الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Sleep related breathing disorders (SRBDs) are disorders caused by a decline or interruption in breathing during sleep and these are the primary cause of excessive daytime sleepiness and includes several conditions: obstructive sleep apnea syndrome (OSAS), central sleep apnea disorders, and sleep related hypoventilation and hypoxemia disorders. Obstructive sleep apnea syndrome (OSAS) is the most common disorder and characterized by repetitive collapse of the upper airway which may be complete (apnea) or partial (hypopnea) that leads to snoring, sleep interruption, hypoxemia, hypercapnia, alternation of intrathoracic pressure and increased sympathetic activity. The severity of hypoxemia and hypercapnia directly related to the severity of OSAS, so in mild patients the oxyhemoglobin saturation drops to 95% but may DROP below 80% in severe cases. The aim of this study was to evaluate the impact of chronic intermittent hypoxia and nocturnal hypercapnea on global myocardial performance utilizing Two-dimensional-2D, M-mode echocardiography, Pulsed-wave Doppler Analysis-PW, Tissue Doppler Imaging-TDI and speckle tracking in patients with Sleep-related breathing disorders. To elucidate our aim, a case control study was conducted on 142 adult subjects who attended to outpatient clinics and Mansoura university sleep center, chest department at Mansoura University Hospital, started at August 2016 to August 2018. Laboratory investigation included Morning Arterial blood gases (ABGs), Complete blood count (CBC), Thyroid function (TSH & free T4), Lipid profile, Liver function tests and Serum creatinine. Results : The mean age in OSA group was 43.60±8.58 years, and in OHS group was (38.65±8.39) while in control group it was 41.23±10.05 years. The majority of subjects in both OSA and control groups (69.6% of OSA group, and 66.7% of control group) were males while OHS group were mainly female (70%). Statistically highly significant differences were found between the studied groups as regards BMI, and NC. (p<0.001). A significantly difference was found between OSA and control groups regarding SaO2, PCO2 (p<0.05) and HCO3 (p<0.001). A significantly difference was found between OHS and control groups regarding each of PCO2 and HCO3 (p<0.001). A significantly difference was found between OSA and control groups regarding each of STOP-Bang, Epworth, and Berline questionnaires (p<0.001). A significantly difference was found between OHS and control groups regarding Epworth (p<0.001). A significantly difference was found between OSA and OHS groups regarding STOP-Bang questionnaire (p<0.001). Conclusion : There is Impact of chronic intermittent hypoxia and nocturnal hpercapnia on myocardial performance in OSA & OHS patients in comparing with control group assessed by different modes of echocardiography through TAPSE, TDI, GLS% which show subtle diastolic dysfunction with normal ejection fraction. According to ECHO findings, A significantly difference was found between OSA and control groups regarding each of MPI, GLS, TAPSE and grade of DD by TDI. Also, OHS and control groups significantly differed regarding GLS, TAPSE and grade of DD by TDI. However, each of EF %, MPI, TAPSE and grade of DD by TDI were significantly differed among OSA and OHS groups.