and neck; and they may have obstructive sleep apnea, a disease that can be debilitating and even fatal. (American Academy of Otolaryngology--Head and Neck Surgery Foundation Annual Meeting & OTO EXPO)

Pillar Procedure Safe, Effective for Snoring, and Bed Partner Recommended (AAOHNS)

A variety of outpatient surgical procedures have undergone evaluation for the treatment of snoring, including laser assisted uvulopalatopharyngoplasty, radiofrequency treatment to the soft palate, injection snoreplasty, and the newest treatment, palatal implants made of polyethylene terephthalate palatal, the Pillar(r) implants. (American Academy of Otolaryngology Head and Neck Surgery Annual Meeting & OTO EXPO)

Gastric Reflux High in Patients with Sleep Disorders (AAOHNS)

Obstructive sleep apnea, gastroesophageal reflux, and laryngopharyngeal reflux may have dangerous consequences if they persist undiagnosed or untreated. Researchers have initiated a study to examine the prevalence of GERD and LPR in patients diagnosed with breathing-related sleep disorders. (American Academy of Otolaryngology Head and Neck Surgery Annual Meeting & OTO EXPO)

Craniofacial profile in Asian and white subjects with obstructive sleep apnoea -- Lam et al. 60 (6): 504 -- Thorax

“Conclusions: A crowded posterior oropharynx and a steep thyromental plane predict OSA across two different ethnic groups and varying degrees of obesity.”

Tracheal and neck position influence upper airway airflow dynamics by altering airway length.
J Appl Physiol. 1993 Nov;75(5):2084-90.

Entrez PubMed: Acquired laryngeal deviation associated with cervical spine disease in erosive polyarticular arthritis. Use of the fiberoptic bronchoscope in rheumatoid disease.

Entrez PubMed: [Deviation and rotation of the larynx in computer tomography]   Shibusawa M, Yano K.

Entrez PubMed:[Deviation and rotation of the larynx in computer tomography] Shibusawa M, Yano K.

“Seventy one percent of the subjects' larynges deviated and/or rotated to the right side, while 17% to the left side. Six percent showed neither deviation nor rotation. As to the rest of 6%, deviation and rotation were in opposite directions. Besides, the length of the thyroid alae were measured in 282 subjects. Left ala was longer in 55%, and right was in 23%, and almost equal in 22%.”

Vocal Cord Dysfunction: A Thorough Review (UTMB Department of Otolaryngology)  

All That Wheezes Is Not Asthma: Diagnosing the Mimics (Emergency Medicine)
By Francisco J. Soto, MD, and Kalpalatha K. Guntupalli, MD  

"Especially when the standard therapy for asthma has failed to produce improvement, the clinician should be alert to signs of other conditions that can closely resemble asthma, ranging from congestive heart failure to vocal cord dysfunction."

The trachea: normal anatomic features, imaging and causes of displacement. (NIH.GOV)

Effect of tracheal and tongue displacement on upper airway airflow dynamics(NIH.GOV)

Neuromuscular activity and upper airway collapsibility. Mechanisms of action in the decerebrate cat.(NIH.GOV) 

Structural basis for alterations in upper airway collapsibility. (NIH.GOV)  

Epiglottic movements during breathing in humans (NIH.GOV)

National Jewish Medical and Research Center

Diseases - Vocal Cord Dysfunction (VCD) -

About Vocal Cord Dysfunction (VCD)

Learn the basics:

What is vocal cord dysfunction?

What are the symptoms of VCD?

What happens in VCD?

Management and Treatment of Vocal Cord Dysfunction (VCD)

How is vocal cord dysfunction diagnosed?

What things can trigger symptoms?

Relationships to Other Conditions Asthma is often associated with other conditions: allergies, sinusitis, VCD (vocal cord dysfunction) and GERD (gastgroespohageal reflux disease).

Environmental and Occupational Health-Associated Vocal Cord Dysfunction

SLEEP DISORDERS-Medfacts-National Jewish Medical and Research Center

Oxygen and Fibromyalgia

A Snapshot of Fibromyalgia

THE OXYGEN MODEL OF CANCER

Tired Children, Teenagers in Pain

Majid Ali's Aging Healthfully Virtual Library

Journal of Respiratory Diseases: When to suspect vocal cord dysfunction as a cause of wheezing: in what circumstances should .

Apnea, Sleep : Article by Ralph Downey III, PhD -eMedicine -

Sleep Apnea Associated with Stomach Acid Backflow into Throat medicalnewstoday.com

Respiratory Physiology (WA & WFSA)

The Physiology of Oxygen Delivery

Vocal Cord Dysfunction: A Thorough Review (UTMB Department of Otolaryngology)

Vocal Cord Dysfunction in Patients With Exertional Dyspnea* -- Morris et al. 116 (6): 1676 -- Chest

Pulmonary-Function Testing in Diagnosing Upper-Airway Obstruction
 Pulmonary function testing provides an effective way of testing upper airway obstruction
(rtmagazine.com)

"Dr. Quinn's Online Textbook of Otolaryngology: Grand Rounds Archive"

Vocal Cord Dysfunction: A Thorough Review (UTMB Department of Otolaryngology)

Correlation between Symptoms and Laryngeal Signs in Laryngopharyngeal Reflux.
Laryngoscope. 2005 Nov;115(11):1947-1952. PMID: 16319603

The upper airway in sleep: physiology of the pharynx (NY U. School of Medicine)

All That Wheezes Is Not Asthma: Diagnosing the Mimics (Emergency Medicine)
By Francisco J. Soto, MD, and Kalpalatha K. Guntupalli, MD

"Especially when the standard therapy for asthma has failed to produce improvement, the clinician should be alert to signs of other conditions that can closely resemble asthma, ranging from congestive heart failure to vocal cord dysfunction."

The trachea: normal anatomic features, imaging and causes of displacement. (NIH.GOV)

Effect of tracheal and tongue displacement on upper airway airflow dynamics
(NIH.GOV)

Neuromuscular activity and upper airway collapsibility. Mechanisms of action in the decerebrate cat.(NIH.GOV)

Structural basis for alterations in upper airway collapsibility. (NIH.GOV)

MAP - Literatuur - Inhalt

Epiglottic movements during breathing in humans (NIH.GOV)

Upper airway response to electrical stimulation of the genioglossus in obstructive sleep apnea -- Oliven et al. 95 (5): 2023 .

Effect of hypertension on upper airway function and sleep apnoea.

A Model of Obstructive Sleep Apnea in Normal Humans . Role of the Upper Airway -- KING et al. 161 (6): 1979 (Am. J. Respir. Crit. Care Med.,)

Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature: An Evidence Review Cosponsored by the American Academy

Analysis of tracheal mechanics and applications -- Holzhäuser and Lambert 91 (1): 290 -- Journal of Applied Physiology

Chest: Effects of intermittent negative pressure ventilation on effective ventilation in normal awake subjects

Childhood snoring tied to poor school performance

The Effect of Chronic or Intermittent Hypoxia on Cognition in Childhood: A Review of the Evidence -- Bass et al. 114 (3): 805.

