Sleep is entirely disorganized, especially in apnea syndromes. Microarousals due to respiratory efforts may add up to hundreds of episodes during the night. Non-REM sleep is highly fragmented and some patients do not reach SWS. REM sleep is also fragmented. The patient is sleep-deprived and daytime sleepiness

may become extreme. The apneic index, ie, the number of apneas per hour of sleep, has long been used to quantify the Inhibitors,research,lifescience,medical breathing disorder. Treatment of apneic patients has been transformed by the use of continuous positive airway pressure (CPAP) of 5 to 15 cm H20.54 The only disadvantage of such therapy is the constraint to the patient and his or her partner. Apneas are rapidly eradicated and the symptoms of the illness disappear, especially daytime sleepiness. CPAP is also efficient in the upper airway resistance Inhibitors,research,lifescience,medical syndrome, though no other means have been tested extensively to date. Mandibular selleck chemical MEK162 advancement devices may be of value in nonsevere cases of obstructive sleep apnea syndrome. Postural alarm can be used in position-dependent apneics. No specific medications, drugs (eg, ventilation stimulants), or oxygen therapy have been shown to be effective on sleep apneas. In all cases, the patient should be asked to lose weight. promotion surgical treatments55 are Inhibitors,research,lifescience,medical based on the identification of

the site of airway obstruction (nose, soft palate, and/or tongue). The protocols include various forms of reconstruction depending on the needs and the anatomy of the patient. They range from tracheotomy, glossectomy (surgical removal or laser evaporation of a portion of the tongue), radiofrequency shrinkage of Inhibitors,research,lifescience,medical the obstructive tissues of the upper airway (nose, palate, or tongue), or suspension

techniques with sutures of the tongue base, nasal reconstruction, uvulopalatopharyngoplasty, mandibular osteotomy with genioglossus advancement, hyoid myotomy and suspension, and maxillomandibular advancement. Conclusion Excessive daytime sleepiness is a frequent complaint in industrialized societies, and has a significant impact on work and family life. Physicians have several Inhibitors,research,lifescience,medical methods to affirm the existence of daytime somnolence and diagnose between the numerous causes of hypersomnia. They also have access to large array of medications and therapeutic strategies, which are constantly increasing in quantity and quality. Notes Part of the work was supported by Technical Service Agreement T7/83/2 from the World Health Organization and Drug_discovery the Région Rhône-Alpes (thématiques prioritaires santé, 2000-2002, grant No. 01 018675 01). Dr Jérôme Vix, from the Polyclinique de Rïllïeux (France), is acknowledged for his helpful comments on the manuscript.
Humans, like many other mammals, are awake through the daytime hours and sleep during the night. In some people, this normal sleep-wake rhythm, so taken for granted by most of us, can become chronically impaired, leading to a group of disorders called circadian rhythm sleep disorders (CRSDs).