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P3642 25% of them to have OSA. 11% of the high risk group had both symptoms and
The value of predicted formula titration in patients with obstructive sleep sleep studies compatible with OSA, and have since started CPAP treatment.
apnea syndrome Conclusions: OSA is highly prevalent in men with type 2 diabetes and may be
Mehmet Ali Habesoglu, Oguz Kokturk. Pulmonary Disease, Baskent University, under diagnosed. Questionnaires can provide a useful screening tool to highlight
Faculty of Medicine, Adana, Turkey; Pulmonary Disease, Gazi University, people requiring further investigations.
Faculty of Medicine, Ankara, Turkey
Continuous positive airway pressure (CPAP) has become a cornerstone in the P3645
treatment of obstructive sleep apnea syndrome (OSAS). Today, constant pressure Ear or finger pulse oximetry during sleep in suspected obstructive sleep
CPAP treatment determined by manual titration during attended second night apnea syndrome: does it matter?
polysomnography is the standard treatment of OSAS today, however it is expen- Wilfried Pujol 2 , Françoise Bertran 1 , Colette Couque 1 , Hervé Normand 1 .
1
sive and time consuming. Predicted formula titration developed by Hoffstein et Explorations Fonctionnelles, CHU, Caen, France; 2 Pneumologie, CHU, Caen,
al was an alternative practical method (Hoffstein V. et al. Am J Respir Crit Care France
Med 1994;150: 486-8). In our study, predicted formula titration pressure (Pcal )
and automatic titration pressure (Paut ) were compared to reveal any benefit of The severity of the obstructive sleep apnoea syndrome (OSAS) is assessed by the
predetermined CPAP to CPAP therapy. Forty-four patients with OSAS who require apnoea/hypopnoea index (AHI). The definition of hypopnoea includes a 3 or 4%
CPAP therapy were included in the study. There was no significant difference dip in pulse oximeter saturation (SpO2 ). We have previously shown that during
between the mean values of Paut and Pcal (p=0.363), however there was a signifi- experimental transient oxygen desaturation, the decrease in SpO2 was higher at
cant correlation between two variables (r=0.407; p=0.002). The distribution of the the ear than at the finger site. Our aim was to compare the number of hypopnoeas
difference between Paut and Pcal (Paut - Pcal ) is ±1 cmH2 0 in 48%, ±2 cmH2 0 detected at both sites with the same oximeter.
in 81% and ±3 cmH2 0 in 88% of the patients. It can be concluded that split Thirteen consecutive patients with suspected OSAS were equipped with a commer-
night manual titration or automatic CPAP titration using Pcal as the reference value cial sleep recording system (Cidelec, France), whose software had been modified
will be a practical method. Pcal may be recalculated according to the changing by the manufacturer to allow the simultaneous recording of two external oximeters
anthropometric measurements of the patients without a control PSG study for (Datex-Ohmeda 3900P, Colorado). Steady-state response (11.5% oxygen inspired
readjusting automatic CPAP. gas) of the two oximeters, each of them with its specific probe, was shown identical
on six subjects.
The number of hypopnoeas was calculated, on the same valid night periods, with
P3643 the commercial algorithm fed with the ear or the finger SpO2 signal.
Assesment of sleep with polysomnography in patients with interstitial lung There was no difference in the duration of valid SpO2 recording at both sites nor
disease in the number of hypopnoeas per night detected with the 4% dip criteria (finger:
Muge Aydogdu 1 , Bulent Ciftci 1 , Selma Firat Guven 1 , Tansu Ciftci 2 , 45.5±54.4 vs ear: 38.3±54.6, p > 0.3). However, with the 3% dip criteria, a nearly
Yurdanur Erdogan 1 . 1 Chest Disease, Ataturk Gogus Hastanesi, Ankara, Turkey; significant higher number of hypopnoeas was detected, surprisingly, at the finger
2
Chest Disease, Gazi University, Ankara, Turkey site (60.2±59.8 vs 48.8±60.6, p = 0.052).
