Sleep Disordered Breathing

References

• The Report of an American Academy of Sleep Medicine Task Force: Sleep-related breathing disorders in adults. Recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22: 667–689, 1999.
   Google Scholar
• Lugaresi, E., Cirignotta, F. & Montagna, P.: Snoring. Pathogenic, Clinical, and Therapeutic Aspects. In: Principles and Practice of Sleep Medicine (ed. M. H. Kryger, T. Roth & W. C. Dement), pp. 494–500. W. B. Saunders, Philadelphia, 1989.
   Google Scholar
• Dalmasso, F. & Prota, R.: Snoring, analysis, measurement, clinical implications and applications. Eur Respir J 1996; 9: 146–159.
   Google Scholar
• Hoffstein, V.: Snoring. In: Principles and Practice of Sleep Medicine. (ed. M. H. Kryger, T. Roth & W. C. Dement), pp. 813–826. W.B. Saunders Company, Philadelphia, 2000.
   Google Scholar
• Fletcher, E. C.: Abnormalities of Respiration During Sleep. Grune & Stratton, Orlando,Florida, 1986.
   Google Scholar
• Phillipson, E. A.: Control of breathing during sleep. Am Rev Respir Dis 118: 909–939, 1978.
   PubMedGoogle Scholar
• Gould, G. A., Whyte, K.F., Rhind, G.B., Airlie, M.A., Catterall, J.R., Shapiro, C.M.& Douglas, N.J.: The sleep hypopnea syndrome. Am Rev Respir Dis 137: 895–898, 1988.
   Google Scholar
• Moser, N.J.& Phillips, B.A.: What is hypopnea anyway? Chest 105: 426–428, 1994.
   PubMedGoogle Scholar
• Deegan, P. C. & McNicholas, W. T.: Pathophysiology of obstructive sleep apnea. Eur Respir J 8: 1161–1178, 1995.
   Google Scholar
• Issa, F. G., McNamara, S. G. & Sullivan, C. E.: Arousal responses to airway occlusion in sleeping dogs: comparison of nasal and tracheal occlusions. J Appl Physiol 62: 1832–1836, 1987.
   Google Scholar
• Bowes, G., Townsend, E. R., Bromley, S. M., Kozar, L. F. & Phillipson, E. A.: Role of carotid body and of afferent vagal stimuli in the arousal response to airway occlusion in sleeping dogs. Am Rev Respir Dis 123: 644–647, 1981.
   Google Scholar
• Berthon-Jones, M. & Sullivan, C. E.: Ventilation and arousal responses to hypercapnia in normal sleeping humans. J Appl Physiol 54: 59–67, 1984.
   Google Scholar
• Hedemark, L. L. & Kronenberg, R. S.: Ventilatory and heart rate responses to hypoxia and hypercapnia during sleep in adults. J Appl Physiol 53: 307–312, 1982.
   Google Scholar
• Gleeson, K., Zwillich, C. W. & White, D. P.: The influence of increasing ventilatory effort on arousal from sleep. Am Rev Respir Dis 142: 295–300, 1990.
   Google Scholar
• Guilleminault, C. & Dement, W. C.: Sleep apnea syndrome. Liss, New York, 1978.
   Google Scholar
• Guilleminault, C., Tilkian, A. & Dement, W. C.: The sleep apnea syndrome. Ann Rev Med 27: 465–484, 1976.
   PubMed Web of Science ®Google Scholar
• Stradling, J. R.: Obstructive sleep apnea: definitions, epidemiology, and natural history. Thorax 50: 683–689, 1995.
   PubMedGoogle Scholar
• Association of Sleep Disorders Centers: Diagnostic classification of sleep and arousal disorders. Sleep 2: 1–137, 1979.
   PubMedGoogle Scholar
• Guilleminault, C., Stoohs, R., Clerk, A., Cetel, M. & Maistros, P.: A cause of excessive daytime sleepiness: the upper airway resistance syndrome. Chest 104: 781–787, 1993.
   PubMed Web of Science ®Google Scholar
• Douglas, N. J.: Sleep apnea/hypopnea syndrome. In: Crofton and Douglas's Respiratory Diseases (ed. A. Seaton, D. Seaton & A. G. Leitch), pp. 1250–1263. Blackwell Science, London, 2000.
   Google Scholar
• Lugaresi, E., Cirignotta, F., Coccagna, G. & Nana, C.: Some epidemiological data on snoring and cardiocirculatory disturbances. Sleep 3: 221–224, 1980.
   PubMed Web of Science ®Google Scholar
• Koskenvuo, M., Kaprio, J., Telakivi, T., Partinen, M., Heilddla, K. & Sarna, S.: Snoring as a risk factor for ischemic heart disease and stroke in men. BMJ 294: 16–19, 1987.
   PubMed Web of Science ®Google Scholar
• Gislason, T., Aberg, H. & Taube, A.: Snoring and systemic hypertension - an epidemiological study. Acta Med Scand 222: 415421, 1987.
   Google Scholar
• Lindberg, E., Taube, A., Janson, C., Gislason, T., Svärdsudd, K. & Boman, G.: A 10-year follow-up of snoring in men. Chest 114: 1048–1055, 1998
   Google Scholar
• Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S. & Badr, S.: Occurrence of sleep disordered breathing among middle aged adults. N Engl J Med 328: 1230–1235, 1993.
   PubMed Web of Science ®Google Scholar
• Lavie, P.: Incidence of sleep apnea in a presumably healthy working population: A significant relationship with excessive daytime sleepiness. Sleep 6: 312–318, 1983.
   PubMed Web of Science ®Google Scholar
• Berry, D. T., Webb, W. B., Block, A. J. & Switzer, D. A.: Sleep-disordered breathing and its concomitants in a subclinical population. Sleep 9: 478–483, 1986.
   Google Scholar
• Gislason, T., Almqvist, M., Eriksson, G., Taube, A. & Boman, G.: Prevalence of sleep apnea syndrome among Swedish men: an epidemiological study. J Clin Epidemiol 41: 571–576, 1988.
   PubMed Web of Science ®Google Scholar
• Cirignotta, F., D'Alessandro, R., Partinen, M., Zucconi, M., Cristina, E., Gerardi, R., Cacciatore, F. M. & lugaresi, E.: Prevalence of every night snoring and obstructive sleep apneas among 30-69-year-old men in Bologna, Italy. Acta Psychiatr Scand 79: 366–372, 1989.
   Google Scholar
• Stradling, J. R. & Crosby, J. H.: Predictors and prevalence of obstructive sleep apnea and snoring in 1001 middle aged men. Thorax 46: 85–90, 1991.
   Google Scholar
• Olson, L. G., King, M. T., Hensley, M. J. & Saunders, N. A.: A community study of snoring and sleep-disordered breathing. Prevalence. Am J Respir Crit Care Med 152: 711–716, 1995.
   Google Scholar
• Davies, R. J. 0. & Stradling, J. R.: The epidemiology of sleep apnea. Thorax 51 (Suppl 2): S65-S70, 1996.
   Google Scholar
• Partinen, M.: Epidemiology of obstructive sleep apnea syndrome. Curr Opin Pulm Med 1: 482–487, 1995.
   PubMedGoogle Scholar
• Slyper, A. H.: Childhood obesity, adipose tissue distribution, and the pediatric practitioner. Pediatrics 102: 131, 1998.
   Google Scholar
• White, D. P., Lombard, R. M., Cadieux, R. J. & Zwillich, C. W.: Pharyngeal resistance in normal humans: influence of gender, age and obesity. J Appl Physiol 58: 365–371, 1985.
   Google Scholar
• White, D. P.: Pathophysiology of obstructive sleep apnea. Thorax 50: 797–804, 1995.
   PubMedGoogle Scholar
• Ancoli-Israel, S., Kripke, D. F., Mason, W. & Kaplan, 0. J.: Sleep apnea and periodic movements in an aging sample. J Gerontol 40: 419–425, 1985.
   Google Scholar
• Redline, S., Tosteson, T., Tishler, P. V., Carskadon, M. A. & Millman, R. P.: Studies in the genetics of obstructive sleep apnea. Am Rev Respir Dis 145: 440–444, 1992.
   Google Scholar
• Douglas, N. J., Luke, M. & Mathur, R.: Is the sleep apnea/hypopnea syndrome inherited? Thorax 48: 719–721, 1993.
