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October 3, 1977

Retrognathia and Sleep Apnea

JAMA. 1977;238(14):1496-1497. doi:10.1001/jama.1977.03280150066012

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To the Editor.—  In the article "Retrognathia and Sleep Apnea" (237:1596, 1977) Imes et al demonstrated clinically significant hypoxemia from airway obstruction during sleep. The following case of a patient with a "short" neck and history of snoring points out airway obstruction as a possible cause of myocardial damage and offers some simple therapeutic measures. It should be emphasized that tracheotomy was used successfully by the authors and should be seriously considered in patients with sequelae of hypoxemia caused by airway obstruction while sleeping.A 55-year-old man was anesthetized by me for cholecystectomy, cystoscopy, resection of carcinomatous bladder, and arterial embolectomies. He was of muscular build with a short neck and gave a history of snoring loudly in his sleep. His first myocardial infarction occurred at 45 years of age in early morning after awakening. His second myocardial infarction occurred after chest pain awakened him at night. He subsequently had