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July 1981

Sleeping and BreathingWhat to Do for a Lack of Both

Author Affiliations

Department of Internal Medicine Pulmonary Division University of Texas Medical Branch Galveston, TX 77550

Arch Intern Med. 1981;141(8):989. doi:10.1001/archinte.1981.00340080029010

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Obstructive sleep apnea (OSA), a form of periodic breathing during sleep, is the most common cause of respiratory failure during sleep. It causes a relative lack of breathing and sleeping that bodes disaster for the patient. Alternately breathing and not breathing, the afflicted sleeper struggles to inspire through an obstructed upper airway or, more correctly, an occluded oropharynx. He repeatedly experiences episodic hypoxemia, which, in turn, disrupts his sleep. (This use of the male pronoun is convenient and correct, statistically; OSA is rare in women.)

Obstructive sleep apnea is a multisystem disorder involving metabolic, respiratory, and neural abnormalities. The cause of the airway obstruction is multifaceted and includes the following: structural encroachment on the oropharyngeal lumen, subatmospheric intrapharyngeal pressure, and hypotonicity of oropharyngeal muscles. Similarly, secondary disease manifestations appear in multiple systems; respiratory failure, cor pulmonale, and hypersomnolence are characteristic of severe OSA, and this complex is usually referred to

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