   Google Scholar
• Pillar, G. & Lavie, P.: Assessment of the role of inheritance in sleep apnea syndrome. Am J Respir Crit Care Med 151: 688–691, 1995.
   PubMedGoogle Scholar
• ElBayadi, S., Millman, R. P., Tishler, P. V. & Redline, S.: A family study of sleep apnea: anatomic and physiologic interactions. Chest 98: 554–559, 1990.
   PubMedGoogle Scholar
• Wetter, D., Young, T., Bidwall, T., Bach, S. & Palta, M.: Smoking as a risk factor for sleep disordered breathing. Arch Intern Med 154: 2219–2224, 1994.
   PubMed Web of Science ®Google Scholar
• Issa, F. G. & Sullivan, C. E. Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiat 45: 353–359, 1982.
   PubMed Web of Science ®Google Scholar
• Krol, R. C., Knuth, S. L. & Bartlett, D.: Selective reduction of genioglossus muscle activity by alcohol in normal subjects. Am Rev Respir Dis 129: 247–250, 1984.
   PubMed Web of Science ®Google Scholar
• Lopes, J. M., Tabachnik, E., Muller, N. L., Levison, H. & Bryan, A. C.: Total airway resistance and respiratory muscle activity during sleep. J Appl Physiol 54: 733–737, 1983.
   Google Scholar
• Hudgel, D. W.: Variable site of airway narrowing among obstructive sleep apnea patients. J Appl Physiol 61: 1403–1409, 1986.
   PubMed Web of Science ®Google Scholar
• Schafer, M. E.: Upper airway obstruction and sleep disorders in children with craniofacial anomalies. Clin Plast Surg 9: 555–567, 1982.
   PubMedGoogle Scholar
• Guilleminault, C.: Treatments in obstructive sleep apnea. In: Obstructive sleep apnea syndrome: clinical research and treatment (ed. C. Guilleminault & M. Partinen), pp. 99–118. Raven Press, New York, 1990.
   Google Scholar
• Sher, A. E.: Mechanisms of airway obstruction in Robin sequence: Implication for treatment. Cleft Palate Craniofac J 29: 224–231, 1992.
   PubMedGoogle Scholar
• Brown, G., Bradley, T. D., Phillipson, E. A., Zamel, N. & Hoffstein, V.: Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea. Am Rev Respir Dis 132: 211–215, 1985.
   PubMed Web of Science ®Google Scholar
• Brouillette, R. T. & Thach, B. T.: Control of genioglossus muscle inspiratory activity. J Appl Physiol 49: 801–808, 1980.
   Google Scholar
• Remmers, J. E., DeGroot, W. J., Sauerland, E. K. & Anch, A. M. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 44: 931–938, 1978.
   Google Scholar
• Suratt, P. M., McTier, R. F. & Wilhoit, S. C.: Upper airway muscle activation is augmented in patients with obstructive sleep apnea compared with that in normal subjects. Am Rev Respir Dis 137: 889–894, 1988.
   Google Scholar
• DeWeese, E. L. & Sullivan, T. Y.: Effects of upper airway anesthesia on pharyngeal patency during sleep. J Appl Physiol 64: 1346–1353, 1988.
   Google Scholar
• McNicholas, W. T., Coffey, M., McDonnell, T., O'Regan, R. & Fitzgerald, M. X.: Upper airway obstruction during sleep in normal subjects after selective topical oropharyngeal anesthesia. Am Rev Respir Dis 135: 1316–1319, 1987.
   Google Scholar
• Chadwick, G. A., Crowley, P., Fitzgerald, M. X., O'Regan, R. G. & McNicholas, W. T.: Obstructive sleep apnea following topical oropharyngeal anesthesia in loud snorers. Am Rev Respir Dis 143: 810–813, 1991.
   Google Scholar
• Sériès, F., Cornier, Y., Desmeules, M. & La Forge, J.: Effects of respiratory drive on upper airways in sleep apnea patients and normal subjects. J Appl Physiol 67: 973–979, 1989.
   PubMedGoogle Scholar
• Hudgel, D. W. & Harasick, T.: Fluctuation in timing of upper airway and chest wall inspiratory muscle activity in obstructive sleep apnea. J Appl Physiol 69: 443–450, 1990.
   PubMedGoogle Scholar
• Guilleminault, C. & Rosekind, M.: The arousal threshold: sleep deprivation, sleep fragmentation and obstructive sleep apnea syndrome. Bull Eur Physiopathol Respir 17: 341–349, 1981.
   PubMedGoogle Scholar
• Leiter, J. C., Knuth, S. L. & Bartlett, D.: The effect of sleep deprivation on activity of the genioglossus muscle. Am Rev Respir Dis 132: 1242–1245, 1985.
   PubMedGoogle Scholar
• Sériès, F., Roy, N. & Marc, I.: Effects of sleep deprivation and sleep fragmentation on upper airway collapsibility in normal subjects. Am J Respir Crit Care Med 150: 481–485, 1994.
   PubMed Web of Science ®Google Scholar
• Douglas, N. J.: How to reach a diagnosis in patients who may have the sleep apnea/hypopnea syndrome. Thorax 50: 883–886, 1995.
   PubMedGoogle Scholar
• Strollo Jr, P. J. & Rogers, R. M.: Current concepts - Obstructive sleep apnea. N Engl J Med 334: 99–104, 1996.
   Google Scholar
• Douglas, N. J., Thomas, S. & Jan, M. A.: Clinical value of polysomnography. Lancet 339: 347–350, 1992.
   Google Scholar
• Sériès, F., Marc, I., Cornier, Y. & La Forge, J.: Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome. Ann Intern Med 119: 449–453, 1993.
   PubMed Web of Science ®Google Scholar
• Montserrat, J. M., Farré, R., Ballester, E., Felez, M. A., Past& M. & Navajas, D.: Evaluation of nasal prongs for estimating nasal flow. Am J Respir Crit Care Med 155: 211–215, 1997.
   Google Scholar
• Redline, S., Tosteson, T., Boucher, M. A. & Millman, R. P.: Measurements of sleep-related breathing disturbances in epidemiologic studies: Assessment of the validity and reproducibility of a portable monitoring device. Chest 100: 1281–1286, 1991.
   Google Scholar
• Peled, N., Greenberg, A., Pillar, G., Zinder, 0., Levi, N. & Lavie, P.: Contributions of hypoxia and respiratory disturbance index to sympathetic activation and blood pressure in obstructive sleep apnea syndrome. Am J Hypertens 11: 1284–1289, 1998.
   Google Scholar
• Chugh, K. D., Weaver, T. E. & Dinges, D. F.: Neurobehavioral consequences of arousals. Sleep 19: S198-5201, 1996.
   Google Scholar
• Rivlin, J., Hoffstein, V., Kalbfleisch, J., McNicholas, W., Zamel, N. & Bryan, A. C.: Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 129: 355–360, 1984.
   PubMed Web of Science ®Google Scholar
• Fredburg, J. J., Wohl, M. B., Glass, G. M. & Dorkin, H. L.: Airway area by acoustic reflections measured at the mouth. J Appl Physiol 48: 749–758, 1980.
   Google Scholar
• Larsson, S. G., Gislason, T. & Lindholm, C. E.: Computed tomography of the oropharynx in obstructive sleep apnea. Acta Radiologica 9: 401–405, 1988.
   Google Scholar
• Schwab, R. J., Gefter, W. B., Hoffman, E. A., Gupta, K. B. & Pack, A. I.: Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am Rev Respir Dis 148: 1385–1400, 1993.
   Google Scholar
• Galvin, F. R., Rooholamini, S. A. & Stanford, W.: Obstructive sleep apnea: diagnosis with ultrafast CT. Radiology 171: 775–778, 1989.
   PubMedGoogle Scholar
• Abbey, N. C., Block, A. J., Green, D., Mancuso, A. & Hellard, D. W.: Measurement of pharyngeal volume by digitized magnetic resonance imaging. Effect of nasal continuous positive airway pressure. Am Rev Respir Dis 140: 717–723, 1989.
   Google Scholar
• Rodenstein, D. 0., Dooms, G., Thomas, Y., Liistro, G., Stanescu, D. C., Culee, C. & Aubert-Tulkens, G.: Pharyngeal shape and dimensions in healthy subjects, snorers and patients with obstructive sleep apnea. Thorax 45: 722–727, 1990.
   Google Scholar
• Hudgel, D. W.: Treatment of obstructive sleep apnea. A Review. Chest 109: 1346–1358, 1996.
