pituitrin and Sleep-Apnea--Obstructive

Topics: Beryllium; Environmental Exposure; Health Education; Humans; Lung Diseases; Norepinephrine; Occupational Diseases; Occupational Exposure; Ozone; Pulmonary Disease, Chronic Obstructive; Respiration, Artificial; Risk Assessment; Sepsis; Sleep Apnea, Obstructive; Vasopressins

Topics: Humans; Male; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

We analyzed the outcome of nocturnal enuresis after adenotonsillectomy in children with sleep disordered breathing. We also evaluated differences in demographic, clinical, laboratory and polysomnography parameters between responders and nonresponders after adenotonsillectomy.. We prospectively evaluated children 5 to 18 years old diagnosed with sleep disordered breathing (snoring or obstructive sleep apnea syndrome) on polysomnography and monosymptomatic primary nocturnal enuresis requiring adenotonsillectomy to release upper airway obstruction. Plasma antidiuretic hormone and brain natriuretic peptide were measured preoperatively and 1 month postoperatively.. Sleep studies were done in 46 children and 32 also underwent blood testing preoperatively and postoperatively. Mean ± SD patient age was 8.79 ± 2.41 years and the mean number of wet nights weekly was 6.39 ± 1.26. Polysomnography revealed obstructive sleep apnea syndrome in 71.7% of patients and snoring in 28.3%. After adenotonsillectomy 43.5% of patients became dry. Preoperative polysomnography findings indicated that responders, who were dry, had significantly more arousals and obstructive apnea episodes but fewer awakenings than nonresponders, who were wet. Significant increases in plasma antidiuretic hormone and significant decreases in plasma brain natriuretic peptide were seen in all children with no difference between responders and nonresponders. No difference between the groups was noted in age, gender, race, body mass index, constipation, preoperative number of wet nights weekly or type of sleep disordered breathing.. Nocturnal enuresis resolved after adenotonsillectomy in almost half of the children with sleep disordered breathing. Those who became dry had more frequent arousal episodes caused by apnea events than those who remained wet.

Topics: Adolescent; Child; Child, Preschool; Comorbidity; Female; Humans; Hypertrophy; Male; Natriuretic Peptide, Brain; Nocturnal Enuresis; Palatine Tonsil; Polysomnography; Prospective Studies; Sleep Apnea, Obstructive; Snoring; Tonsillectomy; Vasopressins

To investigate the impact of obstructive sleep apnea syndrome (OSAS) on night-time secretion of brain natriuretic peptide (BNP) and antidiuretic hormone (ADH) in older men with nocturia accompanied by nocturnal polyuria.. One hundred six men with nocturia aged ≥ 60 years underwent full-night polysomnography to determine whether they had OSAS. Blood count, standard chemistry panel, BNP, urinary ADH, urinary creatinine (u-Cre), and urinary osmolarity were measured at 6:00 AM, and a frequency volume chart was recorded on the same day that polysomnography was performed.. We evaluated 83 patients after excluding 18 with mild OSAS and 5 with nocturnal polyuria index <0.35. Participants with OSAS had higher apnea-hypopnea index (P < .0001) than those without OSAS. Body mass index and systolic blood pressure were higher in OSAS patients than those in the control group. BNP was higher in the OSAS patients than in the control patients (48.6 ± 41.4 vs 30.7 ± 31.5; P = .0006). On urinalysis, OSAS patients showed higher urinary sodium and u-Cre secretion than controls (24.7 ± 11.3 vs 16.2 ± 5.1; P <.0001). Urine osmolarity was also higher in OSAS patients than in the control patients (616 ± 172 vs 516 ± 174; P = .0285). There was no significant difference in urinary ADH and u-Cre (6.7 ± 10.4 vs 6.8 ± 7.8; P = .3617) between the 2 groups.. Our results indicated that older men with nocturnal polyuria and OSAS did not compensate their fluid imbalance presented with decreased secretion of ADH but increased BNP level.

Topics: Aged; Aged, 80 and over; Circadian Rhythm; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

Topics: Humans; Male; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

Topics: Humans; Male; Natriuretic Peptide, Brain; Nocturia; Polyuria; Sleep Apnea, Obstructive; Vasopressins

Obstructive sleep apnea-hypopnea syndrome (OSAHS) in children with hypoxemia might influence the nocturnal secretion of antidiuretic hormone (ADH) that is associated with polyuria, even nocturia.. The impact of OSAHS on the secretion levels of ADH was studied in pediatric patients with adenotonsillar hypertrophy.. Forty-eight children (28 with OSAHS, 20 as normal controls) were recruited in this study. Respiratory indexes of all subjects were monitored by polysomnography and 12-h urinary volume was recorded during sleep. Vein blood was sampled to detect the levels of ADH in serum using a radioimmunoassay technique, both before and after adenotonsillectomy.. After surgery for OSAHS, the mean value of the apnea-hypopnea index (AHI) decreased (from 17.36±2.61 to 3.32±1.41, p<0.001), lowest arterial oxygen saturation (LSaO(2)) increased (from 78.34±13.44 to 95.35±6.24, p<0.001), urine volume (UV) in nocturnal 12 h reduced (from 492±90 to 332±56, p<0.001), and ADH level increased (from 63.08±35.15 to 83.10±21.05, p<0.05). The differences in UV and ADH between postoperative children and healthy controls were not statistically significant (both p>0.05).

