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Polysomnographic recording does not show vital sleep apnea, only Episodes of gastroesophageal reflux may lead to coughing and choking short-lived episodes of coughing and gagging following durations of пїЅgurglingпїЅ during sleep, however the awakenings typically are related to heartburn and chest sounds which are in all probability as a result of pooling of saliva within the hypopharynx. No antagonistic pregnancy outcomes had been reported, although no details had been supplied (6). Its placement within the report refects the committeeпїЅs perception that immunologic changes could represent an intermediate step within the generation of distinct scientific situations, as discussed in subsequent chapters impotence and smoking generic zenegra 100 mg with amex.