   Google Scholar
• Browman, C. P., Sampson, M. G., Yolles, S. F., Gujavarty, K. S., Weiler, S. J., Walsleben, J. A., Hahn, P. M. & Mitler, M. M.: Obstructive sleep apnea and body weight. Chest 85: 435–438, 1984.
   Google Scholar
• Sugerman, H. J., Fairman, R. P., Sood, R. K., Engle, K., Wolfe, L. & Kellum, J. M.: Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr 55: 597S-601S, 1992.
   Google Scholar
• Sullivan, C. E., Issa, F. G., Berthon-Jones, M. & Eves, L.: Reversal of obstructive sleep apnea by continuous positive airways pressure applied through the flares. Lancet 8225: 862–865, 1981.
   Google Scholar
• Kribbs, N. B., Pack, A. I., Kline, L. R., Smith, P. L., Schwartz, A. R., Schubert, N. M., Redline, S., Henry, J. N., Gesty, J. E. & Dinges, D. F.: Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 147: 887–895, 1993.
   Google Scholar
• Meurice, J-C., Dore, P., Paquereau, J., Neau, J. P., Ingrand, P., Chavagnat, J. J. & Patte, F.: Predictive factors of long-term compliance with nasal continuous positive airway pressure treatment in sleep apnea syndrome. Chest 105: 429–433, 1994.
   PubMed Web of Science ®Google Scholar
• Clark, G. T., Arand, D., Chung, E. & Tong, D.: Effect of anterior mandibular positioning on obstructive sleep apnea. Am Rev Respir Dis 147: 624–629, 1993.
   PubMed Web of Science ®Google Scholar
• Hanzel, D. A., Proia, N. G. & Hudgel, D. W.: Response of obstructive sleep apnea to fluoxetine and protriptyline. Chest 100: 416–421, 1991.
   Google Scholar
• Rajagopal, K. R., Abbrecht, P. H., Derderian, S. S., Pickett, C., Hofeldt, F., Tellis, C. J. & Zwillich, C. W.: Obstructive sleep apnea in hypothyroidism. Ann Intern Med 101: 491–494, 1984.
   Google Scholar
• Rajagopal, K. R., Abbrecht, P. H. & Jabbari, B.: Effects of medroxyprogesterone acetate in obstructive sleep panea. Chest 90: 815–821, 1986.
   PubMed Web of Science ®Google Scholar
• Fletcher, E. C. & Munafo, D. A.: Role of nocturnal oxygen therapy in obstructive sleep apnea: when should it be used? Chest 98: 1497–1504, 1990.
   Google Scholar
• Guilleminault, C., Simmons, F. B., Motta, J., Cummiskey, J., Rosekind, M., Schroeder, J. S. & Dement, W. C.: Obstructive sleep apnea syndrome and tracheostomy: long-term follow-up experience. Arch Intern Med 141:985-988, 1981.
   Google Scholar
• Shepard. J. W. Jr. & Olson, K. D.: Uvulopalatopharyngoplasty for treatment of obstructive sleep apnea. Mayo Clin Proc 65: 1260–1267, 1990.
   Google Scholar
• Johnson, N. T. & Chinn, J.: Uvulopalatopharyngoplasty and inferior sagittal mandibula osteotomy with genioglossus advancement for treatment of obstructive sleep apnea. Chest 105: 278–283, 1994.
   PubMedGoogle Scholar
• Fischer, A. Q., Chaudary, B. A., Taormina, M. A. & Akhtar, B.: Intracranial hemodynamics in sleep apnea. Chest 102: 1402–1406, 1992.
   PubMed Web of Science ®Google Scholar
• Palomäki, H., Partinen, M., Juvela, S. & Kaste, M.: Snoring as a risk factor for sleep-related brain infarction. Stroke 20: 1311–1315, 1989.
   PubMed Web of Science ®Google Scholar
• Spriggs, D. A., French, J. M., Murdy, J. M., Curless, R. H., Bates, D. & James, 0. F. W.: Snoring increases the risk of stroke and adversely affects prognosis. Q J Med 303: 555–562, 1992.
   Google Scholar
• Ferguson, K. A. & Fleetham, J. A.: Consequences of sleep disordered breathing. Thorax 50: 998–1004, 1995.
   Google Scholar
• Sangal, R. B., Thomas, L. & Mitler, M. M.: Disorders of excessive sleepiness - treatment improves ability to stay awake but does not reduce sleepiness. Chest 102: 699–703, 1992.
   Google Scholar
• Poceta, J. S., Timms, R. M., Jeong, D. U., Swui-ling, H., Erman, M. K. & Mitler, M. M.: Maintenance of wakefulness test in obstructive sleep apnea syndrome. Chest 101: 893–897, 1992.
   Google Scholar
• Kales, A., Caldwell, A. B., Cadieux, R. J., Vela-Bueno, A., Ruch, L. G. & Mayes, S. D.: Severe obstructive sleep apnea - II: Associated psychopathology and psychosocial consequences. J Chron Dis 38: 427–434, 1985.
   Google Scholar
• Klonoff, H., Fleetham, J., Taylor, D. R. & Clark, C.: Treatment outcome of obstructive sleep apnea - physiological and neuro-psychological concomitants. J Nerv Ment Dis 175: 208–212, 1987.
   PubMed Web of Science ®Google Scholar
• Findley, L. J., Barth, J. T., Powers, D. C., Wihoit, S. C., Boyd, D. G. & Suratt, P.: Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia. Chest 90: 686–690, 1986.
   PubMed Web of Science ®Google Scholar
• Cheshire, K., Engleman, H., Deary, I., Shapiro, C. & Douglas, N. J.: Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. Arch Intern Med 152: 538–541, 1992.
   PubMedGoogle Scholar
• Grunstein, R. R., Handelsman, D. J., Lawrence, S. J., Blackwell, C., Caterson, I. D. & Sullivan, C. E.: Neuroendocrine dysfunction in sleep apnea: reversal by continuous positive airways pressure therapy. J Clin Endocrinol Metab 68: 352–358, 1989.
   Google Scholar
• Cooper, B. G., White, J. E., Ashworth, L. A., Alberti, K. G. & Gibson, G. J.: Hormonal and metabolic profiles in subjects with obstructive sleep apnea syndrome and the acute effects of nasal continuous positive airway pressure (CPAP) treatment. Sleep 18: 172–179, 1995.
   Google Scholar
• Saini, J., Krieger, J., Brandenberger, G., Wittersheim, G., Simon, C. & Follenius, M.: Continuous positive airway pressure treatment. Effects on growth hormone, insulin and glucose profiles in obstructive sleep apnea patients. Horm Metab Res 25: 375–381, 1993.
   Google Scholar
• Chiba, S., Ashikawa, T., Moriwaki, H., Tokunaga, M., Miyazaki, H. & Moriyama, H.: The influence of sleep breathing disorder on growth hormone secretion in children with tonsil hypertrophy. Nippon Jibiinkoka Gakkai Kaiho 101: 873–878, 1998.
   PubMedGoogle Scholar
• Bratel, T., Wennlund, A. & Carlström, K.: Pituitary reactivity, androgens and catecholamines in obstructive sleep apnoea. Effects of continuous positive airway pressure treatment (CPAP). Respir Med 93: 1–7, 1999.
   Google Scholar
• Mckeon, J. L., Saunders, N. A., Muree-Allen, K., Olson, L. G., Gyulay, S., Dickeson, J., Houghton, A., Wlodarczyk, J. & Hensley, M. J.: Urinary uric acid: creatinine ratio, serum erytlunpoietin and blood 2,3-diphosphoglycerate in patients with obstructive sleep apnea. Am Rev Respir Dis 142: 8–13, 1990.
   Google Scholar
• Krieger, J., Sforza, E., Delame, C., Petiau, C.: Decrease in haematocrit with continuous positive airway pressure treatment in obstructive sleep apnea patients. Eur Respir J 5: 228–233, 1992.
   Google Scholar
• Krieger, J., Follenius, M., Sforza, E., Brandenberger, G. & Peter, J. D.: Effects of treatment with nasal continuous positive airway pressure on atrial natriuretic peptide and arginine vasopressin release during sleep in patients with obstructive sleep apnea. Clin Sci 80: 443–449, 1991.
   Google Scholar
• Braghiroli, A., Sacco, C., Erbetta, M., Ruga, V. & Donner, C. F.: Overnight urinary uric acid: creatinine ratio for detection of sleep hypoxemia. Am Rev Respir Dis 148: 173–178, 1993.