We conclude that the SpO2 measurement site might influence the AHI, and that
The interstitial lung diseases (ILD) comprise over 200 entities and include a wide SpO2 dips in OSAS are not solely related to arterial oxygen saturation.
spectrum of diseases. It was known that sleep quality is poor and marked oxygen
desaturations occur during sleep in patients with ILD. We aimed to examine the
sleep structure, oxygenation and breathing pattern and determine whether rele- P3646
vance between the advanced disease and the sleep disorders exists and whether Polysomnographic profile of patients with fibromyalgia (FMS) and obsructive
polysomnograpy is necessary in ILD patients. 37 patients who were hospitalized sleep apnea (OSA)
and diagnosed as ILD were examined in the study and standard polysomnography Valeri N. Marchenko 1 , Sergei Ramaniuk 2 , Paul Venizelos 2 . 1 Hospital Therapy,
was performed to all. PSG results revealed that total sleep time, time spent in Pavlov State Medical University, Saint-Petersburg, Russia; 2 Hospital, West
NREM stage 3 and 4, and in REM sleep were decreased. Severe oxygen desatura- Region Sleep Center, Cleveland, OH, United States
tions were detected during sleep and statistically significant positive correlations
were found between mean awake O2 saturation and mean and lowest sleep O2 Introduction: Sleep disturbances are common in patients on chronic pain and
saturations. CRP scoring system was used to assess the disease stage, whether OSA. We studied polysomnographic measures of nocturnal sleep and investigated
advanced or not, and statistically significant negative correlations were found the distribution of Slow-wave sleep (SWS) and REM sleep in patients suffer OSA
between CRP score and awake and sleep O2 saturations. OSAS was diagnosed in and FMS Methods: 12 patients who had FMS and OSA (4 males and 8 females; age
24 patients. In those patients it was found that not the apneas but the hypopneas 56.1+9.2 years) and underwent overnight polysomnography (Medcare Recording
predominate. As a result, a sleep study should be considered as part of the overall System. USA).
assessment in managing patients with ILD, and is especially indicated if there is Results: Objective sleep disturbance was confirmed by PSG in 12 of the 12
incipient pulmonary hypertension, cor pulmonale and nocturnal arrhythmia despite patients. Ten had prolonged sleep latency (LPS>22 min) and sleep fragmentation.
normal awake blood gas tensions and symptoms as snoring and excessive day time In all 12 patients mean sleep efficiency (SE) was 10 >4% SaO2 dips per hour, or a trace highly suggestive of OSA, Pressure level Pmean P90 Pmax P50 P95 Pmax
proceeded to have a home sleep study. bias -0.3 -0.4 -1.5 0.1 -0.2 -0.3
Results: We received 938 questionnaire replies overall (56% response rate): mean precision 1.3 1.9 1.9 1.8 1.5 1.6
age 62 years, mean BMI 30. 4% of all respondents were already known to have max. error 3.2 2.9 3.0 6.8 3.4 3.0
OSA. 63% of respondents scored as being at high risk of OSA according to their min. error -2.6 -4.7 -5.0 -3.6 -4.8 -4.8
significance NS NS P=0.0001 NS NS NS
questionnaire answers (compared to 45% of men in the original primary care
Berlin questionnaire study). Screening oximetry in this high risk group showed Pressure profiles: lab vs. home condition
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home pressure profiles was based on the assessment of bias and precision according diagnosis of OSA were nocturnal respiratory pauses by 90.8% and hypertrophy
to Bland-Altman, as well as non-parametric statistics for paired samples. Both of adenoids by 86.8%. Only 12% of the pediatricians referred the child to an
devices performed similarly, with little bias (except Pmax in the RR) and some otolaryngologist.
degree of imprecision (see Table 1). Conclusion: Pediatricians are not familiarized to diagnosis procedures of OSA,
Considering the whole patient group, we may conclude that the assessment of actualization of the disease seems not to be adequate. The interaction between the
APAP profiles gives comparable results in the laboratory vs. the home condition. pediatrician and the otolaryngologist must be improved.
However, some individuals seem to require considerably different pressure levels
in the two settings.