Children's sleeping habits linked to behaviour
Globe and Mail - Toronto,Ontario,Canada

"... they receive treatment for their sleep-related breathing ... Researchers at the Mayo Clinic in Minnesota recently ... with a device to measure blood pressure and body ... "

Polysomnography and Sleep Disorders
Anthony Murro, M.D.
Department of Neurology
Medical College of Georgia

For the Practitioner - Sleep Apnea Information - American Sleep Apnea Association - ASAA

the American Sleep Apnea Association Brochure

Sleep Apnea Action Handbook

[PDF] Obstructive Sleep Obstructive Sleep Apnea in Apnea in Adults and Children View as HTML

Obstructive Sleep Apnea Diagnosis and Treatment [PDF] View as HTML

Pregnancy - Miscarriage and Loss: Sleep apnea: Any miscarriage connection? at Pregnancy & Baby

Study: treating sleep apnea may combat asthma

Loud snorers risk sudden death at night

"Somers and his coworkers reviewed the medical records of 112 people who had undergone sleep tests at the clinic and had died suddenly of heart-related causes. Of them, 78 had sleep apnea and 34 did not."

Snoring in kids may predict hyperactivity - Children's Health - MSNBC.com

"WASHINGTON - Young children who snore could be at greater risk of becoming hyperactive later than those who sleep quietly, U.S. researchers reported on Friday."

Sleep-Disordered Breathing, Insulin Resistance Linked (Pulmonary Reviews)

Insulin Resistance and Obstructive Sleep Apnea: Is Increased Sympathetic Stimulation the Link?

Sleep-disordered Breathing and Insulin Resistance in Middle-aged and overweight men (RUSH Pulmonary and Critical Care)

Unusual manifestations in primary hypothyroidism. Prog Clin Biol Res. 1983;116:169-87. Related Articles

Google Search: longitudinal tension trachea

Airway Physiology and Reflexes (Dept. of Otolaryngology, UTMB)

Maximum expiratory flow changes induced by longitudinal tension on trachea in normal subjects.
J Appl Physiol. 1977 Sep;43(3):537-44 (Entrez PubMed)

Influence of smooth muscle tone and longitudinal tension on the collapsibility of immature airways.
Pediatr Pulmonol. 1988;5(3):132-8.(Entrez PubMed)

Neuromuscular Activity and Upper Airway Collapsibility . Mechanisms of Action in the Decerebrate Cat -- ROWLEY et al. 156 (2).

The Hypotonic Upper Airway in Obstructive Sleep Apnea . Role of Structures and Neuromuscular Activity -- SCHWARTZ et al. 157 .

Google Search: longitudinal tension trachea

Craniofacial profile in Asian and white subjects with obstructive sleep apnoea -- Lam et al. 60 (6): 504 -- Thorax

"Conclusions: A crowded posterior oropharynx and a steep thyromental plane predict OSA across two different ethnic groups and varying degrees of obesity.^"

Tracheal and neck position influence upper airway airflow dynamics by altering airway length.
J Appl Physiol. 1993 Nov;75(5):2084-90.

"We conclude that alterations in airflow mechanics with caudal tracheal displacement and changes in neck positions are primarily due to alterations in airway length."

Acquired laryngeal deviation associated with cervical spine disease in erosive polyarticular arthritis. Use of the fiberoptic bronchoscope in rheumatoid disease.

Deviation and rotation of the larynx in computer tomography

Helical CT scanning of laryngeal deviation.

Pro: Sleep Apnea Is an Anatomic Disorder -- Schwab 168 (3): 270 -- American Journal of Respiratory and Critical Care Medicine

The Hypotonic Upper Airway in Obstructive Sleep Apnea . Role of Structures and Neuromuscular Activity -- SCHWARTZ et al. 157 .

The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome -- Da. (ERS Journals Ltd)

"We conclude that the relationships between general obesity, hyoid position, soft palate length, and OSA are probably secondary to variation in neck circumference."

A MODEL OF OBSTRUCTIVE SLEEP APNEA IN NORMAL HUMANS -- Stanescu et al. 163 (4): 1031 -- American Journal of Respiratory and C.

A Model of Obstructive Sleep Apnea in Normal Humans . Role of the Upper Airway -- KING et al. 161 (6): 1979 -- American Journ.

Physiological and pathophysiological implications of upper airway reflexes in humans.
Jpn J Physiol. 2000 Feb;50(1):3-14. Review. Nishino T

Hypoxic apnoea induced by N2 inhalation can be reversed by the aspiration reflex in anaesthetized cats.

 Respir Med. 1991 Jan;85 Suppl A:61-5.

Reversal of apnoea by aspiration reflex in anaesthetized cats.
Eur Respir J. 1991 Oct;4(9):1117-25 Related Articles

[Clinical neurological findings in brain-dead patients] Rinsho Shinkeigaku. 1993 Dec;33(12):1321-4. Review. Japanese.

Laryngeal inputs in defensive airway reflexes in humans.
Pulm Pharmacol Ther. 2004;17(6):377-81. Review.

Obstructive sleep apnea, inflammation, and cardiopulmonary disease.
Front Biosci. 2004 Sep 1;9:2892-900.

[Respiratory functions of the upper airway with special reference to physiological implications of respiratory disease] Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jan;28(1):3-4.

Rapid development of obstructive sleep apnea following hemidiaphragmatic and unilateral vocal cord paralysis as a complication of mediastinal surgery (American College of Chest Physicians)

Teens Getting High Without Drugs

Cluster Headache With Obstructive Sleep Apnea and Periodic Limb Move. (Blackwell Synergy: Headache, Vol 45, Issue 1, pp. 81-83)

Pain and Sleep Apnea - American Sleep Apnea Association - ASAA

One Third Of Epilepsy Patients Found To Have Sleep Apnea
Finding hints at broader issues in understanding of sleep and brain function

The Sleep Site: FIBROMYALGIA, BACK PAIN, NECK PAIN AND
HEADACHES ARE OFTEN RELATED TO TREATABLE
SLEEP PROBLEMS!

District judge removed from office (AP)

"HARRISBURG, Pa. - A district judge who blamed his bad behavior on sleep apnea was removed from office Tuesday for inappropriate conduct, failing to cooperate with investigators and showing a lack of remorse."

Officer Who Slept in Crisis Resigns
Thomas Bissett, 42, says he suffers from a sleep disorder.

"Groundbreaking study helps explain why preemie brains improve over time

"Groundbreaking study helps explain why preemie brains improve over time Infants born prematurely and with hypoxia--inadequate oxygen to the blood--are able to recover some cells, volume and weight in the brain after oxygen supply is restored, Yale School of Medicine researchers report in Experimental Neurology."

