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{{Sleep apnea}}
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{{CMG}} {{AE}} Saarah T. Alkhairy, M.D.


==Overview==
==Overview==
Sleep apnea was first described in literature in the 19th century. It was often misdiagnosed as either narcolepsy or skepticism. In 1981, Collin Sullivan invented the [[continuous positive airway pressure]] ([[CPAP]]) for the treatment of sleep apnea. Prior to its recognition as a unique disorder, sleep apnea was viewed as either a type of insomnia or an age-related phenomenon.


Sleep apnea was initially referred to as [[Pickwickian syndrome]] by [[William Osler]], who was a famous physician in the early 20th century.  He described the clinical picture of an adult with obstructive sleep apnea syndrome using the character - Joe, "the fat boy" from the [[Charles Dickens]]' novel - ''The Pickwick Papers.''  The introduction of [[continuous positive airway pressure]] (CPAP) was first described in 1981 by Colin Sullivan and associates in Sydney, [[Australia]].<ref>{{Cite journal|author=Sullivan CE, Issa FG, Berthon-Jones M, Eves L. |title=Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares |journal=Lancet|volume=1 |issue=8225 |pages=862–5 |year=1981|month=April |pmid= 6112294 |doi=10.1016/S0140-6736(81)92140-1}}</ref>  
==Discovery==
*In 1890, Silas Weir Mitchell, a neurologist and American toxicologist, described sleep apnea as [[respiratory failure]] in sleep because of the "failure of the chest and diaphragmatic movements" <ref name="Lavie1984">{{cite journal|last1=Lavie|first1=[ill]etz|title=[ill]othing New Under the Moon|journal=Archives of Internal Medicine|volume=144|issue=10|year=1984|pages=2025|issn=0003-9926|doi=10.1001/archinte.1984.04400010145023}}</ref>
*During the second half of the 19th century, the clinical features of sleep apnea were thoroughly described:<ref name="Lavie1984">{{cite journal|last1=Lavie|first1=[ill]etz|title=[ill]othing New Under the Moon|journal=Archives of Internal Medicine|volume=144|issue=10|year=1984|pages=2025|issn=0003-9926|doi=10.1001/archinte.1984.04400010145023}}</ref>
:*Airway obstructions
:*Noisy snoring
:*[[Nocturnal]] [[insomnia]]
:*Excessive [[somnolence]]
*Medical literature describes early reports of those severely affected with sleep apnea with [[hypoxemia]], [[hypercapnia]], and [[congestive heart failure]] (CHF)
*Prior to its characterization as a unique disorder, sleep apnea was often diagnosed as either [[narcolepsy]], insomnia, or [[skepticism]]<ref name="Lavie1984">{{cite journal|last1=Lavie|first1=[ill]etz|title=[ill]othing New Under the Moon|journal=Archives of Internal Medicine|volume=144|issue=10|year=1984|pages=2025|issn=0003-9926|doi=10.1001/archinte.1984.04400010145023}}</ref>


==Historical Perspective==
==Development of Treatment Strategies==
The clinical picture of this condition has long been recognized as a character trait, without an understanding of the disease process. The term "[[Pickwickian syndrome]]" that is sometimes used for the syndrome was coined by the famous early 20th century physician, [[William Osler]], who must have been a reader of [[Charles Dickens]]. The description of Joe, "the fat boy" in Dickens's novel ''[[The Pickwick Papers]]'', is an accurate clinical picture of an adult with obstructive sleep apnea syndrome.
*In 1981, Colin Sullivan and associates in Sydney improved the management of obstructive sleep apnea with [[continuous  positive airway pressure]] ([[CPAP]]) <ref name="SullivanBerthon-Jones1981">{{cite journal|last1=Sullivan|first1=ColinE.|last2=Berthon-Jones|first2=Michael|last3=Issa|first3=FaiqG.|last4=Eves|first4=Lorraine|title=REVERSAL OF OBSTRUCTIVE SLEEP APNOEA BY CONTINUOUS POSITIVE AIRWAY PRESSURE APPLIED THROUGH THE NARES|journal=The Lancet|volume=317|issue=8225|year=1981|pages=862–865|issn=01406736|doi=10.1016/S0140-6736(81)92140-1}}</ref>
*By the late 1980s, [[CPAP]] was transformed from the bulky and noisy first models and became widely used, which lead to specialized clinics for diagnosis and treatment