   PubMed Web of Science ®Google Scholar
• Krieger, J., Benzoni, D., Sforza, E. & Sassard, J.: Urinary excretion of prostanoids during sleep in obstructive sleep apnea patients. Clin Exp Pharmacol Physiol 18: 551–555, 1991.
   PubMedGoogle Scholar
• Carlson, J. T., Rangemark, C. & Hedner, J. A.: Attenuated endothelium-dependent vascular relaxation in patients with sleep apnoea. J Hypertens 14: 577–584, 1996.
   Google Scholar
• Follenius, M., Krieger, J., Krauth, M. 0., Sforza, F. & Brandenberger, G.: Obstructive sleep apnea treatment: peripheral and central effects on plasma renin activity and aldosterone. Sleep 14: 211–217, 1991.
   Google Scholar
• Rangemark, C., Hedner, J. A., Carlson, J. T., Gleerup, G. & Winther, K.: Platelet function and fibrinolytic activity in hypertensive and normotensive sleep apnea patients. Sleep 18: 188–194, 1995.
   PubMed Web of Science ®Google Scholar
• Bokinsky, G., Miller, M., Ault, K., Husband, P. & Mitchell, J.: Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure: a preliminary investigation. Chest 108: 625–629, 1995.
   PubMed Web of Science ®Google Scholar
• Sklar, A. H., Chaudhary, B. A. & Harp, R.: Nocturnal urinary protein excretion rates in patients with sleep apnea. Nephron 51: 35–38, 1989.
   PubMedGoogle Scholar
• Silverberg, D. S. & Oksenberg, A.: Essential and secondary hypertension and sleep-disordered breathing: a unifying hypothesis. J Human Hypertension 10: 353–363, 1996.
   PubMedGoogle Scholar
• Findley, L. J., Unverzagt, M. E. & Surrat, P. M.: Automobile accidents involving patients with obstructive sleep apnea. Am Rev Respir Dis 138: 337–340, 1988.
   Google Scholar
• Stradling, J. R.: Obstructive sleep apnea and driving. BMJ 298: 904–905, 1989.
   PubMedGoogle Scholar
• Ulfberg, J., Carter, N. & Edling, C.: Sleep-disordered breathing and occupational accidents. Scand J Work Environ Health 26: 237–242, 2000.
   PubMed Web of Science ®Google Scholar
• Lindberg, E., Janson, C., Svärdsudd, K., Gislason, T., Hetta, J. & Boman, G.: Increased mortality among sleepy snorers: a prospective, population based study. Thorax 53: 631–637, 1998.
   Google Scholar
• He, J., Kryger, M. H., Zorick, F. J., Conway, W. & Roth, T.: Mortality and apnea index in obstructive sleep apnea: experience in 385 male patients. Chest 94: 9–14, 1988.
   Google Scholar
• Partinen, M., Jamieson, A. & Guilleminault, C.: Long-term outcome for obstructive sleep apnea syndrome patients: mortality. Chest 94: 1200–1204, 1988.
   PubMed Web of Science ®Google Scholar
• Partinen, M. & Guilleminault, C.: Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. Chest 97: 27–32, 1990.
   PubMed Web of Science ®Google Scholar
• Quan, S. F.: Evolution of obstructive sleep apnoea (Letter to the editor). Thorax 53: 532, 1998.
   PubMedGoogle Scholar
• Lugaresi, E., Cirignotta, F., Gerardi, R. & Montagna, P.: Snoring and sleep apnea: natural history of heavy snorers disease. In: Guilleminault C, Partinen M, eds. Obstructive sleep apnea syndrome: clinical research and treatment. New York, Raven Press. 25–36, 1990.
   Google Scholar
• Grunstein, R. R.: Sleep apnea - evolution and doubt. Eur Respir J 7: 1741–1743, 1994.
   PubMedGoogle Scholar
• Sforza, E., Addati, G., Cirignotta, F. & Lugaresi, E.: Natural evolution of sleep apnoea syndrome: a five year longitudinal study. Eur Respir J 7: 1765–1770, 1994.
   PubMedGoogle Scholar
• Svanborg, E. & Larsson, H.: Development of nocturnal respiratory disturbance in untreated patients with obstructive sleep apnea syndrome. Chest 104: 340–343, 1993.
   PubMedGoogle Scholar
• Pendelbury, S. T., Pépin, J-L., Veale, D. & Levy, P.: Natural evolution of moderate sleep apnoea syndrome: significant progression over a mean of 17 months. Thorax 52: 872–878, 1997.
   Google Scholar
• Calverley, P. M. A.: Obstructive sleep apnoea: a progressive disorder? Thorax 52: 843–844, 1997.
   Google Scholar
• Smirne, S., Palazzi, S., Zucconi, M., Chierchia, S. & Ferini-Strambi, L.: Habitual snoring as a risk factor for acute vascular disease. Eur Respir J 6: 1357–1361, 1993.
   PubMed Web of Science ®Google Scholar
• Grunstein, R. R., Stenlöf, K., Hedner, J. & Sjostrom, L.: Impact of obstructive sleep apnea and sleepiness on metabolic and cardiovascular risk factors in the Swedish Obese Subjects (SOS) study. Int J Obes 19: 410–418, 1995.
   Google Scholar
• Lindberg, E., Janson, C., Gislason, T., Svärdsudd, K., Hetta, J., Boman, G.: Snoring and hypertension - a 10-year follow-up. Eur Respir J 11: 884–889, 1998.
   Google Scholar
• Norton, P. G. & Dunn, E. V.: Snoring as a risk factor for disease: an epidemiological survey. BMJ 291: 630–632, 1985.
   Google Scholar
• Jennum, P., Schultz-Larsen, K., Davidsen, M. & Christensen, N. J.: Snoring and risk of stroke and ischemic heart disease in a 70 year old population. A 6-year follow-up study. Int J Epidemiol 23: 1159–1164, 1994.
   Google Scholar
• Enright, P. L., Newman, A. B., Wahl, P. W., Manolio, T. A., Haponik, E. F. & Boyle, P. J.: Prevalence and correlates of snoring and observed apneas in 5,201 older adults. Sleep 19: 531–538, 1996.
   Google Scholar
• Qiu, C.: A study on risk factors of ischemic stroke. Chung Hua Liu Hsing Ping Hsueh Tsa Chih 13: 344–347, 1992.
   Google Scholar
• Palomäki, H. & Kaste, M.: Regular light-to-moderate intake of alcohol and the risk of ishemic stroke. Is there a beneficial effect? Stroke 24: 1828–1832, 1993.
   Google Scholar
• Zaninelli, A., Fariello, R., Boni, E., Corda, L., Alicandri, C. & Grassi, V.: Snoring and risk of cardiovascular disease. Int J Cardiol 1991; 32: 347–351.
   Google Scholar
• Peppard, P. E., Young, T., Palta, M. & Skatrud, J.: Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342: 1378–1384, 2000.
   PubMed Web of Science ®Google Scholar
• Begasse, F., Chamontin, B., Fonquemie, L., Didier, A., Chollet, P., Leophonte, P. & Salvador, M.: Should arterial hypertension in sleep apnea syndrome be stressed? Arch Mal Coeur Vaiss 84: 1133–1136, 1991.
   Google Scholar
• Working group on OSA and hypertension: Obstructive sleep apnea and blood pressure elevation: what is the relationship? Blood Press 2: 166–182, 1993.
   PubMedGoogle Scholar
• Brooks, D., Horner, R. L., Kozar, L. F., Render-Teixeira, C. L. & Phillipson, E. A.: Obstructive sleep apnea as a cause of systemic hypertension. Evidence from a canine model. J Clin Invest 99: 106–109, 1997.
   Google Scholar
• Mooe, T., Rabban, T., Wiklund, U., Franklin, K. A., Eriksson, P.: Sleep-disordered breathing in women: occurrence and association with coronary artery disease. Am J Med 101: 251–256, 1996.
   PubMedGoogle Scholar
• Peker, Y., Kraiczi, H., Hedner, J., Löth, S., Johansson, A. & Bende, M.: An independent association between obstructive sleep apnea and coronary artery disease. Eur Respir J 13: 179–184, 1999.
   Google Scholar
• Franklin, K. A., Nilsson, J. B., Sahlin, C., Näslund, U.: Sleep apnea and nocturnal angina. Lancet 345: 1085–1087, 1995.
