R. Richter and B. Timmons, eds. / Respiratory Psychophysiology abstracts 297

that breath sound biofeedback is as effective as bronchodilators in improving FEV, after exercise induced bronchospasm. Breath sound biofeedback may be an important means of controlling bronchospasm and a useful adjunct in the management of bronchial asthma.

DIAGNOSTIC AND TREATMENT OF SLEEP APNOEA: A CASE REPORT

Gismar ZIEGLER

Dr. Margarete Fischer-Bosch Instrtute of Clinical Pharmacolo~, Stuttgart, and Institute for Psycho-

somatic Research Tiibingen, FRG

The frequency of sleep apnoea is about 7% of all sleep disorders. The cause is still unknown, but mainly two hypotheses were discussed:

(1) Obstruction of the upper airways with moving of abdominal thoracic muscles.

(2) A central origin without action of inspiratory muscles.

The criterion for sleep apnoea is more than 20 episodes without breathing for more than 20 sec. Shortly after falling asleep, a 44-year old male patient with severe sleep disorder, developed a Cheyne-Stokes respiration with apnoeic pauses lasting about 30 sec. In the second hour after falling asleep, there were

long lasting apnoeic and hypopnoeic pauses about 50 sec. Only in the REM sleep, did the patient show a normal respiration. Predominantly the patient awoke from an apnoeic period.

A therapeutic test with aminophylline, an analeptic drug, was carried out but failed. In the literature, there are only a few reports; Cherniack (1981) advises a tracheostomy. But I think that this treatment is unacceptable.

One conclusion is that all patients with severe and therapy-refractory sleep-disorders should be observed and tested in a sleep-laboratory by mea- surement of respiration. Further research is needed and I will report about a therapeutic test with Naloxone, an opiate antagonist and Protriptyline, a tricyclic antidepressant (see Conway et al., 1982).

References

Cherniack, N S. (1981).Respiratory dysrhythmias during sleep. New England Journal of Medicine, 305. 325-330.

Conway. W.A., Zorick. F, Piccione, P, and Roth. T. (1982). Protfiptyline in the treatment of sleep apnoea. Thorax, 37, 49-53.