Search

Resume Introduction Une etude epidemiologique basee sur un questionnaire « sommeil/respiration » a ete realisee dans un echantillon de sujets de sexe masculin, en activite. Methodes Les 850 hommes, âges de 22 a 66 ans, ont repondu a un questionnaire de sommeil complete avec des informations sur leur mode de vie et leurs antecedents medicaux. Deux groupes ont ete compares : les « sedentaires » (sans aucun exercice) et les sujets faisant au moins cinq heures d’exercice de loisirs par semaine. Resultats Parmi les troubles respiratoires pendant le sommeil, seule la reponse a la question trop peu specifique « Vous a-t-on dit que vous avez ronfle ? » etait significativement plus frequente parmi les sedentaires. Par ailleurs, ces sujets declaraient plus souvent une hypertension arterielle sous traitement. Conclusions Cette enquete sur une population active ne met pas en evidence une difference significative de prevalence des symptomes de troubles respiratoires pendant le sommeil entre sujets sedentaires et les sujets pratiquant un exercice modere de loisirs. Le groupe sedentaire declare plus souvent hypertension arterielle sous traitement. Ce resultat peut s’expliquer par les limites d’une enquete par questionnaire et par le relativement faible contraste du niveau d’exercice de loisirs entre les temoins et les sedentaires.

Resume Introduction Cette etude a evalue l’hypothese de la presence de troubles respiratoires du sommeil chez des sujets exposes a des faibles concentrations de CO sur leur lieu de travail. Methodes Deux cent trente sujets exposes a des concentrations moyennes de 1 a 5 ppm de CO a leur travail et 116 sujets temoins non exposes ont ete etudies avec un protocole comprenant un questionnaire de sommeil auto rempli et des mesures anthropometriques. Resultats Les deux groupes avaient des donnees anthropometriques et des habitudes de vie similaires, a l’exception d’un âge legerement plus bas pour les sujets exposes. Aucune difference n’a ete trouvee pour les antecedents medicaux, pour les troubles respiratoires pendant le sommeil ou les alterations du sommeil. Conclusions L’exposition professionnelle a des basses concentrations de CO ne semble pas affecter la motricite pharyngienne pendant le sommeil, Il faut souligner que ce resultat est obtenu avec une approche relativement peu sensible (questionnaire) ; un protocole comprenant des enregistrements polysomnographiques, applique a des sujets exposes a des concentrations CO plus elevees pourrait arriver a d’autres conclusions.

Resume Introduction Nous avons analyse la prevalence et les facteurs de risque du ronflement habituel dans un echantillon de sujets masculins de la population active de Lorraine. Methodes Les 850 sujets, âges de 22 et 66 ans, ont repondu a un questionnaire sur la frequence du ronflement, leur mode de vie, leurs antecedents personnels et familiaux. Des mesures anthropometriques ont ete completees par un examen non invasif de permeabilite de voies aeriennes superieures. Resultats La prevalence du ronflement habituel etait de 34,6 % ; augmentant avec l’âge, le poids et ses indices derives. Nous avons identifie (par regression logistique) les variables independamment associees au ronflement habituel : l’âge, le poids, l’obstruction nasale nocturne, le diagnostic d’apnees du sommeil par un medecin, et l’hypertrophie du voile du palais et de la luette. Le resultat original a ete la mise en evidence d’un effet « protecteur » d’une grande taille ; l’exercice de loisir n’apparait significatif qu’a l’analyse univariee. Conclusions Cette etude rapporte une prevalence du ronflement habituel similaire a d’autres etudes utilisant les memes methodes. Elle confirme le risque lie a l’âge, au poids, a l’obstruction nasale, et aux modifications nasopharyngees. Un effet protecteur d’une haute taille apparait comme element original, jamais signale par les enquetes precedentes.

This questionnaire-based epidemiological study was aimed at identifying possible sleep disturbance in a sample of active French males.Eight hundred and fifty male subjects, aged 22 to 66 years, completed a structured sleep questionnaire supplemented by information about their life habits and medical history. The study compared the prevalence of positive responses between an "at risk" group of sedentary people (with no declared leisure exercise) and a control group of "exercising" subjects (with more than 5 hours of planned exercise weekly).Among the symptoms suggesting sleep-disordered breathing, only the question "Have you ever been told that you snore?" significantly separated the two groups. In addition, the sedentary group declared a history of treated hypertension significantly more often.The present survey identified only one item that differed significantly between a sedentary of men and an exercising group - a history of treated hypertension. The result may be explained by the limitations of a questionnaire survey and by the limited contrast in exercise practice: the "sedentary" subjects had an occupational labour demand (not quantified), and the control group had a relatively modest leisure physical activity.

This study explored the possibility that occupational exposure to low concentrations of carbon monoxide (CO) could influence the synchronisation of upper airway and lower respiratory muscles and thus induce sleep disordered breathing.Two hundred and thirty subjects exposed to between 1 and 5 ppm (peaks up to 25 ppm) at work and one hundred and sixteen unexposed controls were studied with a protocol comprising anthropomorphic measurements and a self-completed French translation of the Wisconsin Sleep Questionnaire.The two groups had similar anthropomorphic and lifestyle data with the exception that the exposed group were slightly younger (2.5 years). No differences were found in personal or family history, sleep related breathing disorder (snoring, breathing pauses etc) and disturbed sleep.Occupational exposure to low concentrations of CO do not seem to affect ventilatory drive and the synchronisation of upper airway and respiratory muscles during sleep. It should be recognised that these results were obtained by a relatively insensitive technique (questionnaire); a protocol including polysomnography applied to subjects exposed to higher concentrations of CO could lead to other conclusions.

