To the Editor.—
Although the authors of the article "Prolonged Doxapram Infusion in Obesity-Hypoventilation Syndrome" (239:340, 1978) emphasize the value of doxapram as a respiratory stimulant with potential benefit to many patients, their patient had a history of excessive daytime hypersomnolence, which is highly suggestive of the obstructive sleep apnea syndrome.1-3 Important additional information regarding intermittent loud snoring during naps or nighttime sleep would raise this suspicion even further. An overnight sleep study including EEG and continuous ear oximetry as well as monitoring respiratory variables such as chest and abdominal wall motion and nasal or oral air flow would establish the diagnosis with certainty.This is of great importance since relief of the upper airway obstruction, which is usually due to relaxed pharangeal and throat tissues, is curative. A rubber nasal pharangeal airway may be used, but usually a tracheostomy is necessary. After relief of the upper airway obstruction,
Cohn MA. Sleep Apnea. JAMA. 1978;240(1):23. doi:10.1001/jama.1978.03290010027012
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