Does nocturnal sweating suggest sleep apnea?

Does nocturnal sweating suggest sleep apnea?

This was the question of

today about sweating in sleep...

In clinical context, nocturnal sweating can be a  sensitive sign of sleep apnea.  But, its not specific.

Sweating often improves with OSA treatment.

 JR


Infants

Sleep. 1993 Aug;16(5):409-13.

Clinical symptoms associated with brief obstructive sleep apnea in normal infants.

Kahn A1, Groswasser J, Sottiaux M, Rebuffat E, Sunseri M, Franco P, Dramaix M, Bochner A, Belhadi B, Foerster M.

Author information

Abstract

Relatively little data exist concerning the manifestations of repeated obstructive sleep apnea in normal infants. A questionnaire concerning daytime and sleep habits was completed by the parents of 4,100 healthy infants before they underwent a 9-hour night monitoring study. One hundred infants with an obstructive apnea index above 1.2 were randomly selected. They formed the "apnea" group. From the initial population, 300 infants with noapnea were also selected to form the "no-apnea" group. Both groups were matched for sex, gestational age, post conceptional age, birth weight, mother's age, parity and a family history of sudden infant death. Five variables from the questionnaires significantly differentiated the two groups of infants. When awake, the infants with apnea were characterized by a greater frequency of breathholding spells (22% of apnea infants) and episodes of fatigue during feeding (28%) than the non-apnea infants. During sleep, they exhibited a greater frequency of profuse sweating (15%), snoring (26%) or noisy breathing (44%). Multiple symptoms were present in some infants. A stepwise logistic regression resulted in two significant independent variables: profuse sweating during sleep (p = 0.008) and noisy breathing (p = 0.002). The predictive value of these two symptoms was tested on a new group of 650 healthy infants. The two independent variables led to the correct classification of 60 of the 67 infants with apnea (89.67%) and 382 of the 583 non-apnea infants (65.5%). A positive history alone had a positive predictive value of 0.21.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID:

 

8378681

 

[PubMed - indexed for MEDLINE]

Children

Arch Dis Child. 2012 May;97(5):470-3. doi: 10.1136/adc.2010.199638. Epub 2011 Mar 22.

Night sweats in children: prevalence and associated factors.

So HK1, Li AM, Au CT, Zhang J, Lau J, Fok TF, Wing YK.

Author information

Abstract

OBJECTIVE:

The authors aimed to examine the prevalence and factors associated with night sweats (NS) in primary school children.

STUDY DESIGN:

Cross-sectional design.

RESULTS:

Among 6381 children (median age 9.2 (7.7-10.7) years) with complete information on NS, 3225 were boys (50.5%). 747 children (11.7%) were reported to have weekly NS in the past 12 months. Boys were more likely than girls to have NS (p<0 .0001="" children="" class="highlight" have="" likely="" more="" nbsp="" ns="" span="" to="" were="" with="">sleep

-related symptoms and respiratory and atopic diseases. In addition, they were more likely to be hyperactive and have frequent temper outbursts. Using an ordinal regression model, NS was found to be significantly associated with male gender, younger age, allergic rhinitis, tonsillitis and symptoms suggestive of obstructive sleep apnoea, insomnia and parasomnia.

CONCLUSION:

NS is prevalent among school-aged children and is associated with the presence of sleep-related symptoms and respiratory and atopic diseases.

Adults

• Respiratory medicine

Nocturnal sweating—a common symptom of obstructive sleep apnoea: the Icelandic sleep apnoea cohort

1. Erna Sif Arnardottir1,2, 
2. Christer Janson3, 
3. Erla Bjornsdottir1,2, 
4. Bryndis Benediktsdottir1,2,
5. Sigurdur Juliusson4, 
6. Samuel T Kuna5,6, 
7. Allan I Pack5, 
8. Thorarinn Gislason1,2