   PubMed Web of Science ®Google Scholar
• Peter, J. H., Koehler, U., Grote, L. & Podszus, T.: Manifestations and consequences of obstructive sleep apnoea. Eur Respir J 8: 1572–1583, 1995.
   PubMedGoogle Scholar
• Palomäki, H., Partinen, M., Erkinjuntti, T. & Kaste, M.: Snoring, sleep apnea syndrome and stroke. Neurology 42 (suppl. 6): 75–82, 1992.
   Google Scholar
• Hedner, J., Ejnell, H. & Caidahl, K.: Left ventricular hypertrophy independent of hypertension in patients with obstructive sleep apnea. J Hypertens 8: 941–946, 1990.
   PubMed Web of Science ®Google Scholar
• Krieger, J., Grucker, D., Sforza, E., Chambron, J. & Kurtz, D.: Left ventricular ejection fraction in obstructive sleep apnea: efects of long-term treatment with nasal continuous airway pressure. Chest 100: 917–921, 1991.
   PubMed Web of Science ®Google Scholar
• Malone, S., Liu, P. P., Holloway, R., Rutherford, R., Xie, A. & Bradley, T. D.: Obstructive sleep apnea in patients with dilated cardiomyopathy: effects of continuous positive airway pressure. Lancet 338: 1480–1484, 1991.
   Google Scholar
• Lavie, P., Herer, P., Peled, R., Berger, I., Yoffe, N., Zomer, J. & Rubin, A. H.: Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 18: 149–157, 1995.
   PubMed Web of Science ®Google Scholar
• Weitzenblum, E., Krieger, J., Apprill, M., Vallée, E., Ehrhart, M., Ratomaharo, J., Oswald, M. & Kurtz, D.: Daytime pulmonary hypertension in patients with obstructive sleep apnea. Am Rev Respir Dis 138: 345–349, 1988.
   Google Scholar
• Sforza, E., Krieger, J., Weitzenblum, E., Apprill, M., Lampert, E. & Ratamaharo, J.: Long-term effects of treatment with nasal continuous positive airway pressure on daytime lung function and pulmonary hemodynamics in patients with obstructive sleep apnea. Am Rev Respir Dis 141: 866–870, 1990.
   PubMedGoogle Scholar
• Stern, J. S., Hirsch, J., Blair, S. N., Foreyt, J. P., Frank, A., Kumanyika, S. K., Madans, J. H., Marlatt GA, St-Jeor ST, Stunkard AJ. Weighing the options: criteria for evaluating weight-management programs. The committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat obesity. Obes Res 3: 591–604, 1995.
   Google Scholar
• Atkinson, R. L.: Proposed standards for judging the success of the treatment of obesity. Ann Intern Med 119: 677–80, 1993.
   PubMed Web of Science ®Google Scholar
• Balsiger, B. M., Luque de Leon, E. & Sarr, M. G.: Surgical treatment of obesity: who is an appropriate candidate? Mayo Clin Proc 72: 551–557, 1997.
   Google Scholar
• The Expert Panel on the Identification, Evaluation,, and Treatmen of Overweight and Obesity in Adults: Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 158: 1855–1867, 1998.
   PubMedGoogle Scholar
• Bray, G. A.: Health hazards of obesity. Endocrinol Metab Clin North Am 25: 907–919, 1996.
   PubMed Web of Science ®Google Scholar
• Pi-Sunyer, F. X.: Short-term medical benefits and adverse effects of weight loss. Ann Intern Med 119: 722–726, 1993.
   PubMed Web of Science ®Google Scholar
• Pi-Sunyer, F. X.: Health implications of obesity. Am J Clin Nutr 53 (Suppl 6): 1595S-1603S, 1991.
   Google Scholar
• Larsson, B., Svärdsudd, K., Welin, L., Wilhelmsen, L., Björntorp, P. & Tibblin, G.: Abdominal adipose tissue distribution, obesity and risk of cardiovascular diseases and death: 13 year follow up of participants in the study of men born in 1913. BMJ 288: 1401–1404, 1984.
   Google Scholar
• Daniel, M., Marion, S. A., Sheps, S. B., Hertzman, C. & Gamble, D.: Variation by body mass index and age in waist-to-hip ratio associations with glycemic status in an aboriginal population at risk for type 2 diabetes in British Columbia, Canada. Am J Clin Nutr 69: 455–460, 1999.
   Google Scholar
• Simon, J. A., Seeley, D. G., Lipschutz, R. C., Vittinghoff, E., Browner & W. S.: The relation of smoking to waist-to-hip ratio and diabetes mellitus among elderly women.Prev Med 26: 636–644, 1997.
   Google Scholar
• Eliasson, B., Attval, S., Taskinen, M. R., Smith, U.: Smoking cessation improves insulin sensitivity in healthy middle-aged men. Eur J Clin Invest 27: 450–456, 1997.
   PubMed Web of Science ®Google Scholar
• Laaban, J. P., Cassuto, D., Orvoen-Frija, E., Thou, M. C., Mundler, 0., Leger, D., Oppert, J. M.: Cardiorespiratory consequences of sleep apnea syndrome in patients wiht massive obesity. Eur Respir J 11: 20–27, 1998.
   Google Scholar
• Wilcox, I., McNamara, G., Collins, F. L., Grunstein, R. R. & Sullivan, C. E.: "Syndrome Z": the interaction of sleep apnoea, vascular risk factos and heart disease. Thorax 53 (Suppl 3): S25-S28, 1998.
   Google Scholar
• Levinson, P. D., McGarvey, S. T., Carlisle, C. C., Eveloff, S. E., Herbert, P. N., Millman, R. P.: Adiposity and cardiovascular risk factors in men with obstructive sleep apnea. Chest 103: 1336–1342, 1993.
   PubMed Web of Science ®Google Scholar
• Schafer, H., Berner, S., Ewig, S., Hasper, E., Tasci, S. & Luderitz, B.: Cardiovascular morbidity in patients with obstructive sleep apnea in relation to the severity of respiratory disorder. Dtsch Med Wochenschr. 123: 1127–1133, 1998.
   PubMedGoogle Scholar
• Kolanowski, J.: Surgical treatment for morbid obesity. Br Med Bull 53: 433, 1997.
   PubMedGoogle Scholar
• Pories, W. J., Swanson, M. S., MacDonald, K. G., Long, S. B., Morris, P. G., Brown, B. M., Barakat, H. A., deRoman, R. A., Israel, G., Dolezal, J. M., et al.: Who would thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222: 339–350, 1995.
   PubMed Web of Science ®Google Scholar
• Wittels, E. H. & Thompson, S.: Obstructive sleep apnea and obesity. Otolaryngol Clin North Am 23: 751–760, 1990.
   PubMedGoogle Scholar
• Shelton, K. E., Woodson, H., Gay, S. & Suratt, P. M.: Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 148: 462–466, 1993.
   Google Scholar
• Hoffstein, V., Zamel, N. & Phillipson, E. A.: Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea. Am Rev Respir Dis 130: 175–178, 1984.
   PubMedGoogle Scholar
• Koopmann, C. F., Field, R. A. & Coulthard, S. W.: Sleep apnea syndrome associated with a neck mass. Otolaryngol Head Neck Surg 89: 949–952, 1981.
   Google Scholar
• Davies, R. J. 0. & Stradling, J. R.: The relationship between neck circumference, radiographic pharyngeal anatomy and the obstructive sleep apnea syndrome. Eur Respir J 3: 509–514, 1990.
   Google Scholar
• Grunstein, R. R.: Metabolic aspects of sleep apnea. Sleep 19 (Suppl 10): S218–S220, 1996.
   Google Scholar
• Fischer, J. & Raschke, F.: Glucose tolerance, insulin resistance and arterial hypertension in patients with obstructive sleep apnea syndrome. Pneumologie 49 (Suppl 1): 131–135, 1995.
   PubMedGoogle Scholar
• Rössner, S., Lagerstrand, L., Persson, H. E. & Sacha, C.: The sleep apnea syndrome in obesity: risk of sudden death. J Intern Med 230: 135–141, 1991.
   Google Scholar
• Grunstein, R., Wilcox, I., Yang, T. S., Gould, Y. & Hedner, J.: Snoring and sleep apnea in men: association with central obesity and hypertension. Int J Obesity 17: 533–540, 1993.
   PubMed Web of Science ®Google Scholar
• Grunstein, R.: Endocrine disorderes. In: Principles and Practice of Sleep Medicine (ed. M. H. Kryger, T. Roth & W. C. Dement), pp. 1103–1112. W.B. Saunders Company, Philadelphia, 2000.
