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Do You Ever Take a Sleep History?

Richard P. Millman, MD
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Brown University School of Medicine; Providence, RI 02903 (Millman)

Requests for Reprints: Richard P. Millman, MD, Rhode Island Hospital, Division of Pulmonary, Sleep and Critical Care Medicine, 593 Eddy Street, Providence, RI 02903. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Ann Intern Med. 1999;131(7):535-536. doi:10.7326/0003-4819-131-7-199910050-00010
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Obstructive sleep apnea is a condition in which the pharynx repeatedly collapses during sleep. The patient with obstructive sleep apnea struggles to breathe against a closed airway, resulting in hypoxemia and hypercapnia. Eventually the patient awakes from sleep, the pharyngeal muscles contract, the airway opens, and air rushes in under pressure, creating a loud snorting or gasping sound; in general, this process is subconscious. The patient then drifts into deeper sleep, and the cycle repeats itself. The combination of sleep fragmentation and arterial blood gas alterations can lead to excessive daytime sleepiness, problems with memory, problems with attention and concentration, and personality changes. Blood pressure typically increases in association with apneas during the night, and there is a strong interaction between daytime hypertension and obstructive sleep apnea.



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