P3651
Spirometry and nocturnal oxygen saturation in patients with obstructive
P3648 sleep apnoea with and without COPD
Symptoms of inattention and hyperactivity in children with habitual snoring: Skaidrius Miliauskas, Raimundas Sakalauskas, Diana Barkauskiene. Clinic of
evidence from a community-based study in Istanbul Pulmonology and Immunology, Kaunas Medical University Hospital, Kaunas,
Ayse R. Arman 1 , Refika Ersu 2 , Dilsad Save 3 , Bulent Karadag 2 , Lithuania
Goksin Karaman 1 , Koray Karabekiroglu 1 , Fazilet Karakoc 2 , Elif Dagli 2 ,
Meral Berkem 1 . 1 Child Psychiatry, Marmara University, Istanbul, Turkey; The aim of the study - to find out whether spirometry (FEV1 predict. value) has
2
Pediatric Pulmonology, Marmara University, Istanbul, Turkey; 3 Public Health, any influence on nocturnal oxygen saturation in patients with obstructive sleep
Marmara University, Istanbul, Turkey apnoea (OSA). 200 men (age 53.06±11.55 years) and 63 women (age 58.76±9,25
years) included in the study. OSA confirmed by polysomnography. Basal oxygen
Inattention and hyperactivity are common in children with sleep-disordered breath- saturation (BS), mean and maximum desaturation percent, desaturation indexes,
ing (SDB). We examined the differences for subjective attentional and hyperactivity respiratory disturbance (RDI) and microarousal indexes (MI) were calculated.
measures reported by parents and teachers in habitual snorers (HS) and age- sex Spirometry was performed in all cases and 43 cases of COPD were diagnosed.
matched controls in a community-based case-control study in Istanbul. In 2002, Results: none of means of calculated parameters differed significantly in groups
a survey was carried out to determine the prevalence of snoring in 2147 primary with and without COPD, however in COPD group higher desaturation index
school children. In 2003, 151 HS children and 302 controls are restudied with during REM sleep was found (40,65±31,42 and 61,5±29,5, respectively, p=0.02).
parental SDB questionnaire, Conners’ Parent (Conners-P) and Teacher Scales, Statistically significant results of Pearson’s correlation of FEV1 predict. value
and an inattention hyperactivity scale (IHS). 96 HS and 190 control subjects (age: and parameters of polisomnography were detected. Correlation of FEV1 and RDI
9.4±1.3 years) were evaluated. HS had more symptoms of hyperactivity (p: 0.032), was -0.307, p60 and p 1.25 showed differences in HS compared to controls (5.1% vs. and non REM sleep, general desaturation index were -0.173, -0.273, -0.271
1.4%, p 10 events/hour).We recorded co-
16 male TRIK strain guinea pigs were sensitized by i.p.ovalbumin. 21 d later sensi- morbidities in 93 Caucasian patients (81 males) with a mean (SD) age of 56.5
tization was confirmed by skin tests. Experimental allergic rhinitis was induced by (11.8) years, mean BMI 35.2 (6.3) kg/m2 , mean Epworth score 15.3 (4.5), mean
intranasal ovalbumin challenge. After development of nasal symptoms the animals AHI 39.2 (27.2) events/hour.
of experimental group (E) were challenged with IE capsaicin (1000 mM, 0.25ml), The presence of diabetes mellitus, hypertension and hypercholesterolaemia was
controls (C) received IE saline. Cough was induced during IE stimulation both in defined according to National Cholesterol Education Program guidelines 2 - or
E and C groups by CA and compared to baseline response tested in the start of whether patients were receiving treatment. Blood pressure had to high on at least
the study. Number of coughs was analyzed from pneumotachograph records and 3 separate occasions, to allow for the white coat effect. Data on abdominal girth
cough sound. and triglycerides were usually not recorded.
The number of coughs in C was increased during rhinitis and IE administration Results: see Table
of saline [4(1.5-5) vs 6(3.5-8), p = 0.05]. Similar result was obtained for group
Disease Prevalence in SAHS
of E animals with rhinitis IE challenged with capsaicin [3 (2-4) vs 5(5-6.5), p=
0.034]. This increase is due to rhinitis. We did not find any differences in the Yes No Not recorded
cough response that could be ascribed to IE administration of capsaicin (p = 0.26). Diabetes 23% 29% 48%
Conclusion: IE administration of capsaicin did not affect CA induced cough in Hypertension 73% 23% 4%
guinea pigs with allergic rhinitis. Hypercholesterol 38% 12% 50%
Supported: VEGA 1/2273/05.
Conclusions: Despite missing data, we found a very high prevalence of hyper-
P3650 tension (at least 73% patients) and hypercholesterolaemia (at least 38% patients).
