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Harrison's Principles of Internal Medicine, 18e
| Part 11. Disorders of the Respiratory System > Section 2. Diseases of the Respiratory System > |
Chapter 265. Sleep Apnea
Sections: Obstructive Sleep Apnea, Central Sleep Apnea, Further Readings.
Topics Discussed: sleep apnea syndromes; sleep disorders.
Excerpt:"Obstructive sleep apnea/hypopnea syndrome (OSAHS) is one of the most important medical conditions identified in the last 50 years. It is a major cause of morbidity, a significant cause of mortality, and the most common medical cause of daytime sleepiness. Central sleep apnea is a rare clinical problem. Other sleep disorders are discussed in Chap. 27.OSAHS is defined as the coexistence of unexplained excessive daytime sleepiness with at least five obstructed breathing events (apnea or hypopnea) per hour of sleep (Table 265-1). This event threshold may have to be increased in the elderly. Apneas are defined in adults as breathing pauses lasting  10 s and hypopneas as events 10 s in which there is continued breathing but ventilation is reduced by at least 50% from the previous baseline during sleep. As a syndrome, OSAHS is the association of a clinical picture with specific abnormalities on testing; asymptomatic individuals with abnormal breathing during sleep should not be labeled as having OSAHS.OSAHS raises 24-h mean blood pressure. The increase is greater in those with recurrent nocturnal hypoxemia, is..."
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