ALBERT MILLER, M.D., F.A.C.P.
To the editor: The article of Walsh and colleagues (Ann Intern Med 76:185-192, 1972) suggesting that sleep deprivation secondary to upper airway obstruction is the mechanism for somnolence in the Pickwickian syndrome has impelled us to look at our patients from this point of view. As the authors pointed out, if hypotonicity of the tongue causes airway obstruction, apnea, hypoxic arousal, and sleep deprivation, these will be eliminated by insertion of an airway. Such was the case in two of the three patients they reported.
We wish to communicate our observations in a patient whose symptoms otherwise paralleled those reported
MILLER A. Airway Obstruction and Somnolence. Ann Intern Med. ;81:133–134. doi: 10.7326/0003-4819-81-1-133_2
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Published: Ann Intern Med. 1974;81(1):133-134.
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