Dynamic magnetic resonance imaging of vocal cord closure during deglutition.
Gastroenterology. 1995 Sep;109(3):843-9.
PMID: 7657113 [PubMed - indexed for MEDLINE]

Laryngeal response during forced vital capacity maneuvers in normal adult humans
Am. J. Respir. Crit. Care Med. 150: 729-734. [Abstract]

Glottic aperture and effective minute ventilation during nasal two- level positive pressure ventilation in spontaneous mode
Am. J. Respir. Crit. Care Med. 154: 1857-1863. [Abstract]

National Institutes of Health:
Sleep Information for Health Care Professionals, NHLBI

Sleep Apnea: Is Your Patient at Risk?(pdf)

Sleep Apnea Video PSA [QuickTime Format 2179 Kb]

SLEEP PROBLEMS MAY BE CAUSING YOUR WEIGHT GAIN (www.apneanet.org)

NHLBI, Obesity Guidelines-Home Page

Think Tank on Enhancing Obesity Research at the NHLBI

Executive Summary [PDF document, 44 pages, 208 K,

Full Report [PDF document, 88 pages, 728 K, NIH Publication No.: 04-5249

The National Sleep Foundation

Can't Sleep? / Myths -- and Facts -- About Sleep

Obstructive Sleep Apnea Articles (American Journal of Respiratory and Critical Care Medicine)

Google Search: Hypoxia +Rheumatoid

Google Search INSULIN OBESITY APNEA HYPOXIA

Google Search: hypoxia +pain

Google Search: Hypoxia AND  Blood Viscosity

Medscape Expert Interview with Dr. John Sarno, Part I

Medscape Expert Interview with Dr. John Sarno, Part II

University of Chicago Hospitals: University of Chicago scientists pinpoint cellular cause of SIDS - July 8, 2004

"In the July 8, 2004, issue of the journal Neuron, the researchers describe the specific group of neurons that are responsible for gasping and what happens to these cells when they are deprived of oxygen. Since gasping resets the normal breathing pattern for babies, the scientists suspect that a malfunction in these respiratory pacemakers is the cellular mechanism that leads to SIDS......."Gasping is an important arousal or auto-resuscitation mechanism," Ramirez says. It resets a baby's normal breathing rhythm and also alerts the baby as well as the mother that something is wrong."

Differential contribution of pacemaker properties to the generation of respiratory rhythms during normoxia and hypoxia.
Neuron. 2004 Jul 8;43(1):105-17. PMID: 15233921 Pena F, Parkis MA, Tryba AK, Ramirez JM.

Pacemaker neurons and neuronal networks: an integrative view.
Curr Opin Neurobiol. 2004 Dec;14(6):665-74. Review.
PMID: 15582367 [PubMed - indexed for MEDLINE] Ramirez JM, Tryba AK, Pena F.
Department of Organismal Biology and Anatomy, Committees on Neurobiology, Computational Neuroscience and Molecular Medicine, The University of Chicago, Chicago, Illinois 60637, USA. jramire@uchicago.edu

"Rhythmically active neuronal networks give rise to rhythmic motor activities but also to seemingly non-rhythmic behaviors such as sleep, arousal, addiction, memory and cognition. Many of these networks contain pacemaker neurons."

Determinants of inspiratory activity.
Respir Physiol Neurobiol. 2005 Jul 28;147(2-3):145-57. Review.
PMID: 15964786 [PubMed - indexed for MEDLINE] Ramirez JM, Viemari JC.

"We hypothesize that the balance between synaptic and intrinsic pacemaker properties in the respiratory network is plastic, and that alterations of this balance may lead to dynamic reconfigurations of the respiratory network, which ultimately give rise to different activity patterns."

NO-mediated alterations in skeletal muscle nutritive blood flow and lactate metabolism in fibromyalgia.
Pain. 2005 Dec 20; [Epub ahead of print]
PMID: 16376018 [PubMed - as supplied by publisher]

"In conclusion: (1) There is reduced nutritive flow response to aerobic exercise and reduced maximal exercise time in FM that might relate to higher iNOS protein content and contribute to exertional fatigue in FM; (2) The increased dialysate lactate in FM in response to stimulation of NOS or a nitric oxide donor suggest that FM may be more sensitive than HC to the suppressive effect of nitric oxide on oxidative phosphorylation."

