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


==Overview==
Introduction to the Historical Perspective Page


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>
   


==Historical Perspective==
   
*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.
*The early reports in the medical literature described individuals who were very severely affected, often presenting with severe [[hypoxemia]], [[hypercapnia]] and [[congestive heart failure]]
*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 rapidly improved
*By the late 1980s CPAP was widely adopted
*The availability of an effective treatment stimulated a search for affected individuals
*This led to the establishment of hundreds of specialized clinics dedicated to the diagnosis  and treatment of [[sleep disorders]]


Overview
In the 19th century, sleep apnea was first described in literature. It has often been misdiagnosed as narcolepsy or skepticism. In 1981, Collin Sullivan invented the continuous positive airway pressure (CPAP) for the treatment of sleep apnea. Before sleep apnea was recognized as a separate sleep disorder, it was viewed as a type of insomnia or an age-related phenomenon. In early 20th century, William Osler, coined the term “Pickwickian syndrome” describing “the fat boy” Joe in Charles Dickens novel, The Pickwick Paper. This gave a clinical picture of sleep apnea.
Discovery
*In 1890, Silas Weir Mitchell, a neurologist and American toxicologist, described it 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>
*The second half of the 19th century described sleep apnea very vividly with<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 presenting with hypoxemia, hypercapnia, and congestive heart failure
*Sleep apnea has been misdiagnosed as narcolepsy and skepticism because of somnolence as a clinical sign<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>
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) <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 widely used
*With the an effective treatment available for those with sleep apnea, specialized clinics dedicated to diagnosis and treatment multiplied
Impact on Cultural History
*April 18 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 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>
Famous Cases
*In early 20th century, William Osler, a physician and one of the four founding professors of Johns Hopkins Hospital, coined the term “Pickwickian syndrome” <ref name="pmid3910333">{{cite journal| author=Kryger MH| title=Fat, sleep, and Charles Dickens: literary and medical contributions to the understanding of sleep apnea. | journal=Clin Chest Med | year= 1985 | volume= 6 | issue= 4 | pages= 555-62 | pmid=3910333 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3910333  }} </ref>
*Osler was describing a “the fat boy” Joe in Charles Dickens novel The Pickwick Paper <ref name="pmid3910333">{{cite journal| author=Kryger MH| title=Fat, sleep, and Charles Dickens: literary and medical contributions to the understanding of sleep apnea. | journal=Clin Chest Med | year= 1985 | volume= 6 | issue= 4 | pages= 555-62 | pmid=3910333 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3910333  }} </ref>
*The novel gives a clinical picture of a patient with sleep apnea
==References==
==References==


{{Reflist|2}}
{{Reflist|2}}


[[Category:Sleep disorders]]
[[Category: Sleep disorders]]
[[Category:Medical conditions related to  obesity ]]
[[Category:Medical conditions related to  obesity ]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]

Revision as of 13:12, 2 July 2015

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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.

Introduction to the Historical Perspective Page



Overview

In the 19th century, sleep apnea was first described in literature. It has often been misdiagnosed as narcolepsy or skepticism. In 1981, Collin Sullivan invented the continuous positive airway pressure (CPAP) for the treatment of sleep apnea. Before sleep apnea was recognized as a separate sleep disorder, it was viewed as a type of insomnia or an age-related phenomenon. In early 20th century, William Osler, coined the term “Pickwickian syndrome” describing “the fat boy” Joe in Charles Dickens novel, The Pickwick Paper. This gave a clinical picture of sleep apnea.






Discovery


  • In 1890, Silas Weir Mitchell, a neurologist and American toxicologist, described it as respiratory failure in sleep because of the "failure of the chest and diaphragmatic movements" [1]
  • The second half of the 19th century described sleep apnea very vividly with[1]
  • Airway obstructions
  • Noisy snoring
  • Nocturnal insomnia
  • Excessive somnolence
  • Medical literature describes early reports of those severely affected with sleep apnea presenting with hypoxemia, hypercapnia, and congestive heart failure
  • Sleep apnea has been misdiagnosed as narcolepsy and skepticism because of somnolence as a clinical sign[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 widely used
  • With the an effective treatment available for those with sleep apnea, specialized clinics dedicated to diagnosis and treatment multiplied



Impact on Cultural History

  • April 18 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 a type of insomnia or an age-related phenomenon[3]


Famous Cases

  • In early 20th century, William Osler, a physician and one of the four founding professors of Johns Hopkins Hospital, coined the term “Pickwickian syndrome” [4]
  • Osler was describing a “the fat boy” Joe in Charles Dickens novel The Pickwick Paper [4]
  • The novel gives a clinical picture of a patient with sleep apnea


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.
  4. ↑ 4.0 4.1 Kryger MH (1985). "Fat, sleep, and Charles Dickens: literary and medical contributions to the understanding of sleep apnea". Clin Chest Med. 6 (4): 555–62. PMID 3910333.

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