As there are important differences in the prevalence of snoring in the literature we have studied this prevalence and the risk factors in a sample of the active male population of Lorraine.850 men, aged 22 to 66 tears, volunteered for the study and completed a questionnaire on the frequency of snoring, their lifestyle and their personal and family histories. The usual anthropomorphic measurements were made together with a non-invasive examination of the upper airways.The prevalence of habitual snoring was 34.6%, increasing with age, weight and the derived indices. We identified, by logistic regression, the factors independently associated with habitual snoring in univariate analysis. These were age, weight, nocturnal nasal obstruction, a medical diagnosis of obstructive sleep apnoea, and hypertrophy of the soft palate and uvula. There was evidence that height had a protective effect but exercise activity did not appear to be significant.The 35% prevalence of habitual snoring in our sample of middle aged men is similar to other studies in the literature using the same methods. The present study confirmed that age, weight, girth, nasal obstruction and nasopharyngeal abnormalities are risk factors. The protective effect of height was a new finding not identified in previous studies.

There is no lack of data in the literature reporting on the efficacy of different bronchodilators. However, the discussion concerning the superiority of one bronchodilator over another in patients with chronic bronchitis and airflow obstruction is, and remains, a controversial subject. This has been particularly so since the perfection of synthetic anticholinergics delivered by inhalation without any side-effects. The aim of the present work is to compare the bronchodilator effects of a sympathomimetic, fenoterol (Berotec), and of an anticholinergic, ipratropium bromide (Atrovent), compared to a placebo in twelve unselected chronic bronchitics who had airflow obstruction and were in a stable clinical state. The bronchodilator effect of the two drugs was judged at the same time by variations on forced expired volume (FEV1) which was taken as a reference value, and of the maximum mid-expiratory flow (MEF) measured by spirography and also the variations of pulmonary resistance (delta Rrs) measured by the forced oscillatory method. The comparison of these indices enables the site of action of these agents to be specified. The dose response curve and the duration of action over six hours was assessed for each of the three agents. These were administered in succession and at random over three days by inhalation using an inhalation chamber. All the patients who were included were capable of producing a bronchodilator response but two of them responded only to one agent. The change in the FEV1 was comparable with the two active products. The change in MEF (an index of peripheral airways) was significantly greater following ipratropium.(ABSTRACT TRUNCATED AT 250 WORDS)

L'insuffisance respiratoire aigue (IRA) hypercapnique survient essentiellement enpresence de lesions pleuro-parenchymateuses pulmonaires ou d'atteinte fonctionnelle de la mecanique ventilatoire. Cependant, l'IRA peut survenir en l'absence de telles anomalies. Le but de cette etude, est de verifier l'hypothese selon laquelle une decompensation respiratoire aigue non accompagnee de trouble mecanique ventilatoire est favorisee par un deficit des systemes de regulation de la ventilation. Nous avons etudie 31 patients au decours d'une IRA hypercapnique. Nous avons analyse chez eux la fonction mecanique pulmonaire et lachemosensibilite des centres respiratoi res mesuree par la methode de re-inspirationhypercapnique et hypoxique ainsi que la reponse a l'imposition d'une charge resistiveinspiratoire. Des troubles de la mecanique ventilatoire de type obstructif sont presents dans 55% des cas. Treize patients restants, sans syndrome obstructif ni restrictif, presentent tous une reponse au CO2 inferieures aux limites normales obtenues chez 20 sujets temoins. Cette defaillance se retrouve aussi chez 16 des 18 autres patients. Ces resultats confirment l'hypothese formulee : la deficience de la regulation respiratoire constituerait un facteur essentiel a la survenue d'une IRA grave non expliquee par des troubles de la mecanique ventilatoire. Dans tous les cas, un deficit du control e respir atoire resterait un facteur favorisant la decompensation respiratoire.

Two mini-peak flow meters, the Airmed (mini-Wright) and the Medicheck (Pulmonary Monitor), were assessed against a reference electronic spirometer (Spiromatic, based on a pneumotachograph, integrator and an Apple II computer) in a series of 10 healthy subjects and 20 patients with chronic obstructive lung disease. The devices to be tested were mounted in series with the reference instrument; each subject did five trials. It was found that the Airmed instrument overestimated the flows up to 9 l X s-1 (i.e. in patients, average difference 0.86 l X s-1, p less than 0.001; in healthy subjects, average difference 0.35 l X s-1, p less than 0.001). The correlation with the results of the reference instrument was high (r = 0.992) in healthy subjects, whose regression slope was less than unity (0.763). In patients the correlation was satisfactory (r = 0.974), and the slope close to 1 (1.05). The Medicheck overestimated slightly the results of patients (difference 0.17 l X s-1, p less than 0.01); in normal subjects the overestimation was present only below 10 l X s-1 and the difference with the reference instrument nonsignificant (average 0.19 l X s-1). The results were closely related to those of the reference spirometer in both healthy subjects (r = 0.960) and patients (r = 0.936). As for the first instrument the slope of the regression was below 1 in healthy subjects (0.751) and practically one (1.01) in patients.(ABSTRACT TRUNCATED AT 250 WORDS)