Pediatricians’ knowledge of obstructive sleep disorders An interventional prospective study, recording all the individual parameters of
Silke A.T. Weber, Aracy P.S. Balbani, Jair C. Montovani. Otolaryngology, the metabolic syndrome before and after CPAP treatment could identify which
Botucatu Medical School, Botucatu, Sao Paulo, Brazil parameters are most influenced by the AHI.
References: [1] Eur heart J 2004;25: 735
Aim: to analyze the knowledge of clinical symptoms of obstructive sleep apnea, [2] Circulation 2004;109: 433
their routine investigation and the conducts of pediatricians of São Paulo State,
Brazil.
Methods: We sent questionnaires to 436 pediatricians of São Paulo state, including P3653
self-analysis of their knowledge about OSA, if clinical symptoms are included in 6-min walking test: a predictor of nocturnal hypoxaemia in normoxic
routine anamnesis, and how suspected children should be conducted. patients with COPD
Results: We received 76 answers (17.4%). Of those, 40.8% considered the lectures Stefano Picciolo, Ernesto Crisafulli, Paolo Ruggeri, Giuseppe Girbino,
about OSA during residency insufficient, 44.7% considered it regular and 11.8% Filippo Andò. Pulmonary Medicine, University of Messina, Messina, ME, Italy
good. The questions of anamnesis considered important for the diagnosis of OSA
were mouth breathing by 92.1% of the pediatricians, apneas observed by parents Rationale: Impaired ventilation and gas exchange may cause nocturnal hypox-
by 85.5%, and wheezing by 85.5%. The clinical signs considered relevant for aemia in some patients with COPD, particularly during REM sleep, even though
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they have normal daytime blood gas values. 6-min walking test (6MWT) may (ie, PaCO2 , 45 mm Hg) and normocapnic (ie, PaCO2 , 30% spent with oxygen index AHI (r = 0.87; p 10/h) diagnosed by nocturnal polysomnography (PSG),
patients with mild-severe OSAS. We have therefore retrospectively studied 70 (48 38 patients with BMI≥40kg/m2 were studied. The patients with FEV1 /FVC≤70%
males) consecutive patients with OSAS and chronic hypercapnia (HC) (PaCO2 >45 were excluded. Patients were classified as hypercapnic-PaCO2 ≥46mmHg (N=15);
mmHg) and 80 (60 males) consecutive patients with OSAS and normocapnia normocapnic-PaCO2 10. COPD was present in compared between the 2 groups. Correlations between PaCO2 and the different
52% of HC patients and in 21.8% of NC patients (P<0.05). Overall, mean AHI was variables were determined by linear univariate and multiple (stepwise) regressions.
similar in the two groups while a significant difference was observed in mean age Significant differences between both groups were noted in: Average nocturnal
(54.1±8 yrs NC vs 62.2±1.6 yrs HC, P<0.001), BMI (33.9±0.7 NC vs 39.3±1.5 SaO2 % (79.7/88.2) p=0.02; % nocturnal time with SaO2 <90% (67.1/43.7) p=0.03;
HC) and mean nocturnal SaO2% (94.3±0.31 NC vs 87.3±0.8 HC, P<0.01). In the FVC% (72.5/83.5) p=0.04; FEV1 % (70.1/83.4) p=0.02; FEF50% (61.7/87.0)
hypercapnic patients the diurnal values of PaCO2 significantly correlated with the p=0.006; TLC% (76.0/85.6) p=0.02. When both sexes were included no correla-
age of the patients (r =0.44, P<0.05), but not with other factors such as BMI, AHI tion between PaCO2 and each independent variable was found. In hypercapnic
and mean nocturnal SaO2 . We further analysed the subgroups of patients without males (N=9) PaCO2 correlated with: age(-0.808)p=0.008; BMI (0.837)p=0.005;
COPD. Again a significant difference was observed in mean age (50±1.9 yrs NC FVC% (-0.741) p=0.02; FEV1 % (-0.711) p=0.03; TLC(L) (-0.670) p=0.04; PE-
vs 56.7±3 yrs HC, P<0.05), BMI (33.6±0.9 NC vs 40.9±4.5 HC, P<0.001) and max% (-0.879) p=0.002. In the stepwise multiple analysis the model that included
mean nocturnal SaO2% (94.3±0.3 NC vs 86.6±1.1 HC, P<0.01), but not in AHI. PEmax, BMI, FVC (R2 =0.978; p<0.0001) explained 98% of the variation of the
We conclude that COPD is an important cause of hypercapnia in patients with PaCO2 . In females PaCO2 did not correlate with any independent variables studied.
