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Clinical Crossroads Update
June 23/30, 2004

Update: A 54-Year-Old Man With Obstructive Sleep Apnea

JAMA. 2004;291(24):3004. doi:10.1001/jama.291.24.3004

In a Clinical Crossroads article published in October 2002, Dr Kuna discussed the epidemiology, pathophysiology, diagnosis, and treatment of obstructive sleep apnea.1 The wife of the patient (Mr J) noted that he sometimes stopped breathing at night. Mr J also recalled that he awoke, on occasion, in the middle of the night with palpitations. A sleep study revealed 206 obstructive events, giving an apnea-hypopnea index of 36 per hour. Mr J tried treatment with nasal continuous positive airway pressure (CPAP), with which Mr J's palpitations ceased, but after about a year he discontinued the nasal CPAP because it interfered with his ability to fall asleep and with his sex life. He did, however, lose 20 lb and weighed 205 lb (his body mass index was 28.6). He felt well and did not experience any difficulties with his sleep patterns or daytime sleepiness.

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