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We evaluated protriptyline, a nonsedating tricyclic antidepressant, as a treatment for obstructive sleep apnea in a double-blind crossover study of five men. After two weeks of treatment, with no change in body weight, daytime somnolence was markedly reduced and nocturnal oxygenation was improved, although apnea duration and frequency were not significantly(More)
The effect of a moderately intoxicating dose of ethanol on sleep was evaluated in five patients with severe emphysematous chronic obstructive pulmonary disease (COPD) (mean FEV1 0.83 L, PaO2 75 mm Hg). Mean serum ethanol before sleep was 129 mg/dl. With alcohol, total sleep time per night decreased from a mean of 293 to 238 min. Relative sleep time per(More)
Respiratory symptoms, forced vital capacity, and the single breath N2 test were assessed in male employees (25 to 54 yr of age) who had been employed for more than 5 yr in the mining industry in Manitoba. The results were compared with those in a similar group of men selected from the general population. The prevalence of cough and/or phlegm in both(More)
In order to assess the role of hypoxemia in the sleep disruption of patients with COPD, we studied patients breathing air and oxygen during sleep. In 24 patients with COPD, we determined the 95% confidence bands for arterial O2 saturation (SaO2) in the various sleep stages. The lowest mean SaO2 was during REM sleep. Patients spent 22.4% of the night(More)
We examined the relationship between breathing pattern and severity of disease in patients with chronic obstructive pulmonary disease (COPD). Resting breathing pattern was recorded for 45 min using the respiratory inductance plethysmograph (RIP) in 22 patients with stable COPD. Six subjects (moderate group) had FEV1 25 to 50% predicted, 8 subjects (severe(More)
The respiratory inductance plethysmograph (RIP) was used to record resting breathing for 45 min in 12 patients with stable chronic obstructive pulmonary disease (COPD) and 8 age- and sex-matched control subjects. The COPD group had mean FEV1.0 of 31% predicted (range: 15 to 49%), mean PaO2 of 70 mmHg (56 to 83 mmHg), and mean PaCO2 of 37 mmHg (31 to 47(More)
Patients with interstitial lung disease (ILD) have a rapid shallow breathing pattern while awake that is thought to be due to activation of lung reflexes. We wondered whether sleep would result in changes in respiratory control and thus cause hypoxemia and poor sleep quality. Eleven patients with ILD (5 men and 6 women) and 11 age- and sex-matched control(More)
In 41 patients with hypoxemic COPD, nocturnal changes in arterial O2 saturation were compared with measurements of hypoxic and hypercapnic ventilatory control, which were carried out during wakefulness. In 24 patients, sleep was judged visually, whereas in 17, sleep was staged by electroencephalogram (EEG). There were no differences between the 2 groups in(More)
OBJECTIVE To determine the best clinical method for identifying peripheral vestibular nystagmus, by comparing eye movement examination with optic fixation, and with fixation removed using Frenzel's glasses, infra-red video-Frenzel's goggles or an ophthalmoscope, with results of electronystagmography. METHOD One hundred patients referred for(More)