[Initiation of therapy in the sleep apnea syndrome using continuous positive pressure respiration]. / Zahájení lécby spánkového apnoického syndromu metodou trvalého pretlaku v dýchacích cestách.

BACKGROUND: Continuous positive airway pressure is the most important therapeutic method of sleep apnea syndrome (SAS). The prerequisite for its initiation is assessment of the optimal positive pressure and adaptation of the patient to this treatment. The basic criterium for assessment of positive pressure is elimination of apnoic intervals. The objective of the present work was to evaluate the optimal positive pressure CPAP according to the continuity of sleep and the appearance of an abnormally long (longer than 30 mins.) episode of REM sleep ("REM rebound"). METHODS AND RESULTS: CPAP was indicated in 13 patients with SAS (12 men, 1 woman), mean age 52.1 +/- 8.8 (SD) years, mean body mass index (BMI) 37.4 +/- 10.5. Severe cases of SAS were involved and/or SAS associated with other diseases (acromegaly-2, hypertension-8, IHD-4, chronic bronchopulmonary obstruction-3, and stroke-1). During one-night polysomnographic monitoring gradually the CPAP pressure was increased. Optimal positive pressure was signalized in addition to indicators of ventilation by uninterrupted sleep and "REM rebound". For treatment equipment of SEFAM Co. was used: 2x Pression+, 7x REM+, 4x REM+Control. Two patients refused CPAP treatment during the adaptation night. Eleven patients accepted CPAP treatment. The mean positive pressure value was 10.4 +/- 3.0 mbar. Assessment based on "REM rebound" was possible in six patients and based on continuity in 5 patients. Later pressure changes were called for in one patient (during adaptation he did not have "REM rebound"). CONCLUSIONS: Assessment of the optimal CPAP pressure as the lowest positive pressure compatible with regular breathing, as well as stabilized normal oxygen saturation of peripheral blood, continuous sleep and possibly "rebound" REM sleep proved useful.

[The sleep apnea syndrome. Basic diagnostic and therapeutic possibilities]. / Syndrom spánkové apnoe. Základní diagnostické a terapeutické moznosti.

The sleep apnoea syndrome (SAS) involves impaired regular breathing during sleep. It causes poor quality sleep and thus subsequent somnolence in daytime, it leads to periodic oxygen desaturation and has serious cardiovascular consequences. The authors describe methods used for the diagnosis and quantification of the intensity of SAS which they used (all-night extended polysomnography, ambulatory equipment MESAM 4 and afternoon polysomnography) and they list also the main therapeutic procedures used in SAS.

[The physician and the computer. 27. Equipment-computer connection (signal processing)]. / Lékar a pocítac. 27. Spojení prístroj-pocítac (zpracování signálu).

The authors discuss basic problems of analogue - digital transmission focused on practical questions with regard to the application of medical technique in combination with a computer. They discuss the different parts of the digital-measurement chain, different methods of signal transmission and finally also practical applications.