Topics: Adenoidectomy; Case-Control Studies; Child; Female; Humans; Male; Nocturia; Polysomnography; Postoperative Period; Preoperative Period; Sleep Apnea, Obstructive; Tonsillectomy; Treatment Outcome; Vasopressins

To explore the influence of obstructive sleep apnea hypopnea syndrome (OSAHS) in children on the secretion of antidiuretic hormone (ADH).. Thirty pediatric patients with OSAHS were examined with polysomnography (PSG) and urinary volume was recorded during sleep, and vein blood was sampled in deep sleep to detect the level of ADH in serum using radioimmunoassay technique, which were performed before and after adenotonsillectomy. Among twenty heath children were also detected the secretion of ADH as normal controls.. After surgery, apnea-hypopnea index (AHI) decreased (from 17.4 +/- 2.6 to 3.3 +/- 1.4, t = 27.68, P < 0.001), lowest SaO2 increased (from 0.783 +/- 0.134 to 0.954 +/- 0.062, t = 6.45, P < 0.001). The level of ADH in OSAHS patients (63.1 +/- 35.2) ng/L was much lower than that in health children (85.1 +/- 22.2) ng/L (t = 2.75, P < 0.01). The serum ADH level in postoperative patients (83.1 +/- 21.2) ng/L was increased significantly compared with that of preoperative (t = 2.56, P < 0.05), and no statistical difference versus that of health children (t = 0.17, P > 0.05). Nycturia volume of preoperative OSAHS children (492 +/- 90) ml was significant higher than that of postoperative (332 +/- 56) ml or normal controls (346 +/- 62) ml (t was 7.85 and 6.43, both P < 0.001). There was no significance in nycturia volume between postoperative group and control group (t = 0.77, P > 0.05).. After adenotonsillectomy in children with OSAHS caused by adenotonsillar hypertrophy, the sleep pattern and ADH secretion could become normal.

Topics: Adenoidectomy; Case-Control Studies; Child; Female; Humans; Male; Polysomnography; Polyuria; Sleep Apnea, Obstructive; Tonsillectomy; Vasopressins

The mechanisms involved in the development and maintenance of hypertension in obstructive sleep apnoea (OSA) are not clear. We hypothesized that OSA patients have an abnormal renal handling of sodium and water during the night.. We studied 29 OSA patients and 19 healthy controls at night with serial determinations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), arginine vasopressin (AVP), aldosterone (Aldo), fractional urinary excretion of sodium (FE(Na)), free water clearance (C(H2O)), urinary excretion of aquaporin 2 (u-AQP2), systolic blood pressure (SBP), diastolic blood pressure (DBP) and oxygen saturation.. OSA patients had a higher FE(Na) (0.6 (0.4-1.0) versus 0.4 (0.3-0.6) %; p = 0.017), SBP (129 (114-145) versus 114 (106-122) mmHg; p = 0.001) and DBP (81 (72-87) versus 71 (65-74) mmHg; p<0.001) than healthy controls at night. In hypertensive OSA patients, the FE(Na) correlated significantly with the change in nocturnal DBP (r (2) = 0.411; p = 0.010). Mean level of AVP during the night was higher in OSA patients compared with healthy controls (1.1 (0.8-1.4) versus 0.8 (0.6-1.1) pmol/L; p = 0.033) and correlated with SBP. ANP, BNP, Aldo, C(H2O) and u-AQP2 were the same in OSA and controls.. We conclude that the higher fractional excretion of sodium in OSA is most likely attributable to pressure natriuresis. The correlation between mean AVP and blood pressure suggests that AVP may be part of the pathogenetic mechanism underlying hypertension in these patients.

Topics: Adult; Age Factors; Aldosterone; Aquaporin 2; Arginine Vasopressin; Atrial Natriuretic Factor; Blood Pressure; Female; Humans; Hypertension; Kidney; Male; Middle Aged; Natriuresis; Natriuretic Peptide, Brain; Oxygen; Potassium; Sex Factors; Sleep Apnea, Obstructive; Sodium; Vasopressins; Water