This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
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
Remmers JE, Anch AM. Sleeping and BreathingWhat to Do for a Lack of Both. Arch Intern Med. 1981;141(8):989. doi:10.1001/archinte.1981.00340080029010