ZHT v "common pathways", causes or results, "compensatory response"
	1: Bazar KA, Yun AJ, Lee PY, Daniel SM, Doux JD. Related Articles, Links Obesity and ADHD may represent different manifestations of a common environmental oversampling syndrome: a model for revealing mechanistic overlap among cognitive, metabolic, and inflammatory disorders. Med Hypotheses. 2006;66(2):263-9. PMID: 15905045 [PubMed - in process] "Apparently disparate conditions such as insulin resistance, diabetes, hypertension, syndrome X, obesity, ADHD, depression, psychosis, sleep apnea, inflammation, autism, and schizophrenia may operate through common pathways, and treatments used exclusively for one of these conditions may prove beneficial for the others." 2: Yun AJ, Doux JD, Bazar KA, Lee PY. Related Articles, Links Adventitial dysfunction: an evolutionary model for understanding atherosclerosis. Med Hypotheses. 2005;65(5):962-5. PMID: 16117998 [PubMed - indexed for MEDLINE] 4: Doux JD, Bazar KA, Lee PY, Yun AJ. Related Articles, Links Can chronic use of anti-inflammatory agents paradoxically promote chronic inflammation through compensatory host response? Med Hypotheses. 2005;65(2):389-91. PMID: 15922118 [PubMed - indexed for MEDLINE] 6: Yun AJ, Bazar KA, Gerber A, Lee PY, Daniel SM. Related Articles, Links The dynamic range of biologic functions and variation of many environmental cues may be declining in the modern age: implications for diseases and therapeutics. Med Hypotheses. 2005;65(1):173-8. Epub 2005 Jan 5. PMID: 15893136 [PubMed - indexed for MEDLINE] 7: Bazar KA, Yun AJ, Lee PY. Related Articles, Links "Starve a fever and feed a cold": feeding and anorexia may be adaptive behavioral modulators of autonomic and T helper balance. Med Hypotheses. 2005;64(6):1080-4. Review. PMID: 15823688 [PubMed - indexed for MEDLINE] 8: Yun AJ, Bazar KA, Lee PY, Gerber A, Daniel SM. Related Articles, Links The smoking gun: many conditions associated with tobacco exposure may be attributable to paradoxical compensatory autonomic responses to nicotine. Med Hypotheses. 2005;64(6):1073-9. Review. PMID: 15823687 [PubMed - indexed for MEDLINE] "We hypothesize that the illnesses associated with smoking may be partly attributable to autonomic dysfunction, sympathetic bias, and T helper (Th)2 inflammation induced by a paradoxical compensatory response to intermittent nicotinic exposure. The confusion of interpreting the adrenergia and inflammation associated with nicotine as a primary response instead of a secondary compensation may be explained by the unusually rapid absorption, action, and serum elimination of nicotine. Given the fast action and clearance of nicotine, even heavy smokers spend large portions of the day and the entire night in nicotine withdrawal, at which time rebound sympathetic bias may manifest as a result of desensitization of nicotinic receptors." 9: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Paradoxical strategy for treating chronic diseases where the therapeutic effect is derived from compensatory response rather than drug effect. Med Hypotheses. 2005;64(5):1050-9. PMID: 15780510 [PubMed - indexed for MEDLINE] 10: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Can thromboembolism be the result, rather than the inciting cause, of acute vascular events such as stroke, pulmonary embolism, mesenteric ischemia, and venous thrombosis?: a maladaptation of the prehistoric trauma response. Med Hypotheses. 2005;64(4):706-16. PMID: 15694686 [PubMed - indexed for MEDLINE] 11: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Clinical benefits of hydration and volume expansion in a wide range of illnesses may be attributable to reduction of sympatho-vagal ratio. Med Hypotheses. 2005;64(3):646-50. PMID: 15617881 [PubMed - indexed for MEDLINE] 12: Yun AJ, Bazar KA, Lee PY. Related Articles, Links A new mechanism for diverticular diseases: aging-related vagal withdrawal. Med Hypotheses. 2005;64(2):252-5. PMID: 15607549 [PubMed - indexed for MEDLINE] 13: Yun AJ, Bazar KA, Lee PY. Related Articles, Links Pineal attrition, loss of cognitive plasticity, and onset of puberty during the teen years: is it a modern maladaptation exposed by evolutionary displacement? Med Hypotheses. 2004;63(6):939-50. PMID: 15504560 [PubMed - indexed for MEDLINE] 14: Bazar KA, Yun AJ, Lee PY. Related Articles, Links Debunking a myth: neurohormonal and vagal modulation of sleep centers, not redistribution of blood flow, may account for postprandial somnolence. Med Hypotheses. 2004;63(5):778-82. PMID: 15488646 [PubMed - indexed for MEDLINE] 15: Bazar KA, Lee PY, Joon Yun A. Related Articles, Links An "eye" in the gut: the appendix as a sentinel sensory organ of the immune intelligence network. Med Hypotheses. 2004;63(4):752-8. PMID: 15325028 [PubMed - indexed for MEDLINE] 16: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Modulation of host immunity by HIV may be partly achieved through usurping host autonomic functions. Med Hypotheses. 2004;63(2):362-6. PMID: 15236804 [PubMed - indexed for MEDLINE] 17: Bazar KA, Yun AJ, Lee PY. Related Articles, Links Hypertrophic osteoarthropathy may be a marker of underlying sympathetic bias. Med Hypotheses. 2004;63(2):357-61. PMID: 15236803 [PubMed - indexed for MEDLINE] 18: Joon Yun A, Bazar KA, Lee PY. Related Articles, Links Tumors may modulate host immunity partly through hypoxia-induced sympathetic bias. Med Hypotheses. 2004;63(2):352-6. PMID: 15236802 [PubMed - indexed for MEDLINE] 19: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Modulation of autonomic balance by tumors and viruses. Med Hypotheses. 2004;63(2):344-51. PMID: 15236801 [PubMed - indexed for MEDLINE] 20: Yun AJ, Bazar KA, Lee PY. Related Articles, Links Autonomic dysfunction may be an under-recognized cause of female fertility disorders. Med Hypotheses. 2004;63(1):172-7. PMID: 15193372 [PubMed - indexed for MEDLINE] 21: Bazar KA, Yun AJ, Lee PY. Related Articles, Links Immunomodulatory function of seminal catecholamines may be an adaptation for reproduction. Med Hypotheses. 2004;63(1):168-71. PMID: 15193371 [PubMed - indexed for MEDLINE] 22: Lee PY, Bazar KA, Yun AJ. Related Articles, Links Menstrual variation of autonomic balance may be a factor in exacerbations of certain diseases during the menstrual cycle. Med Hypotheses. 2004;63(1):163-7. PMID: 15193370 [PubMed - indexed for MEDLINE] 23: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Temporal variation of autonomic balance and diseases during circadian, seasonal, reproductive, and lifespan cycles. Med Hypotheses. 2004;63(1):155-62. PMID: 15193369 [PubMed - indexed for MEDLINE] 24: Lee PY, Yun AJ, Bazar KA. Related Articles, Links Conditions of aging as manifestations of sympathetic bias unmasked by loss of parasympathetic function. Med Hypotheses. 