OSAS, however, also in the absence of COPD, age and BMI, but not the severity In conclusion the factors that contribute to chronic hypercapnia in these patients
of OSAS, may be important determinants of chronic hypercapnia. seem to be different for both sexes.
P3655 P3658
Should patients with obstructive sleep apnea syndrome be screened for Upper airway surgery for obstuctive sleep apnea syndrome
hypothyroidism? Aysenur Amasya 1 , Ebru Durgun Duygu 1 , Kemal Deger 2 , Caglar Cuhadaroglu 1 ,
Selma Firat Guven, Bulent Ciftci, Muge Aydogdu. Chest Disease, Ataturk Gogus Nesil Keles 2 , Tayfun Demirel 2 , Senol Caglar 2 , Deniz Kaya 2 . 1 Pulmonary
Hastanesi, Ankara, Turkey Disease, Istanbul University, Istanbul Medicine Faculty, Istanbul, Istanbul,
Turkey; 2 ENT, Istanbul University, Istanbul Medicine Faculty, Istanbul, Istanbul,
The association of hypothyroidism with the obstructive sleep apnea syndrome Turkey
(OSAS) has been reported at varying rates of %1 to %11. In patients with OSAS
the diagnosis of hypothyroidism can easily be missed. In our study we aimed In this study we analysed 540 adult patients who were referred by the ENT de-
to determine the prevalence of hypothyroidism in patients who were diagnosed partment for the nocturnal polysomnogram between June 2002 and January 2005.
as OSAS in our sleep center and the effects of hypothyroidism treatment on Simple snores were 160 of the cases, mild Obstructive Sleep Apnea Syndrome
OSAS. Thyroid function tests were studied in 134 cases that were admitted to (OSAS) were 125 of the cases, moderate OSAS were 150 of the cases and severe
our sleep center with the suspicion of OSAS and underwent polysomnography OSAS were 105 of the cases. Mean AHI was 21.7±19. Most of the cases had
between January to August 2003. 111 cases (%82) were diagnosed as OSAS. a problem of uvulo or soft tissue by alone or together. Septal deviation was
Hypothyroidism was detected in 5 of those 111 OSAS patients (%4.5). Among found in 95 of the cases in whom treatment were necessary. Also 53 patients had
those 5 cases with both OSAS and hypothyroidism, 2 of them were classified as the retrolingual enlargement. At a council we made an uvulopalatoplasty (UPP)
mild OSAS and 3 of them were classified as moderate to severe OSAS. Six months decision for 189 patients, 47 of whom were severe OSAS. We made a treatment of
after the thyroid hormone replacement treatment second PSG was performed to uvulo by Laser assisted uvulopalatoplasty (LAUP) in 81 cases and radiofrequency
all hypothyroid patients. In 2 cases with mild OSAS in addition to resolution of (RF) in 20 cases. Deviation surgery was performed on only 12 patients. Epworth
OSAS symptoms, AHI was also found as < 5 in control PSG. In 3 cases with Sleepiness Scale decreased, family and patient’s pleasure increased on the mild
moderate to severe OSAS no significant reduction in AHI could be detected. CPAP and moderate OSAS after surgery on the other side respiratory disorders also
titration was repeated. In two cases required pressures were found as decreased. In decreased after surgery objectively.Respiratory problems decreased on the severe
our study the prevalence of hypothyroidism and OSAS was found as compatible OSAS patients but AHI continued to be more than 15. When we suspect OSAS,
with the literature and we conclude that biochemical screening for hypothyroidism we evaluate these cases with ENT department and we also think surgery as an
is necessary for all the patients with the suspicion of OSAS. alternative treatment for the mild and moderate OSAS cases.