+Author Affiliations

1. ¹Department of Respiratory Medicine and Sleep, Landspitali—The National University Hospital of Iceland, Reykjavik, Iceland
2. ²Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
3. ³Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala Universitet, Uppsala, Sweden
4. ⁴Department of Otolaryngology, Landspitali—The National University Hospital of Iceland, Reykjavik, Iceland
5. ⁵Division of Sleep Medicine/Department of Medicine, Center for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
6. ⁶Department of Medicine, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA

1. Correspondence toDr Thorarinn Gislason; thorarig@landspitali.is

• Received 26 February 2013
• Accepted 10 April 2013
• Published 14 May 2013

Abstract

Objectives To estimate the prevalence and characteristics of frequent nocturnal sweating in obstructive sleep apnoea (OSA) patients compared with the general population and evaluate the possible changes with positive airway pressure (PAP) treatment. Nocturnal sweating can be very bothersome to the patient and bed partner.

Design Case–control and longitudinal cohort study.

Setting Landspitali—The National University Hospital, Iceland.

Participants The Icelandic Sleep Apnea Cohort consisted of 822 untreated patients with OSA, referred for treatment with PAP. Of these, 700 patients were also assessed at a 2-year follow-up. The control group consisted of 703 randomly selected subjects from the general population.

Intervention PAP therapy in the OSA cohort.

Main outcome measures Subjective reporting of nocturnal sweating on a frequency scale of 1–5: (1) never or very seldom, (2) less than once a week, (3) once to twice a week, (4) 3–5 times a week and (5) every night or almost every night. Full PAP treatment was defined objectively as the use for ≥4 h/day and ≥5 days/week.

Results Frequent nocturnal sweating (≥3× a week) was reported by 30.6% of male and 33.3% of female OSA patients compared with 9.3% of men and 12.4% of women in the general population (p<0 .001="" 11.5="" 33.2="" adjustment="" after="" age="" and="" cardiovascular="" change="" compared="" decreased="" demographic="" difference="" disease="" factors.="" for="" frequent="" from="" full="" hypertension="" in="" insomnia="" nocturnal="" non-users="" of="" p="" pap="" prevalence="" related="" remained="" significant="" sleepiness="" sweating="" symptoms.="" the="" this="" to="" treatment="" was="" with="" younger="">

Conclusions The prevalence of frequent nocturnal sweating was threefold higher in untreated OSA patients than in the general population and decreased to general population levels with successful PAP therapy. Practitioners should consider the possibility of OSA in their patients who complain of nocturnal sweating.

Article summary

Article focus

• Previous studies have suggested a possible relationship between obstructive sleep apnoea and frequent nocturnal sweating. However until now, studies comparing the prevalence of frequent nocturnal sweating in untreated sleep apnoea patients compared with the general population as well as changes with sleep apnoea treatment have been lacking. Our study focuses on the role of nocturnal sweating in sleep apnoea.

Key messages

• Our study indicates a possible role of frequent nocturnal sweating as a marker for untreated sleep apnoea. One-third of adults with sleep apnoea experience this symptom and they are three times more likely to report it compared with adults in the general population. The symptom is responsive to treatment in the majority of sleep apnoea patients.
• Clinicians should include sleep apnoea in the differential diagnosis of patients presenting with a complaint of nocturnal sweating and further investigate that possibility.

Strengths and limitations of this study

• The strengths of this study include the detailed assessment of a large number of sleep apnea patients studied with a two year follow-up and the comparison with a general population cohort.
• Our study was an observational study, not a randomised controlled trial, which may be considered a limitation. Other limitations include the use of subjective measures of sweating and the smaller number of women with sleep apnea than men, due to lower prevalence.

Botox and how it helps cerebral palsy, chronic migraines, and excessive sweating

This article discusses how botox can help ease symptoms of cerebral palsy, chronic migraines, excessive sweating, and other conditions.

Botox isn’t reserved solely for reducing fine lines and wrinkles.

The most potent naturally occurring neurotoxin known to man can be used to treat symptoms of medical conditions such as cerebral palsy, chronic migraines and excessive sweating.

And it’s effective.

“It’s just like with many other medications that are actually poisons – it’s how we use them and where we use them that make the difference,” says Sanford Health’s Dr. William Klava.