2004;62(6):868-70. PMID: 15142638 [PubMed - indexed for MEDLINE] 25: Lee PY, Yun AJ, Bazar KA. Related Articles, Links Acute coronary syndromes and heart failure may reflect maladaptations of trauma physiology that was shaped during pre-modern evolution. Med Hypotheses. 2004;62(6):861-7. PMID: 15142637 [PubMed - indexed for MEDLINE] 26: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Autonomic dysregulation as a basis of cardiovascular, endocrine, and inflammatory disturbances associated with obstructive sleep apnea and other conditions of chronic hypoxia, hypercapnia, and acidosis. Med Hypotheses. 2004;62(6):852-6. PMID: 15142635 [PubMed - indexed for MEDLINE] 27: Yun AJ, Lee PY, Bazar KA. Related Articles, Links Many diseases may reflect dysfunctions of autonomic balance attributable to evolutionary displacement. Med Hypotheses. 2004;62(6):847-51. PMID: 15142634 [PubMed - indexed for MEDLINE] 28: Bazar KA, Khavari P. Related Articles, Links Multiple asymptomatic papules in the popliteal fossa. Arch Dermatol. 1998 Jun;134(6):745, 747-8. No abstract available. PMID: 9645649 [PubMed - indexed for MEDLINE]
	1: Wolk R, Shamsuzzaman AS, Svatikova A, Huyber CM, Huck C, Narkiewicz K, Somers VK. Related Articles, Links Hemodynamic and autonomic effects of smokeless tobacco in healthy young men. J Am Coll Cardiol. 2005 Mar 15;45(6):910-4. PMID: 15766828 [PubMed - indexed for MEDLINE] "CONCLUSIONS: Oral snuff tobacco increases heart rate, blood pressure, and epinephrine. Despite the increase in blood pressure, there is no decrease in either MSNA or peripheral vascular resistance. Smokeless tobacco is a powerful autonomic and hemodynamic stimulus. Catecholamine release from the adrenal medulla likely contributes to this response." 2: Black CE, Huang N, Neligan PC, Levine RH, Lipa JE, Lintlop S, Forrest CR, Pang CY. Related Articles, Links Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. Am J Physiol Regul Integr Comp Physiol. 2001 Oct;281(4):R1097-104. PMID: 11557615 [PubMed - indexed for MEDLINE] 3: Hirsch JM, Hedner J, Wernstedt L, Lundberg J, Hedner T. Related Articles, Links Hemodynamic effects of the use of oral snuff. Clin Pharmacol Ther. 1992 Oct;52(4):394-401. PMID: 1424411 [PubMed - indexed for MEDLINE] 4: McPhaul M, Punzi HA, Sandy A, Borganelli M, Rude R, Kaplan NM. Related Articles, Links Snuff-induced hypertension in pheochromocytoma. JAMA. 1984 Nov 23-30;252(20):2860-2. PMID: 6541713 [PubMed - indexed for MEDLINE] 15: Mills PJ, Kennedy BP, Loredo JS, Dimsdale JE, Ziegler MG. Related Articles, Links Effects of nasal continuous positive airway pressure and oxygen supplementation on norepinephrine kinetics and cardiovascular responses in obstructive sleep apnea. J Appl Physiol. 2006 Jan;100(1):343-8. PMID: 16357087 [PubMed - in process] "The findings indicate that one of the mechanisms through which CPAP reduces NE levels is through an increase in the clearance of NE from the circulation." 3: Alvarez Lario B, Alonso Valdivielso JL, Alegre Lopez J, Martel Soteres C, Viejo Banuelos JL, Maranon Cabello A. Related Articles, Links Fibromyalgia syndrome: overnight falls in arterial oxygen saturation. Am J Med. 1996 Jul;101(1):54-60. PMID: 8686716 [PubMed - indexed for MEDLINE] "CONCLUSIONS: Patients with FS showed small overnight falls in SaO2% and spent more time during the night in SaO2% below 92% and 90% than did the control group. These alterations that, as a whole, are not due to the presence of an associated SAS could be important in FS musculoskeletal pathophysiology." 1: Selic C, Siccoli MM, Hermann DM, Bassetti CL. Related Articles, Links Blood pressure evolution after acute ischemic stroke in patients with and without sleep apnea. Stroke. 2005 Dec;36(12):2614-8. Epub 2005 Nov 10. PMID: 16282549 [PubMed - indexed for MEDLINE] "BACKGROUND AND PURPOSE: Sleep apnea (SA) is an independent risk factor for arterial hypertension and is present in 50% to 70% of patients with ischemic stroke. The effects of SA on blood pressure (BP) and stroke outcome in the acute stroke phase are essentially unknown. ......CONCLUSIONS: SA severity is associated with high 24-hour BP values but only weakly with stroke severity and outcome. Conversely, NDS is linked with a more severe stroke and a poorer evolution but not with SA severity. These data suggest different, although overlapping, pathophysiological and clinical implications of circadian and nocturnal BP values in acute stroke." 1: Meadows GE, Kotajima F, Vazir A, Kostikas K, Simonds AK, Morrell MJ, Corfield DR. Related Articles, Links Overnight changes in the cerebral vascular response to isocapnic hypoxia and hypercapnia in healthy humans: protection against stroke. Stroke. 2005 Nov;36(11):2367-72. Epub 2005 Oct 13. PMID: 16224083 [PubMed - in process] "CONCLUSIONS: Our findings indicate that substantial differences exist in the regulation of the cerebral circulation in response to hypoxia and hypercapnia on waking from sleep. An intact cerebral vascular response to IH, during this time period, could be interpreted as a protective mechanism against cerebral ischemia and stroke; this is of particular relevance to patients with obstructive sleep apnea who arouse from sleep during hypoxia."
	More Apnea results from ahajournals.org of "the American Heart Association."
	11: Cistulli PA, Grunstein RR. Related Articles, Links Medical devices for the diagnosis and treatment of obstructive sleep apnea. Expert Rev Med Devices. 2005 Nov;2(6):749-63. PMID: 16293102 [PubMed - in process] "......The discovery of continuous positive airway pressure treatment, and the resultant recognition of the high prevalence of snoring and obstructive sleep apnea, and their impact on health, has spawned a new and rapidly growing global industry. Whilst diagnostic technologic advancements have evolved relatively rapidly, many questions relating to the use of such devices in clinical practice remain unresolved. Similarly, on the therapeutic front, advances in continuous positive airway pressure technology have broadened the use of such treatment, although compliance remains an important impediment to widespread treatment of this common disorder. This has prompted a search for simpler treatment alternatives, ranging from surgical, medical and dental therapies, although none have matched the efficacy of continuous positive airway pressure. Advances in our understanding of the neurobiology of sleep and respiration herald the prospect of pharmacologic treatment in the longer term." 1: Johansson SE, Sundquist K, Qvist J, Sundquist J. Related Articles, Links Smokeless tobacco and coronary heart disease: a 12-year follow-up study. Eur J Cardiovasc Prev Rehabil. 