The Problems of Sleep-Related Respiratory Disorders

Abstract

The incidence of respiratory abnormalities during sleep continues to increase as more physicians are becoming aware of these clinical entities. However, the medical literature on this subject is somewhat confusing in that different problems have been tied together under the diagnosis of obesity-hypoventilation syndrome or Pickwickian syndrome. These terms were useful in calling our attention to previously seldom-recognized clinical problems. Precise definitions of these sleep-related problems are now needed to understand better the physiological processes involved in the evolution of primary (central) alveolar hypoventilation, central apnea, upper airway occlusion, and mixed apnea. This will eventually lead to the proper noninvasive treatment regimens for these entities, which can present with the exact awake-symptom complex. Elsewhere in this issue, Strohl et al (p 1230) describe the use of medroxyprogesterone acetate as a therapeutic agent in patients with mainly sleep-associated upper airway occlusions. Only four of nine responded, but in these four a