   Google Scholar
• The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 20: 1183–1197, 1997.
   PubMed Web of Science ®Google Scholar
• Chapin, B. L., Medina, S., Le, D., Busse11, N. & Busse11, K.: Prevalence of undiagnosed diabetes and abnormalities of carbohydrate metabolism in a U.S. Army population. Diabetes Care 22: 426–429, 1999.
   Google Scholar
• Alberti, K. G., Zimmet, P. Z. for the WHO Consultation.: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15: 539–553, 1998.
   Google Scholar
• Sugimori, H., Miyakawa, M., Yoshida, K., Izuno, T., Takahashi, E., Tanaka, C., Nakamura, K., Hinohara, S.: Health risk assessment for diabetes mellitus based on longitudinal analysis of MHTS database. J Med Syst 22: 27–32, 1998.
   PubMedGoogle Scholar
• Shaw, J. E., Zimmet, P. Z., de-Courten, M., Dowse, G. K., Chitson, P., Gareeboo, H., Hemraj, F., Fareed, D., Tumilehto, J. & Alberti, K. G.: Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius? Diabetes Care 22: 399–402, 1999.
   Google Scholar
• DECODE Study Group on behalf of the Eurpean Diabetes Epidemiology Study Group.: Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. BMJ 317: 371–375, 1998.
   PubMed Web of Science ®Google Scholar
• Lowe, L. P., Liu, K., Greenland, P., Metzger, B. E., Dyer, A. R. & Stamler, J.: Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men. Diabetes Care 20: 163–169, 1997.
   Google Scholar
• Andersson, D. K. G., Svärdsudd, K. & Tibblin, G.: Prevalence and incidence of diabetes in a Swedish community 1972–1987. Diabetic Med 8: 428–434, 1991.
   Google Scholar
• Harris, M. I., Flegal, K. M., Cowie, C. C., Eberhardt, M. S., Goldstein, D. E., Little, R. R., Wiedmeyer, H. M. & Byrd Holt, D. D.: Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care 21: 518–524, 1998.
   Google Scholar
• Kawakami, N., Takatsuka, N., Shimizu, H. & Ishibashi, H.: Effects of smoking on the incidence of non-insulin-dependent diabetes mellitus. Replication and extension in a Japanese cohort of male employes. Am J Epidemiol 145: 103–109, 1997.
   Google Scholar
• Perry, I. J., Wannamethee, S. G., Walker, M. K., Thomson, A. G., Whincup, P. H. & Shaper, A. G.: Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men. BMJ 310: 560–564, 1995.
   Google Scholar
• Ferrannini, E. & Camastra, S.: Relationship between impaired glucose tolerance, non-insulin-dependent diabetes mellitus and obesity. Eur J Clin Invest 28 (suppl 2): 3–7, 1998.
   Google Scholar
• Haffner, S. M., Mitchell, B. D., Stern, M. P., Hazuda, H. P. & Patterson, J. K.: Public health significance of upper body adiposity for non-insulin-dependent diabetes mellitus in Mexican Americans. Int J Obes 16: 177–184, 1992.
   Google Scholar
• Ohlson, L. 0., Larsson, B., Svärdsudd, K., Welin, L., Eriksson, H., Wilhelmsen, L., Björntorp, P. & Tibblin, G.: The influence of body fat distribution on the incidence of diabetes mellitus: 13.5 year of follow-up of the participants in the study of men born in 1913. Diabetes 34: 1055–1058, 1985.
   Google Scholar
• Carlsson, S., Persson, P. G., Alvarsson, M., Efendic, S., Norman, A., Svanstrom, L., Ostenson, C. G. & Grill, V.: Weight history, glucose intolerance, and insulin levels in middle-aged Swedish men. Am J Epidemiol 1998; 148: 539–545.
   Google Scholar
• Ronnemaa, T., Ronemaa, E. M., Puukka, P., Pyorala, K. & Laakso, M.: Smoking is independently associated with high plasma insulin levels in nondiabetic men. Diabetes Care 19: 1229–1232, 1996.
   PubMed Web of Science ®Google Scholar
• Chaturvedi, N., Stevens, L. & Fuller, J. H.: Which features of smoking determine mortality risk in former cigarette smokers with diabetes? The World Health Organization Multinational Study Group. Diabetes Care 20: 1266–1272, 1997.
   PubMed Web of Science ®Google Scholar
• Stampfer, M. J., Colditz, G. A., Willett, W. C., Manson, J. E., Arky, R. A., Hennekens, C. H., et al.: A prospective study of moderate alcohol drinking and risk of diabetes in women. Am J epidemiol 128: 549–558, 1988.
   PubMed Web of Science ®Google Scholar
• Godsland, I. F., Leyva, F., Walton, C., Worthington, M. & Stevenson, J. C.: Associations of smoking, alcohol and physical activity with risk factors for coronary heart disease and diabetes in the first follow-up cohort of the Heart Disease and Diabetes Risk Indicators in a Screened Cohort study (HDDRISC-1). J Intern Med 244: 33–41, 1998.
   Google Scholar
• Wei, M., Gibbons, L. W., Mitchell, T. L., Kampert, J. B., Lee, C. D. & Blair, S. N.: The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Ann Intern Med 130: 89–96, 1999.
   Google Scholar
• Reaven, G. M.: Role of insulin resistance in human disease. Diabetes 37: 1595–1607, 1988.
   PubMed Web of Science ®Google Scholar
• Alberti, K. G.: Impaired glucose tolerance: what are the clinical implications? Diabetes Res Clin Pract 40: S3–S8, 1998.
   Google Scholar
• Bloomgarden, Z. T.: Insulin resistance: current concepts. Clin Ther 20: 216–231, 1998.
   PubMed Web of Science ®Google Scholar
• Landsberg, L.: Pathophysiology of obesity-related hypertension: role of insulin and sympathetic nervous system. J Cardiovasc Pharmacol 23 (Suppl 1): Sl-S8, 1994.
   Google Scholar
• Ferrannini, E., Natali, A., Bell, P., Cavallo-Perin, P., Lalic, N. & Mingrone, G.: Insulin resistance and hypersecretion in obesity. J Clin Invest 100: 1166–1173, 1997.
   Google Scholar
• Stoohs, R. A., Facchini, F. & Guilleminault, C.: Insulin resistance and sleep-disordered breathing in healthy humans. Am J Respir Crit Care Med 154: 170–174, 1996.
   PubMed Web of Science ®Google Scholar
• Strohl, K. P.: Diabetes and sleep apnea. Sleep 19: S225–S228, 1996.
   Google Scholar
• Brooks, B., Cistulli, P. A., Borkman, M., Ross, G., McGhee, S., Grunstein, R. R., Sullivan, C. E. & Yue, D. K.: Obstructive sleep apnea in obese noninsulin-dependent diabetes patients: effect of continuous positive airway pressure treatment on insulin responsiveness. J Clin Endocrinol Metab 79: 1681–1685, 1996.
   Google Scholar
• Katsumata, K., Okada, T., Miyao, M. & Katsumata, Y.: High incidence of sleep apnea syndrome in a male diabetic population. Diabetes Res Clin Pract 13: 45–51, 1991.
   PubMedGoogle Scholar
• Strohl, K. P., Novak, R. D., Singer, W., Callan, C., Boehm, K. D., Denko, C. W. & Hoffstein, V. S.: Insulin levels, blood pressure and sleep apnea. Sleep 17: 614–618, 1994.
   Google Scholar
• Jennum, P., Schultz-Larsen, K. & Christensen, N.: Snoring, sympathetic activity and cardiovascular risk factors in a 70 year old population. Eur J Epidemiol 9: 477–482, 1993.
   Google Scholar
• Rosenow, F., McCarthy, V. & Caruso, A. C.: Sleep apnea in endocrine diseases. J Sleep Res 7: 3–11, 1998.
   PubMedGoogle Scholar
• Pierzchala, W. & Ograbek, M.: Sleep apnea syndrome in patients with diabetes. Effectiveness of treatment for respiratory assistance at night with continuous positive airway pressure. Wiad Lek 51: 166–172, 1998.
   Google Scholar
• Guilleminault, C., Briskin, J. G., Greenfield, M. S. & Silvestri, R.: The impact of autonomic nervous system dysfunction on breathing during sleep. Sleep 4: 263–278, 1981.