2005 Aug;12(4):387-92. PMID: 16079648 [PubMed - in process] 2: Henley SJ, Thun MJ, Connell C, Calle EE. Related Articles, Links Two large prospective studies of mortality among men who use snuff or chewing tobacco (United States). Cancer Causes Control. 2005 May;16(4):347-58. PMID: 15953977 [PubMed - indexed for MEDLINE] "CONCLUSIONS: These two prospective studies provide limited evidence that current use of chewing tobacco or snuff may increase mortality from heart disease and stroke." 6: Metules T, Bauer J. Related Articles, Links Unstable angina: is your care up to snuff? RN. 2005 Feb;68(2):22-7; quiz 28. Review. No abstract available. PMID: 15736768 [PubMed - indexed for MEDLINE] 7: Levy DT, Mumford EA, Cummings KM, Gilpin EA, Giovino G, Hyland A, Sweanor D, Warner KE. Related Articles, Links The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts. Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(12):2035-42. PMID: 15598758 [PubMed - indexed for MEDLINE] 8: Critchley JA, Unal B. Related Articles, Links Is smokeless tobacco a risk factor for coronary heart disease? A systematic review of epidemiological studies. Eur J Cardiovasc Prev Rehabil. 2004 Apr;11(2):101-12. Review. PMID: 15187813 [PubMed - indexed for MEDLINE] 9: Rohani M, Agewall S. Related Articles, Links Oral snuff impairs endothelial function in healthy snuff users. J Intern Med. 2004 Mar;255(3):379-83. PMID: 14871462 [PubMed - indexed for MEDLINE] 10: Asplund K. Related Articles, Links [Use of snuff entails lower risk of cardiovascular diseases than does smoking] Lakartidningen. 2003 Jun 19;100(25):2206-10. Review. Swedish. PMID: 12872508 [PubMed - indexed for MEDLINE] 11: Asplund K. Related Articles, Links Smokeless tobacco and cardiovascular disease. Prog Cardiovasc Dis. 2003 Mar-Apr;45(5):383-94. Review. PMID: 12704595 [PubMed - indexed for MEDLINE] 4: Black CE, Huang N, Neligan PC, Levine RH, Lipa JE, Lintlop S, Forrest CR, Pang CY. Related Articles, Links Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. Am J Physiol Regul Integr Comp Physiol. 2001 Oct;281(4):R1097-104. PMID: 11557615 [PubMed - indexed for MEDLINE] "It was observed that nicotine (10(-7) M) amplified (P < 0.05) the norepinephrine (NE)-induced concentration-dependent (10(-7)-10(-5) M) increase in skin vasoconstriction compared with the control. This amplification effect of nicotine in NE-induced skin vasoconstriction was not blocked by the nicotine-receptor antagonist hexamethonium (10(-6) M) or the cyclooxygenase inhibitor indomethacin (10(-5) M). ........ The present findings were interpreted to indicate that acute exposure of human skin vasculature to nicotine was associated with 1) amplification of NE-induced skin vasoconstriction and 2) impairment of endothelium-dependent skin vasorelaxation. Cyclooxygenase products and nicotine receptors blocked by hexamethonium were not involved in the amplification of NE-induced skin vasoconstriction by nicotine. These findings may provide further insight into the pathogenesis of skin vasospasm in skin flap surgery and skin ischemic disease associated with cigarette smoking or use of smokeless tobacco." 1: Bonsignore MR, Parati G, Insalaco G, Castiglioni P, Marrone O, Romano S, Salvaggio A, Mancia G, Bonsignore G, Di Rienzo M. Links Baroreflex control of heart rate during sleep in severe obstructive sleep apnoea: effects of acute CPAP. Eur Respir J. 2006 Jan;27(1):128-135. PMID: 16387945 [PubMed - as supplied by publisher] "The small increase in baroreflex control of heart rate during sleep may be of clinical relevance as it was accompanied by reduced cardiovascular variability, which is acknowledged as an independent cardiovascular risk factor." 2: Borgel J, Sanner BM, Bittlinsky A, Keskin F, Bartels NK, Buechner N, Huesing A, Rump LC, Mugge A. Links Obstructive sleep apnoea and its therapy influence high-density lipoprotein cholesterol serum levels. Eur Respir J. 2006 Jan;27(1):121-127. PMID: 16387944 [PubMed - as supplied by publisher] "An independent relationship was found between the change of apnoea-hypopnoea index and the change of high-density lipoprotein cholesterol or triglycerides, respectively. All patients with abnormal serum lipid/lipoprotein levels improved significantly under bilevel or continuous positive airway pressure therapy. This study demonstrates an influence of obstructive sleep apnoea and its therapy on high-density lipoprotein cholesterol levels." 3: Del Campo F, Hornero R, Zamarron C, Abasolo DE, Alvarez D. Links Oxygen saturation regularity analysis in the diagnosis of obstructive sleep apnea. Artif Intell Med. 2005 Dec 27; [Epub ahead of print] PMID: 16386411 [PubMed - as supplied by publisher] "CONCLUSION: We conclude that ApEn analysis of SaO(2) data obtained from pulse oximetric recordings could be useful as a diagnostic technique for OSA subjects." 8: Cherniack NS, Longobardo G, Evangelista CJ. Related Articles, Links Causes of cheyne - stokes respiration. Neurocrit Care. 2005;3(3):271-9. PMID: 16377843 [PubMed - in process] "Cheyne - Stokes respiration (CSR) is one of several types of unusual breathing with recurrent apneas (dysrhythmias). Reported initially in patients with heart failure or stroke, it was then recognized both in other diseases and as a component of the sleep apnea syndrome. CSR is potentiated and perpetuated by changing states of arousal that occur during sleep. The recurrent hypoxia and surges of sympathetic activity that often occur during the apneas may have serious health consequences. Heart failure and stroke are risk factors for sleep apnea. The recurrent apneas and intermittent hypoxia occurring with sleep apnea further damage the heart and brain. Although all breathing dysrhythmias do not have the same cause, instability in the feedback control involved in the chemical regulation of breathing is the leading cause of CSR. Mathematical models have helped greatly in the understanding of the causes of recurrent apneas." 8: Rowat AM, Dennis MS, Wardlaw JM. Links Hypoxaemia in Acute Stroke Is Frequent and Worsens Outcome. Cerebrovasc Dis. 2005 Dec 23;21(3):166-172 [Epub ahead of print] PMID: 16388191 [PubMed - as supplied by publisher] "Conclusion: Hypoxaemia during acute stroke assessment was associated with increased risk of death. Although SaO(2) is lower during transfers, hypoxaemia occurs in all stages of the admission process. Further research is necessary to determine whether strategies to avoid hypoxaemia during acute assessment improve stroke survival." 6: Carriere A, Galinier A, Fernandez Y, Carmona MC, Penicaud L, Casteilla L. Links [Physiological and physiopathological consequences of mitochondrial reactive oxygen species.] Med Sci (Paris). 