The Importance of Suspecting Sleep Apnoea as a Common Cause of Excessive Daytime Sleepiness: Further Experience from the Diagnosis and Management of 19 Patients

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Abstract
Over 18 mo., 19 patients were referred for assessment of excessive daytime sleepiness and/or loud snoring. Respiratory studies during sleep were performed in 14 of these patients with additional features such as disturbed sleep, observed apnea during sleep, morning headache, mental and personality changes, hypertension and cardiac failure. Nocturnal respiratory studies undertaken for periods of 4-8 h confirmed a diagnosis of the sleep apnea syndrome in 8 patients. In these patients, apneas lasting from 30-144 s occurred frequently during sleep (from 35-291 episodes per patient). In one severely affected patient, tracheostomy abolished all symptoms. The use of conservative therapy such as weight loss, protriptyline or a neck collar, highlighted the inadequacies of current medical treatment. Awareness of the symptom complex and potential complications of the sleep apnea syndrome is important because the diagnosis may easily be missed if the patient presents with 1 or 2 isolated complaints.

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