History

Obstructive sleep apnea (OSA) is a common disorder that affects one of four men and one of 11 women in the world (1). Though it has been described since the 1970s, it was not until 20 years later that its prevalence and importance as a public health problem was widely recognized. How has this disorder, with clear signs and symptoms, been hiding in plain view for so many years? Features of OSA have been described for more than 100 years and interestingly enough, they first appeared in fictional literature. William Shakespeare (2), for instance, was aware of the connection between obesity and sleepiness when describing the picturesque Sir John Falstaff in Henry IV (Fig. 1). Falstaff was well known for his corpulence and propensity for napping and was occasionally found, “fast asleep behind the arras, and snoring like a horse.”