2005 Dec;22(1):47-53. French. PMID: 16386220 [PubMed - as supplied by publisher] 10: Blohm U, Potthoff D, van der Kogel AJ, Pircher H. Links Solid tumors "melt" from the inside after successful CD8 T cell attack. Eur J Immunol. 2005 Dec 30; [Epub ahead of print] PMID: 16385625 [PubMed - as supplied by publisher] 11: Sheng WH, Chiang BL, Chang SC, Ho HN, Wang JT, Chen YC, Hsiao CH, Hseuh PR, Chie WC, Yang PC. Links Clinical manifestations and inflammatory cytokine responses in patients with severe acute respiratory syndrome. J Formos Med Assoc. 2005 Oct;104(10):715-23. PMID: 16385373 [PubMed - in process] 2: Spaak J, Egri ZJ, Kubo T, Yu E, Ando S, Kaneko Y, Usui K, Bradley TD, Floras JS. Related Articles, Links Muscle sympathetic nerve activity during wakefulness in heart failure patients with and without sleep apnea. Hypertension. 2005 Dec;46(6):1327-32. Epub 2005 Nov 14. PMID: 16286569 [PubMed - indexed for MEDLINE] "......In a subgroup (n=8), treatment of obstructive sleep apnea lowered MSNA by 12 bursts per 100 heartbeats (P=0.003). Convergence of independent excitatory influences of HF and sleep apnea on central sympathetic neurons results in higher MSNA during wakefulness in HF patients with coexisting sleep apnea. This additional stimulus to central sympathetic outflow may accelerate the progression of HF; its attenuation by treatment of sleep apnea represents a novel nonpharmacological opportunity." 1: Otsuka R, Ribeiro de Almeida F, Lowe AA, Linden W, Ryan F. Links The effect of oral appliance therapy on blood pressure in patients with obstructive sleep apnea. Sleep Breath. 2006 Jan 4;:1-8 [Epub ahead of print] PMID: 16391938 [PubMed - as supplied by publisher] "This study suggests that successful OSA treatment with an OA may also be beneficial to lower blood pressure in OSA patients, as previously suggested for nasal continuous positive airway pressure therapy." 1: Billups KL. Links Erectile dysfunction as an early sign of cardiovascular disease. Int J Impot Res. 2005 Dec;17 Suppl 1:S19-24. PMID: 16391539 [PubMed - in process] "The diagnosis of ED could become a powerful clinical tool to improve early detection of atherosclerosis and initiate prompt aggressive medical management of associated cardiovascular risk factors. International Journal of Impotence Research (2005) 17, S19-S24. doi:10.1038/sj.ijir.3901425." 1: Chen ML, Tablizo MA, Kun S, Keens TG. Related Articles, Links Diaphragm pacers as a treatment for congenital central hypoventilation syndrome. Expert Rev Med Devices. 2005 Sep;2(5):577-85. Review. PMID: 16293069 [PubMed - indexed for MEDLINE] 1: D'Andrea MR. Related Articles, Links Add Alzheimer's disease to the list of autoimmune diseases. Med Hypotheses. 2005;64(3):458-63. PMID: 15617848 [PubMed - indexed for MEDLINE] 1: Abrams B. Related Articles, Links Long-term sleep apnea as a pathogenic factor for cell-mediated autoimmune disease. Med Hypotheses. 2005;65(6):1024-7. Epub 2005 Aug 5. PMID: 16084665 [PubMed - indexed for MEDLINE] 1: Jyothula SS, Ramachandran S. Related Articles, Links Reversible ventricular arrhythmia in REM sleep associated with hypoxic sleep-disordered breathing. Sleep Med. 2006 Jan;7(1):81-2. Epub 2005 Nov 28. No abstract available. PMID: 16314147 [PubMed - in process] 1: Goncalves MA, Guilleminault C, Ramos E, Palha A, Paiva T. Related Articles, Links Erectile dysfunction, obstructive sleep apnea syndrome and nasal CPAP treatment. Sleep Med. 2005 Jul;6(4):333-9. PMID: 15946896 [PubMed - indexed for MEDLINE] "CONCLUSIONS: ED in OSAS is related to nocturnal hypoxemia, and about 75% of OSAS patients with ED treated with nasal CPAP showed remission at one-month follow-up, resulting in significant improvement in quality of life." 2: Margel D, Tal R, Livne PM, Pillar G. Related Articles, Links Predictors of erectile function improvement in obstructive sleep apnea patients with long-term CPAP treatment. Int J Impot Res. 2005 Mar-Apr;17(2):186-90. PMID: 15510189 [PubMed - indexed for MEDLINE] 3: Perimenis P, Karkoulias K, Markou S, Gyftopoulos K, Athanasopoulos A, Barbalias G, Kiriazopoulou V, Spiropoulos K. Related Articles, Links Erectile dysfunction in men with obstructive sleep apnea syndrome: a randomized study of the efficacy of sildenafil and continuous positive airway pressure. Int J Impot Res. 2004 Jun;16(3):256-60. PMID: 15057257 [PubMed - indexed for MEDLINE] 4: Karacan I, Karatas M. Related Articles, Links Erectile dysfunction in sleep apnea and response to CPAP. J Sex Marital Ther. 1995 Winter;21(4):239-47. PMID: 8789505 [PubMed - indexed for MEDLINE] 1: Hirshkowitz M, Schmidt MH. Related Articles, Links Sleep-related erections: clinical perspectives and neural mechanisms. Sleep Med Rev. 2005 Aug;9(4):311-29. Review. PMID: 15994100 [PubMed - indexed for MEDLINE] 3: Yu DP, Wei AY, Zhan JC, Zhang P. Related Articles, Links [Obstructive sleep apnea and erectile dysfunction] Zhonghua Yi Xue Za Zhi. 2005 Jan 12;85(2):141-2. Review. Chinese. No abstract available. PMID: 15774230 [PubMed - indexed for MEDLINE] 4: Feinsilver SH. Related Articles, Links Erectile dysfunction in obese men. JAMA. 2004 Nov 24;292(20):2466-7; author reply 2467. No abstract available. PMID: 15562119 [PubMed - indexed for MEDLINE] 6: Li F, Feng Q, Zhang X, Liu Q. Related Articles, Links [Treatment for erectile dysfunction patients with obstructive sleep apnea syndrome by nasal continual positive airway pressure] Zhonghua Nan Ke Xue. 2004 May;10(5):355-7. Chinese. PMID: 15190828 [PubMed - indexed for MEDLINE] 8: Margel D, Cohen M, Livne PM, Pillar G. Related Articles, Links Severe, but not mild, obstructive sleep apnea syndrome is associated with erectile dysfunction. Urology. 2004 Mar;63(3):545-9. PMID: 15028455 [PubMed - indexed for MEDLINE] 9: Siroky MB, Azadzoi KM. Related Articles, Links Vasculogenic erectile dysfunction: newer therapeutic strategies. J Urol. 2003 Aug;170(2 Pt 2):S24-9; discussion S29-30. Review. PMID: 12853769 [PubMed - indexed for MEDLINE] 10: Arruda-Olson AM, Olson LJ, Nehra A, Somers VK. Related Articles, Links Sleep apnea and cardiovascular disease. Implications for understanding erectile dysfunction. Herz. 2003 Jun;28(4):298-303. PMID: 12825145 [PubMed - indexed for MEDLINE] 11: Ziegler D. Related Articles, Links Diagnosis and treatment of diabetic autonomic neuropathy. Curr Diab Rep. 2001 Dec;1(3):216-27. Review. PMID: 12643202 [PubMed - indexed for MEDLINE] 12: Tomori Z, Donic V, Benacka R, Kuchta M, Koval S, Jakus J. Related Articles, Links [Regulation of respiration and its sleep-related disorders] Sb Lek. 2002;103(1):65-71. Slovak. PMID: 12448939 [PubMed - indexed for MEDLINE] 13: Seftel AD, Strohl KP, Loye TL, Bayard D, Kress J, Netzer NC. Related Articles, Links Erectile dysfunction and symptoms of sleep disorders. Sleep. 