P3656 P3659
Chronic respiratory failure in patients with obstructive sleep apnea (OSA) Bronchial reactivity in patients with obstructive sleep apnea syndrome
Olga Y. Chizhova 1 , Alexandr I. Gorelov 2 , Svetlana A. Boldueva 3 . 1 Therapy, St. treated with continuous positive airway pressure
Petersburg Medical Academy, St. Petersburg, Russia; 2 Therapy, Medical Unit Piotr Korczynski, Katarzyna Gorska, Piotr Bielicki, Krzysztof Byskiniewicz,
N-122, St. Petersburg, Russia; 3 Therapy, St. Petersburg Medical Academy, St. Ryszarda Chazan. Pneumonology, Medical School, Warsaw, Poland
Petersburg, Russia
The continuous positive airway pressure (CPAP) is the most accepted treatment
We studied pulmonary function abnormalities in 253 male patients with obstruc- method of patients with sleep apnea syndrome. The aim of this study was to
tive sleep apnea (OSA) confirmed by overnight polysomnography (PSG) (Embla, estimate the influence of CPAP for bronchial hyperreactivity (BHR). We recruited
Island) without chronic airflow obstruction. Patients were classified as hypercapnic 76 patients with sleep apnea, without allergy, with negative background of asthma,
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never treated for chronic pulmonary diseases. The mean apnea hypopnea index performance on all subjective and objective measures, compared with when no
was 54,3±20,3. The mean age was 51,7±11,0, BMI 32,7±5,4. We performed nap was taken. Furthermore, there was a significant improvement in subjective
twice bronchial provocative tests with metacholine before and after two weeks workplace efficiency assessed by the workplace Questionnaire (WPQ).
of CPAP treatment. We noted 6 patients (8%) with BHR before treatment, and
19 patients (25%) after CPAP treatment. The increase of BHR in this group was
significantly higher then in the control group.
The subgroup with new-revealed BHR had significant lower AHI (45,4±14,8 vs.
56,6±21,1) and lower FEV1 (2,8±0,8 vs. 3,3±0,6). The value of the positive
pressure, age, BMI, inflammation markers, smoking habit, IgE, skin prick tests
were not responsible for observed bronchial hyperreactivity.
We conclude that initially lower FEV1 and lower AHI may predispose to increase
of bronchial reactivity due to CPAP treatment but the mechanism of these findings
is unclear.
P3660
Sleep apnoea and quality of life in growth hormone deficient adults before Conclusion: The results suggest that in the workplace environment a brief post-
and six months following growth hormone therapy lunch nap is beneficial to subsequent afternoon subjective and objective perfor-
Yüksel Peker 1,2 , Johan Svensson 3 , Jan Hedner 2 , Ludger Grote 2 , mance and thus improves workplace efficiency.
Gudmundur Johannsson 3 . 1 Sleep Medicine Unit, Dept of Neurorehabilitation,
Skaraborg County Hospital, Skövde, Sweden; 2 Sleep Lab., Dept of Pulmonary
Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; 3 Research
Center Endocinology and Metabolism, Sahlgrenska University Hospital,
Gothenburg, Sweden
345. Physiological studies in healthy
We determined the prevalence of obstructive sleep apnoea (OSA) in 20 consec-
utive growth hormone deficient (GHD) adults (12 men, 8 women; mean age 53 humans
years), and addressed the clinical response to 6-month GH replacement therapy
in patients with and without OSA. An overnight sleep study was performed and
Minor Symptom Evaluation Profile (MSEP), Functional Outcome of Sleep Ques-
tionnaire (FOSQ), Short Form 36 (SF-36) and Epworth Sleepiness Scale (ESS) P3662
questionnaires were applied. OSA, defined as an Apnea-Hypopnea Index (AHI) of The functional model of “Ondine’s curse” syndrome
10/h or more, was found in 13 subjects (65%). At baseline, the OSA patients had Michail A. Pogodin, Michail P. Granstrem. Laboratory of Respiratory
less Slow-Wave Sleep (SWS; 10.5% vs 28.6%, p=0.001) and REM-sleep (9.5% Physyology, I.P. Pavlov Institut of Physiology, St. Petesburg, Russia
vs 15.5%, p=0.043). Neither onset of severe OSA nor worsening of the prevalent
OSA was observed following GH therapy. In the GHD patients with concomitant Evidence suggests, that there are patients with “Ondine’s Curse” syndrome who,
OSA, an increase was observed in REM-sleep time (10.1 vs 12.7%; p=0.048). when awake, breathe with their corticospinal tracts. We investigated the ability
Moreover, MSEP for General Well-being and Responsiveness, FOSQ scores for of a healthy person to control the device of mechanical ventilation of their own
General Productivity, Activity Level and Vigilance as well as SF36 domains for lungs through contraction of muscles which are activated with their corticospinal