   PubMedGoogle Scholar
• Ress, P. J., Prior, J. G., Cochrane, G. M. & Clark, T. J.: Sleep apnea in diabetic patients with autonomic neuropathy. J R Soc Med 74: 192–195, 1981.
   Google Scholar
• Mondini, S. & Guilleminault, C.: Abnormal breathing patterns during sleep in diabetes. Ann Neurol 17: 391–395, 1985.
   PubMed Web of Science ®Google Scholar
• Ficker, J. H., Dertinger, S. H., Siegfried, W., Konig, H. J., Pentz, M., Sailer, D., Katalinic, A. & Hahn, E. G.: Obstructive sleep apnea and diabetes mellitus: the role of cardiovascular autonomic neuropathy. Eur Respir J 11: 14–19, 1998.
   Google Scholar
• Sobotka, P. A., Liss, H. P. & Vinik, A. I.: Impaired hypoxic ventilatory drive in diabetic patients with autonomic neuropathy. J Clin Endocrinol Metab 62: 658–663, 1986.
   Google Scholar
• Catterall, J. R., Calverley, P. M., Ewing, D. J., Shapiro, C. M., Clarke, B. F. & Douglas, N. J.: Breathing, sleep, and diabetic autonomic neuropathy. Diabetes 33: 1025–1027, 1984.
   Google Scholar
• Poluektov, M. G., Eligulashvili, T. S., Mel'nichenko, G. A. & Vein, A. M.: The connection between respiratory disorders during sleep and peripheral autonomic insufficiency in diabetics. Zh Nevropatol Psikhiatr Im S S Korsakova 97: 11–14, 1997.
   Google Scholar
• Soler, N. G. & Eagleton, L. E.: Autonomic neuropathy and the ventilatory responses of diabetics to progressive hypoxemia and hypercarbia. Diabetes 31: 609–614, 1982.
   Google Scholar
• Cheng, N., Cal, W., Jiang, M. & Wu, S.: Effect of hypoxia on blood glucose, hormones, and insulin receptor functions in newborn calves. Pediatr Res 41: 852–856, 1997.
   PubMed Web of Science ®Google Scholar
• Taylor, P. M.: Effects of hypoxia on endocrine and metabolic responses to anaesthesia in ponies. Res Vet Sci 66: 39–44, 1999.
   PubMedGoogle Scholar
• Pison, C. M., Chauvin, C., Perrault, H., Schwebel, C., Lafond, J. L., Boujet, C. & Leverve, X. M.: In vivo hypoxic exposure impaires metabolic adaptations to a 48 hour fast in rats. Eur Respir J 12: 658–665, 1998.
   Google Scholar
• Scheen, A. J. & Van Cauter, E.: The roles of time of day and sleep quality in modulating glucose regulation: clinical implications. Horn Res 49: 191–201, 1998.
   PubMedGoogle Scholar
• Van Cauter, E.: Endocrine physiology. In: Principles and Practice of Sleep Medicine (ed. M. H. ICryger, T. Roth, W. C. Dement), pp. 266–278. W.B. Saunders Company, Philadelphia, 2000.
   Google Scholar
• Coy, T. V., Dimsdale, J. E., Ancoli-Israel, S. & Clausen, J.: Sleep apnoea and sympathetic nervous system activity: a review. J Sleep Res 5: 42–50, 1996.
   Google Scholar
• Ziegler, M. G., Nelesen, R., Mills, P., Ancoli-Israel, S., Kennedy, B. & Dimsdale, J. E.: Sleep apnea, norepinephrine-release rate, and daytime hypertension. Sleep 20: 224–231, 1997.
   Google Scholar
• Hedner, J., Darpö, B., Ejnell, H., Carlson, J. & Caidahl, K.: Reduction in sympathetic activity after long-term CPAP treatment in sleep apnoea: cardiovascular implications. Ear Respi J 8: 222–229, 1995.
   Google Scholar
• Somers, V. K., Dyken, M. E., Clary, M. P. & Abboud, F. M.: Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 96: 1897–1904, 1995.
   Google Scholar
• Minemura, H., Akashiba, T., Yamamoto, H., Akahoshi, T., Kosaka, N. & Hone, T.: Acute effects of nasal continuous positive airway pressure on 24-hour blood pressure and catecholamines in patients with obstructive sleep apnea. Intern Med 37: 1009–1013, 1998.
   Google Scholar
• Hedner, J., Ejnell, H., Sellgren, J., Hedner, T. & Wallin, G.: Is high and fluctuating muscle nerve sympathetic activity in the sleep apnea syndrome of pathogenetic importance for the development of hypertension? J Hypertens 6 (Suppl 4): S529–S531, 1988.
   Google Scholar
• Ehlenz, K., Kohler, U., Mayer, J., Peter, J. H., von Wichert, P. & Kaffarnik, H.: Plasma levels of catecholamines and cardiovascular parameters during sleep in patients with sleep apnea syndrome. In: Peter J, Podszus T, von Wichert P, eds. Sleep-related Disorders and Internal Diseases. Berlin: Springer-Verlag. 321–325, 1987.
   Google Scholar
• Goldstein, D.: Plasma norepinephrine in essential hypertension: a study of the studies. Hypertension 3: 48–52, 1981.
   PubMed Web of Science ®Google Scholar
• Franco-Morselli, R., Elghozi, J., Joly, E., DiGiuliu, S. & Meyer, P.: Increased plasma adrenaline concentrations in benign essential hypertension. BMJ 2: 1251–1254, 1977.
   PubMed Web of Science ®Google Scholar
• Mancia, G., Grassi, G., Parati, G. & Daffonchio, A.: Evaluating sympathetic activity in human hypertension. J Hypertens 11: S13–S19, 1993.
   Google Scholar
• Otsuka, N., Ohi, M., Chin, K., Kita, H., Noguchi, T., Hata, T., Nohara, R., Hosokawa, R., Fujita, M. & Kuno, K.: Assessment of cardiac sympathetic function with iodine-123-MIBG imaging in obstructive sleep apnea syndrome. J Nucl Med 38: 567–572, 1997.
   Google Scholar
• Lavie, P., Yaffe, N., Berger, I. & Peled, R.: The relationship between the severity of sleep apnea syndrome and 24-h blood pressure values in patients with obstructive sleep apnea. Chest 103: 717–721, 1993.
   Google Scholar
• Dimsdale, J. E., Coy, T., Ancoli-Israel, S., Mills, P., Clausen, J. & Ziegler, M. G.: Sympathetic nervous system alteration in sleep apnea. The relative importance of respiratory disturbance, hypoxia, and sleep quality. Chest 111: 639–642, 1997.
   Google Scholar
• Somers, V. K., Mark, A. L., Abboud, F. M.: Sympathetic activation by hypoxia and hypercapnia-implications for sleep apnea. Clin Exp Hypertens. Part A Theory Pract A10 (Suppl. 1): 413–422, 1988.
   Google Scholar
• Dempsey, J. A.: Sleep apnea causes daytime hypertension. J Clin Invest 99: 1–2, 1997.
   PubMedGoogle Scholar
• Naughton, M. T., Benard, D. C., Liu, P. P., Rutherford, R., Rankin, F. & Bradley, T. D.: Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med 152: 473–479, 1995.
   Google Scholar
• Bradley, T. D.: Hemodynamic and sympathoinhibitory effects of nasal CPAP in congestive heart failure. Sleep 19: S232–5235, 1996.
   PubMedGoogle Scholar
• Noda, A., Okada, T., Yasuma, F., Nakashima, N. & Yokota, M.: Cardiac hypertrophy in obstructive sleep apnea syndrome. Chest 107: 1538–1544, 1995.
   PubMed Web of Science ®Google Scholar
• Baylor, P., Mouton, A., Shamoon, H. H. & Goebel, P.: Increased norepinephrine variability in patients with sleep apnea syndrome. Am J Med 99: 611–615, 1995.
   PubMedGoogle Scholar
• Ziegler, M. G., Nelesen, R. A., Mills, P. J., Ancoli-Israel, S., Clausen, J. L., Watkins, L. & Dimsdale, J. E.: The effect of hypoxia on baroreflexes and pressor sensitivity in sleep apnea and hypertension. Sleep 18: 859–865, 1995.
   Google Scholar
• Fletcher, E. C.: An animal model of the relationship between systemic hypertension and repetitive episodic hypoxia as seen in sleep apnea. J Sleep Res 4: 71–77, 1995.