2002 Sep 15;25(6):643-7. PMID: 12227360 [PubMed - indexed for MEDLINE] 14: Fanfulla F, Malaguti S, Montagna T, Salvini S, Bruschi C, Crotti P, Casale R, Rampulla C. Related Articles, Links Erectile dysfunction in men with obstructive sleep apnea: an early sign of nerve involvement. Sleep. 2000 Sep 15;23(6):775-81. PMID: 11007444 [PubMed - indexed for MEDLINE] 15: Conway AJ, Handelsman DJ, Lording DW, Stuckey B, Zajac JD. Related Articles, Links Use, misuse and abuse of androgens. The Endocrine Society of Australia consensus guidelines for androgen prescribing. Med J Aust. 2000 Mar 6;172(5):220-4. Erratum in: Med J Aust 2000 Apr 3;172(7):334. PMID: 10776394 [PubMed - indexed for MEDLINE] 16: Konermann M, Sanner BM, Rawert B, Haupt G. Related Articles, Links [Sleep apnea and erectile dysfunction] Dtsch Med Wochenschr. 1999 May 21;124(20):631-5. Review. German. No abstract available. PMID: 10370386 [PubMed - indexed for MEDLINE] 18: Hirshkowitz M, Karacan I, Arcasoy MO, Acik G, Narter EM, Williams RL. Related Articles, Links Prevalence of sleep apnea in men with erectile dysfunction. Urology. 1990 Sep;36(3):232-4. PMID: 2392814 [PubMed - indexed for MEDLINE] 19: Hirshkowitz M, Karacan I, Gurakar A, Williams RL. Related Articles, Links Hypertension, erectile dysfunction, and occult sleep apnea. Sleep. 1989 Jun;12(3):223-32. PMID: 2740693 [PubMed - indexed for MEDLINE] 2: Haczynski J, Lew-Starowicz Z, Darewicz B, Krajka K, Piotrowicz R, Ciesielska B. Links The prevalence of erectile dysfunction in men visiting outpatient clinics. Int J Impot Res. 2006 Jan 5; [Epub ahead of print] PMID: 16395328 [PubMed - as supplied by publisher] 14: Camacho ME, Reyes-Ortiz CA. Links Sexual dysfunction in the elderly: age or disease? Int J Impot Res. 2005 Dec;17 Suppl 1:S52-6. PMID: 16391544 [PubMed - in process] 15: Schwarz ER, Rodriguez J. Links Sex and the heart. Int J Impot Res. 2005 Dec;17 Suppl 1:S4-6. PMID: 16391542 [PubMed - in process] "Some unique organic and psychological factors contributing to ED have been identified in patients with underlying cardiovascular problems. Certain risk factors are common to the development of coronary artery disease, heart failure and ED, including diabetes mellitus, hypertension, smoking and dyslipidemia. Additionally, the use of medications such as beta blockers, digoxin and thiazide diuretics might eventually cause but more likely worsen sexual dysfunction. These unintended consequences can lead to medical noncompliance in misguided efforts to retain satisfactory sexual activity, and thereby worsen cardiovascular problems. Accordingly, it is important for physicians dealing with patients with cardiovascular diseases to address sexual concerns in their patients." 16: Schwarz ER, Rastogi S, Rodriguez JJ, Kapur V, Sulemanjee N, Gupta R, Rosanio S. Links A multidisciplinary approach to assess erectile dysfunction in high-risk cardiovascular patients. Int J Impot Res. 2005 Dec;17 Suppl 1:S37-43. PMID: 16391541 [PubMed - in process] 17: Rastogi S, Rodriguez JJ, Kapur V, Schwarz ER. Links Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem. Int J Impot Res. 2005 Dec;17 Suppl 1:S25-36. PMID: 16391540 [PubMed - in process] 18: Billups KL. Links Erectile dysfunction as an early sign of cardiovascular disease. Int J Impot Res. 2005 Dec;17 Suppl 1:S19-24. PMID: 16391539 [PubMed - in process] 19: Rodriguez JJ, Al Dashti R, Schwarz ER. Links Linking erectile dysfunction and coronary artery disease. Int J Impot Res. 2005 Dec;17 Suppl 1:S12-8. PMID: 16391538 [PubMed - in process] 20: Rosen R, Shabsigh R, Berber M, Assalian P, Menza M, Rodriguez-Vela L, Porto R, Bangerter K, Seger M, Montorsi F. Links Efficacy and tolerability of vardenafil in men with mild depression and erectile dysfunction: the depression-related improvement with vardenafil for erectile response study. Am J Psychiatry. 2006 Jan;163(1):79-87. PMID: 16390893 [PubMed - in process] 1: Voustianiouk A, Kaufmann H, Diedrich A, Raphan T, Biaggioni I, Macdougall H, Ogorodnikov D, Cohen B. Related Articles, Links Electrical activation of the human vestibulo-sympathetic reflex. Exp Brain Res. 2005 Nov 25;:1-11 [Epub ahead of print] PMID: 16308690 [PubMed - as supplied by publisher] 1: Garet M, Barthelemy JC, Degache F, Pichot V, Duverney D, Roche F. Related Articles, Links Modulations of human autonomic function induced by positive pressure-assisted breathing. Clin Physiol Funct Imaging. 2006 Jan;26(1):15-20. PMID: 16398665 [PubMed - in process] 1: Garet M, Barthelemy JC, Degache F, Pichot V, Duverney D, Roche F. Related Articles, Links Modulations of human autonomic function induced by positive pressure-assisted breathing. Clin Physiol Funct Imaging. 2006 Jan;26(1):15-20. PMID: 16398665 [PubMed - in process] 2: Eiken O, Nowak J, Jogestrand T, Mekjavic IB. Related Articles, Links Effects of local arteriosclerosis on carotid baroreflex sensitivity and on heart rate and arterial pressure variability in humans. Clin Physiol Funct Imaging. 2006 Jan;26(1):9-14. PMID: 16398664 [PubMed - in process] 3: Osei-Owusu P, Scrogin KE. Related Articles, Links Role of the Arterial Baroreflex in 5-HT1A Receptor Agonist-mediated Sympathoexcitation Following Hypotensive Hemorrhage. Am J Physiol Regul Integr Comp Physiol. 2006 Jan 5; [Epub ahead of print] PMID: 16397093 [PubMed - as supplied by publisher] 4: Heindl S, Vahlkamp K, Weitz G, Fehm HL, Dodt C. Related Articles, Links Differential effects of hydrocortisone on sympathetic and hemodynamic responses to sympathoexcitatory manoeuvres in men. Steroids. 2005 Dec 30; [Epub ahead of print] PMID: 16388832 [PubMed - as supplied by publisher] 5: Bonsignore MR, Parati G, Insalaco G, Castiglioni P, Marrone O, Romano S, Salvaggio A, Mancia G, Bonsignore G, Di Rienzo M. Related Articles, Links Baroreflex control of heart rate during sleep in severe obstructive sleep apnoea: effects of acute CPAP. Eur Respir J. 2006 Jan;27(1):128-35. PMID: 16387945 [PubMed - in process] 6: Floras JS. Related Articles, Links Baroreflex sensitivity and heart rate variability were associated with total cardiac mortality following MI. Evid Based Cardiovasc Med. 1998 Dec;2(4):98-9. No abstract available. PMID: 16379849 [PubMed - in process] 7: Courtar DA, Spaanderman ME, Aardenburg R, Janssen BJ, Peeters LL. Related Articles, Links Low plasma volume coincides with sympathetic hyperactivity and reduced baroreflex sensitivity in formerly preeclamptic patients. J Soc Gynecol Investig. 2006 Jan;13(1):48-52. PMID: 16378912 [PubMed - in process] 8: Jouanin JC, Dussault C, Tran D, Guezennec CY. Related Articles, Links