Sleep apnea historical perspective
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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
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 sleep apnea 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 became 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 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 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
- ↑ 1.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 4.0 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.