Although Botox isn’t a “cure” for any of these conditions, it can prevent the social embarrassment of excessive underarm sweat, reduce hours of work missed because of migraine pain, and improve a young athlete’s pitching stance.

Cerebral palsy

Klava says Botox almost revolutionized the care of children with cerebral palsy because it forces muscle relaxation and improves limb function.

Symptoms include spastic movement of the arms and legs and sudden muscle stiffness and contraction caused by miscommunicated signals between the brain and the limbs.

Botox interrupts the communication between the spinal cord and the nerves, which stops the sudden jerking movements.

“When I use it, I’m relaxing the muscle so the child can stretch out better and achieve motor functions and activities that they couldn’t achieve because certain muscles were too tight or too spastic,” Klava says.

He’s used it on kids as young as 2 months and adults as old as 90, and results typically last between four and six months.

“One of the beauties of it as a medication is that if the result you get is not exactly what you want, don’t worry, because it wears off,” he says.

Although it can be used “almost anywhere you have muscle,” Klava says it’s most commonly used in cerebral palsy patients’ bicep, forearm, hamstring and calf muscles.

“We keep expanding what we utilize it for and how we utilize it as we gain more experience with it,” he says.

Chronic migraines

Last spring, after reading an article in The Forum about Botox treatment for migraines, Sara Eeg of Greenbush, Minn., asked her doctor if she was a candidate.

The 36-year-old mother of four had suffered from chronic migraines for as long as she could remember, and she’d tried everything, including anti-seizure medication.

“My headaches were just constant. I would have a headache when I woke up in the morning, and I’d have a headache when I went to bed at night,” she says.

So far, Eeg has had three series of injections spaced three months apart.

“Each time I’ve gotten the injections, the pain relief has lasted longer and longer, whereas the first time it kind of wore off after a while,” she says.

She says the shots – 29 the first time, then 31 and most recently 33 – “just pinch a little.”

“The benefits are way worth it. I told her the other day, ‘I would do it every week if I could,’ ” Eeg says of the treatments with Dr. Cynthia Knutson.

Since she started treatment, Eeg says she’s had more energy, she’s more focused, and she’s more interested in life.

“It’s unreal. I feel like I’m better at everything,” the home care administrator says. “My brain isn’t so focused on hurting.”

Knutson, a neurologist with Sanford Health in Fargo, says she’s been seeing plenty of new chronic migraine patients seeking Botox treatment.

“I do Botox one whole day a week, and I’m actually adding another half-day because I’m getting more requests,” she says.

Chronic migraine patients develop a lot of tension in the head, neck and shoulder muscles, and when Botox injections relax those muscles, the headache pain fades.

Injections go in the forehead, above the ears, along the base of the skull, at the top of the neck and into the top of the shoulders.

“It doesn’t work for everybody, but it works for a large majority of patients who have this type of migraine,” Knutson says.

Excessive sweating

Dr. Yulia Khan, dermatologist with Sanford Dermatology & Laser Clinic, says Botox is a last-resort treatment for hyperhidrosis, or excessive sweating.

“A lot of people say it’s lifesaving because they’ve tried a lot of different things,” she says.

The injections – usually about 20 – into the superficial layer of the skin in the underarms (and sometimes the forehead, back of the head, hands or feet) stop most sweating at the site for six to eight months at a time.

“With each repeated treatment, that period extends more and more,” Khan says.

Results are reversible, so sweating returns over time, and most hyperhidrosis patients know when they’re due for an appointment.

“Instead of affecting muscles, like in the case of spasticity, or for cosmetic rejuvenation, it works on the nerves that affect the sweat glands,” she says.

Most of Khan’s patients, both male and female, are between the ages of 15 and 35.

“It tends to be younger adults because excessive sweating becomes more prominent after puberty,” she says.

Other uses of Botox

• Crossed eyes

• Eye twitching

• Gummy smile

• Teeth grinding

• Vocal cord dysfunction

• Urinary incontinence or overactive bladder

Read more here