The early reports of obstructive sleep apnea in the medical literature described individuals who were very severely affected, often presenting with severe [[hypoxemia]], [[hypercapnia]] and [[congestive heart failure]].
==Impact on Cultural History==
 
*April 18th is  Sleep Apnea  Awareness Day in recognition of Colin Sullivan (Australian physician, professor, and inventor)
The management of obstructive sleep apnea was revolutionized with the introduction of [[continuous positive airway pressure]] (CPAP), first described in 1981 by Colin Sullivan and associates in [[Sydney]], [[Australia]].<ref>{{Cite journal|author=Sullivan CE, Issa FG, Berthon-Jones M, Eves L. |title=Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares |journal=Lancet |volume=1 |issue=8225 |pages=862–5 |year=1981|month=April |pmid= 6112294 |doi=10.1016/S0140-6736(81)92140-1}}</ref> The first models were bulky and noisy, but the design was rapidly improved and by the late 1980s CPAP was widely adopted. The availability of an effective treatment stimulated an aggressive search for affected individuals and led to the establishment of hundreds of specialized clinics dedicated to the diagnosis and treatment of [[sleep disorders]]. Though many types of sleep problems are recognized, the vast majority of patients attending these centers have sleep-disordered  breathing.
*Before sleep apnea was recognized as a separate  sleep disorder, it was viewed as either a type of insomnia or an age-related phenomenon<ref name="pmid23560353">{{cite journal| author=Shaw R, McKenzie S, Taylor T, Olafiranye O, Boutin-Foster C, Ogedegbe G et al.| title=Beliefs and attitudes toward  obstructive sleep apnea  evaluation and treatment among blacks. | journal=J Natl Med Assoc | year= 2012 | volume= 104 | issue= 11-12 | pages= 510-9 | pmid=23560353 | doi= | pmc=PMC3740354 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23560353  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 00:12, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

Sleep apnea was first described in literature in the 19th century. It was often misdiagnosed as either narcolepsy or skepticism. In 1981, Collin Sullivan invented the continuous positive airway pressure (CPAP) for the treatment of sleep apnea. Prior to its recognition as a unique disorder, sleep apnea was viewed as either a type of insomnia or an age-related phenomenon.

Discovery

  • In 1890, Silas Weir Mitchell, a neurologist and American toxicologist, described sleep apnea as respiratory failure in sleep because of the "failure of the chest and diaphragmatic movements" [1]
  • During the second half of the 19th century, the clinical features of sleep apnea were thoroughly described:[1]

Development of Treatment Strategies

  • In 1981, Colin Sullivan and associates in Sydney improved the management of obstructive sleep apnea with continuous positive airway pressure (CPAP) [2]
  • By the late 1980s, CPAP was transformed from the bulky and noisy first models and became widely used, which lead to specialized clinics for diagnosis and treatment

Impact on Cultural History

  • April 18th is Sleep Apnea Awareness Day in recognition of Colin Sullivan (Australian physician, professor, and inventor)
  • Before sleep apnea was recognized as a separate sleep disorder, it was viewed as either a type of insomnia or an age-related phenomenon[3]

References

  1. 1.0 1.1 1.2 Lavie, [ill]etz (1984). "[ill]othing New Under the Moon". Archives of Internal Medicine. 144 (10): 2025. doi:10.1001/archinte.1984.04400010145023. ISSN 0003-9926.
  2. Sullivan, ColinE.; Berthon-Jones, Michael; Issa, FaiqG.; Eves, Lorraine (1981). "REVERSAL OF OBSTRUCTIVE SLEEP APNOEA BY CONTINUOUS POSITIVE AIRWAY PRESSURE APPLIED THROUGH THE NARES". The Lancet. 317 (8225): 862–865. doi:10.1016/S0140-6736(81)92140-1. ISSN 0140-6736.
  3. Shaw R, McKenzie S, Taylor T, Olafiranye O, Boutin-Foster C, Ogedegbe G; et al. (2012). "Beliefs and attitudes toward obstructive sleep apnea evaluation and treatment among blacks". J Natl Med Assoc. 104 (11–12): 510–9. PMC 3740354. PMID 23560353.

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