Vitality and Mental Health were improved. We conclude that OSA was common tracts. Seven adult males took part in the experiment. When the volunteer wanted
in GHD adults, and that six-month GH replacement therapy improved REM sleep to make a inspiration then the volunteer pressed the button by the right hand and
and QoL in GHD patients with concomitant OSA. the air was blew into his lungs from the device. Pressure of air in the device was
controlled by movement of the left hand of the volunteer. After an artificial inspi-
ration the volunteer passively exhaled. The volunteer was asked to refrain from
P3661 natural inspiration during self-controllable mechanical ventilation. We established
The power nap - a work place benefit? A randomised controlled trial that, both at natural breathing, and at self-controlled mechanical ventilation, vol-
Nasser H. Al Busaidi, Steven Morrison, Michael Brown, Betty Headley, unteers increased ventilation proportionally to growth of exercise load on bicycle
Andrew McAlister. Respiratory Medicine, Royal Hospital, Muscat, Muscat, ergometer. In conditions of self-controllable mechanical ventilation the volume of
Oman; Thoracic Medicine, Royal Brisbane, Brisbabe, QLD, Australia ventilation was by 25-30% more than in conditions of natural breath. Sometimes,
when sensing the air hunger, the volunteers made natural inspirations which were
Aim: The aim of this randomized controlled study was to examine the subjective asynchronous to mechanical breaths. This asynchronism suggests that natural and
and objective effects of a brief (10 to 20 minutes) post-lunch nap in the workplace. artificial inspirations are generated in different centres. We show that in conditions
Participants: Forty-two healthy adult employees of the Royal Brisbane Hospital, of self-controllable mechanical ventilation, humans breathe with the corticospinal
Australia who had normal sleep-wake habits, and worked regular daytime shifts tracts, ’bypassing’ the motor ways of the brain stem respiratory centres.
participated in a repeated measures study design comprising two experimental
conditions: no-nap (placebo), and the 10 to 20 minute nap.
Method: Subjective measures of alertness, energy and fatigue levels, and objec- P3663
tive measures of performance on tasks measuring short-term memory, attention, Respiratory response to CO2 during self-controllable mechanical ventilation
vigilance and reaction time were taken before the intervention and at two intervals of the lungs
post-intervention (five minutes and two hours) Michail A. Pogodin, Michail P. Granstrem. Laboratory of Physiology Physiology,
Results: Immediately following the nap, there was a decline in subjective alertness I.P. Pavlov Institut of Physiology, St. Petersburg, Russia
and energy levels, due to sleep inertia.
Performance on cognitive tasks revealed significant improvement in some vari- We used respiratory response on CO2 to evaluate the sources of respiratory drive
ables and trends towards improvement in the others. Two hours after the nap no during self-controllable mechanical ventilation of the lungs. We did Read CO2
negative effects were evident. At this time participants improved or maintained rebreathing tests in 8 adult males. The device for mechanical ventilation of lung
was controlled by movement of the volunteer. When the volunteer wanted to make
a inspiration, he moved a pedal of device unbending the right brush. After an
artificial inspiration the volunteer a passivly exhaled. The volunteer was asked
to refrain from natural inspiration during self-controllable mechanical ventilation.
Both at natural breathing, and at self-controlled mechanical ventilation, volunteers
increased ventilation proportionally to growth end-tidal PCO2. The form of a
curve of the minute ventilation-PCO2 relations was similar for both conditions
for each volunteer. The curves were shifted upwards and to the left for 5 of 8
volunteers, downwards for 3 of 8. These results indicate that conscious normal
humans can control the device of mechanical ventilation, being guided on sensation
of air hunger. Inside individual distinctions of responses to CO2 during controlled
mechanical ventilation are result of the voluntary motor control.
P3664
Heavy meals do not affect lung function in healthy subjects
Elise McKeon, Chris Nathan, Nigel McArdle, Kevin Gain. Respiratory Medicine,
Royal Perth Hospital, Perth, WA, Australia
Background: Current guidelines recommend patients abstain from heavy meals
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