   PubMedGoogle Scholar
• Fletcher, E. C., Bao, G. & Li, R.: Renin activity and blood pressure in response to chronic episodic hypoxia. Hypertension 34: 309–314, 1999.
   PubMed Web of Science ®Google Scholar
• Chen, L., Sica, A. L. & Scharf, S. M.: Mechanisms of acute cardiovascular response to periodic apneas in sedated pigs. J Appl Physiol 86: 1236–1246, 1999.
   Google Scholar
• Rowell, L. B., Johnson, D. G., Chase, P. B., Comess, K. A. & Seals, D. R.: Hypoxia raises muscle sympathetic activity but not norepinephrine in resting humans. J Appl Physiol 66: 1736–1743, 1989.
   Google Scholar
• ESCOUlTOU, P., Johnson, D. G. & Rowell, L. B.: Hypoxemia increases plasma catecholamine concentrations in exercising humans. J Appl Physiol 57: 1507–1511, 1984.
   Google Scholar
• Seals, D. R., Johnson, D. G. & Fregosi, R. F.: Hypoxia potentiates exercise-induced sympathetic neural activation in humans. J Appl Physiol 71: 1032–1040, 1991.
   Google Scholar
• Rowell, L. B., Brengelmann, G. L., Savage, M. V. & Freund, P. R.: Does acute hypoxemia blunt sympathetic activity in hyperthermia? J Appl Physiol 66: 28–33, 1989.
   Google Scholar
• Mazzeo, R. S., Bender, P. R., Brooks, G. A., Butterfield, G. E., Groves, B. M., Sutton, J. R., Wolfel, E. E. & Reeves, J. T.: Arterial catecholamine responses during exercise with acute and chronic high-altitude exposure. Am J Physiol 261: E419-E424, 1991.
   Google Scholar
• Brooks, G. A., Butterfield, G. E., Wolfe, R. R., Groves, B. M., Mazzeo, R. S., Sutton, J. R., Wolfel, E. E. & Reeves, J. T.: Increased dependence on blood glucose after acclimatization to 4,300 m. J Appl Physiol 70: 919–927, 1991.
   Google Scholar
• Larson, J. J., Hansen, J. M., Olsen, N. V., Galbo, H. & Dela, F.: The effect of altitude hypoxia on glucose homeostasis in men. J Physiol 504: 241–249, 1997.
   PubMedGoogle Scholar
• Young, P. M., Rose, M. S., Sutton, J. R., Green, H. J., Cymerman, A. & Houston, C. S.: Operation Everest II: plasma lipid and hormonal responses during a simulated ascent of Mt. Everest. J Appl Physiol 66: 1430–1435, 1989.
   Google Scholar
• Imai, Y., Abe, K., Munakata, M., Sakuma, H., Hashimoto, J., Imai, K., Sekino, H. & Yoshinaga, K.: Does ambulatory blood pressure monitoring improve the diagnosis of secondary hypertension? J Hypertens 8: S71–S75, 1990.
   Google Scholar
• Cieslicki, J., Wocial, B., Koziej, M., Palasiewicz, G. & Zielinski, J.: Effect of positive pressure respiration on diurnal catecholamine excretion by patients with obstructive sleep apnea. Pol Arch Med Wewn 95: 106–110, 1996.
   PubMedGoogle Scholar
• Lapinski, M., Przybylowski, T., Lewandowski, J., Januszewicz, A., Wocial, B., Kowalski, J., Droszcz, W. & Januszewicz, W.: Diurnal blood pressure rhythm and urinary catecholamine excretion in obstructive sleep apnoea and hypertension. J Hypertens 11 (suppl 5): S292-S293, 1993.
   Google Scholar
• Homyak, M., Cejnar, M., Elam, M., Matousek, M. & Wallin, B. G.: Sympathetic muscle nerve activity during sleep in man. Brain 114: 1281–1295, 1991.
   PubMedGoogle Scholar
• Nishihara, K. & Mori, K.: The relationship between waking time and urinary epinephrine in bed-rested humans under conditions involving minimal stress. Int J Psychophysiol 6: 133–137, 1988.
   PubMedGoogle Scholar
• Loredo, J. S., Ziegler, M. G., Ancoli-Israel, S., Clausen, J. L. & Dimsdale, J. E.: Relationship of arousals from sleep to sympathetic nervous system activity and BP in obstructive sleep apnea. Chest 116: 655–659, 1999.
   Google Scholar
• Lindberg, E., Sjöstrom, C., Elmasry, A. & Janson, C.: Sleep apnea and snoring in men with hypertension (abstract). Am J Respir Crit Care Med 161: A681, 2000.
   Google Scholar
• Gislason, T. & Almqvist, M.: Somatic diseases and sleep complaints. An epidemiological study of 3201 Swedish men. Acta Med Scand 221: 475–481, 1987.
   Google Scholar
• Mayfield, D., McLeod, G. & Hall, P.: The CAGE questionnaire: Validation of a new alcoholism screening instrument. Am J Psychiatry 131: 1121–1123, 1974.
   PubMed Web of Science ®Google Scholar
• Beresford, T. P., Blow, F. C., Hill, E., Singer, K. & Lucey, M. R.: Comparison of CAGE questionnaire and computer-assisted laboratory profiles in screening for covert alcoholism. Lancet 336: 482–485, 1990.
   Google Scholar
• Saltin, B. & Grimby, G.: Physiological analysis of middle-aged and older former athletes. Circulation 38: 1104–1115, 1968.
   PubMed Web of Science ®Google Scholar
• Lissner, L., Bengtsson, C., Björkelund, C. & Wedel, H.: Physical activity levels and changes in relation to longevity. A prospective study of Swedish women. Am J Epidemiol 143: 54–62, 1996.
   Google Scholar
• Lindberg, E., Elmasry, A., Janson, C. & Gislason, T.: Reported snoring - does validity differ by age? J Sleep Res 9: 197–200, 2000.
   Google Scholar
• Keys, A., Fidanza, F., Karvonen, M. I., Kimura, N. & Taylor, H. L.: Indices of relative weight and height. J Chron Dis 25: 329–343, 1972.
   Google Scholar
• Peaston, R. T.: Routine determination of urinary catecholamines by high performance liquid chromatography with electrochemical detection. J Chromatogr 424: 263–272, 1988.
   PubMedGoogle Scholar
• Rechtschaffen, A. & Kales, A.: A manual of standardised terminology, techniques and scoring system for sleep stages of human subjects. Public Health Service, U. S. Government Printing Office, Washington, D. C., National institutes of health, Publication No. 204, 1968.
   Google Scholar
• Sekikawa, A., Tominaga, M., Takahashi, K., Eguchi, H., Igarashi, M., Ohnuma, H., Sugiyama, K., Manaka, H., Sasaki, H., Fukuyama, H. & Miyazawa, K.: Prevalence of diabetes and impaired glucose tolerance in Fungata area, Japan. Diabetes Care 16: 570–574, 1993.
   PubMed Web of Science ®Google Scholar
• Ohlson, L. 0., Larsson, B., Eriksson, H., Svärdsudd, K., Welin, L. & Tibblin, G.: Diabetes mellitus in Swedish middle-aged men. The study of men born in 1913 and 1923. Diabetologia 30: 386–393, 1987.
   Google Scholar
• Forster, C.: Autonomic nervous system neurotransmitters. In: Principles of Medical Pharmacology (ed. H. Kalant, W. H. E. Roschlau), pp. 135–148. Oxford University Press, New York, 1998.
   Google Scholar
• Eisenhofer, G., Friberg, P., Pacak, K., Goldstein, D. S., Murphy, D. L., Tsigos, C., Quyyumi, A. A., Brunner, H. G. & Lenders, J. W. M.: Plasma metadrenalines: do they provide useful information about sympatho-adrenal function and catecholamine metabolism. Clinical Science 88: 533–542, 1995.
   Google Scholar
• Young, P. M., Sutton, J. R., Green, H. J., Reeves, J. T., Rock, P. B., Houston, C. S. & Cymerman, A.: Operation Everest II: Metabolic and hormonal responses to incremental exercise to exhaustion. J Appl Physiol 73: 2574–2579, 1992.
   PubMed Web of Science ®Google Scholar
• Strohl, K. P., Boehm, K. D., Denko, C. W., Novak, R. D. & Decker, M. J.: Biochemical morbidity in sleep apnea. Ear Nose Throat J 72: 34–41, 1993.
   Google Scholar