ABSTRACT

INTRODUCTION Sleep is important. Animals deprived of sleep die but the function of sleep remains a mystery. The state of sleep interacts with breathing in a number of important ways. For example, respiratory drive alters which, in susceptible patients, may cause nocturnal hypoventilation or central sleep apnoea (cessation of breathing due to loss of respiratory drive). This chapter focuses on one of the commonest sleeprelated breathing disorders, obstructive sleep apnoea.

OBSTRUCTIVE SLEEP APNOEA Obstructive sleep apnoea is neither a new disease nor a rare disease but it has only recently become widely recognized. It is surprising that this disease went unnoticed for so long, especially if one visits a sleep clinic and listens carefully to patients with obstructive sleep apnoea and their bed partners! Embarrassingly for doctors, in the 1830s Charles Dickens appears to have described the condition in The Pickwick Papers. His fat boy, Joe, was an extremely loud snorer and so sleepy that he even nodded off during meals.