History of Sleep Apnea

Sleep apnea is not a new condition. Symptoms of this disorder have been observed for a long time. However, in modern times, doctors came to understand the condition much better and sufferers can have an excellent quality of sleep and quality of life.

But what is the history behind this condition? We delved a bit deeper.  

Sleep apnea itself was named and recognized as an official disorder only late in the twentieth century. However, records show that healers had known about the condition and wrote about it as early as 2,000 years ago.

Charles Dickens wrote a novel called 'The Pickwick Papers.' In this, an overweight character named Joe showed the same symptoms as what doctors would later call 'sleep apnea.' Therefore, in the early nineteenth century, they begin to call it the ‘Pickwickian syndrome.’ 

The condition was attributed to fat and being overweight; however, modern studies have shown that excess body fat is not the only cause of sleep apnea. It can indeed contribute, but other factors such as large tonsils, having a thick neck, a nasal blockage, or a soft, floppy palate can also play a role.  

By the time the fifties and sixties rolled around, new research finally found the core problem in sleep apnea: people were not breathing properly in sleep. Sleep apnea was not a collection of symptoms that just happened together.

In 1965, researchers were able to see apneas during sleep on a polysomnograph. In polysomnography, oxygen levels in the blood, your heart rate, breathing, and brain waves are recorded. Doctors could even see eye and leg movements during sleep. 

Treating With a Tracheotomy

In the 1970s, researchers used dogs as guinea pigs and started to use tracheotomies to treat sleep apnea. William Dement opened the first sleep apnea clinic at Stanford University in California. Tracheotomies were also used on humans, and it was the only way to get air past any type of blockage.

What is a tracheostomy?

It is a procedure usually done to deliver oxygen to the lungs or to bypass an obstructed airway. A cut is made just below the Adam's apple and will go through the windpipe. The doctor will then place a tracheostomy tube. It is a risky procedure and a dramatic solution. Your thyroid gland can be damaged, or a lung can collapse.

It sounds a little crazy today, but this was the only option to treat severe sleep apnea in those days. There were no other options. 

An early form of CPAP therapy

The period between 1975 and 1980 saw an explosion in sleep apnea research. Almost 320 articles appeared in medical literature in these five years alone.

In the early 1980s, researcher Colin Sullivan finalized a type of mask that provided an alternative to a tracheostomy and wasn’t as invasive. 

His initial tests were performed on dogs!

Airflow could be delivered through the mask, creating an early form of CPAP therapy. Colin designed a facial cover and an air pump so that oxygen could be given to the patient throughout the night. For the first masks, a plaster cast was made for each individual nose, and fiberglass was molded over the cast. This shape had air inlets and outlets and had to be stuck to the patient each night with silicone adhesive. Although cumbersome, it worked great, and the same basic concept is still used today.

Ironically, this form of treatment did not immediately catch, but it became the go-to treatment in the years to come.

A turning point

In early 2000, studies about sleep apnea were well underway. In this year, four separate studies demonstrated a definite correlation between obstructive sleep apnea, hypertension, and health.

It was evident: the treatment of sleep apnea was not about relieving daytime sleepiness; it was about helping people live full lives.

A mouthpiece

CPAP treatment is not comfortable for all users. It can also be loud, resulting in many people stop using it. Oral appliance therapy is an alternative for users with mild to moderate sleep apnea. Here, the airway is kept open by a mouthpiece, custom-made for each user.

Today, sleep apnea treatment can be customized to fit the patient. In most cases, CPAP therapy will work, but surgery might also be an option for some patients. 

Arguably, the most critical advance in the history of sleep apnea happened in 1965 when researchers could describe and understand the condition entirely.

Obstructive sleep apnea is now one of America’s major health issues and a common problem. There's evidence that links the condition with heart diseases, heart failure, and strokes. Obesity also increases the risk of obstructive sleep apnea, and it is a massive problem in the US.

Lifestyle changes

Luckily, changing your lifestyle can help alleviate the symptoms of sleep apnea.

You can:

· Lose weight

· Exercise more

· Reduce your alcohol intake, especially before going to bed

· Adjust your medicine that may affect your sleep patterns.

Sleep apnea is nothing new. We are fortunate today that we know more about it than 80 years ago. There is really no reason not to explore options. You are likely to get the solution you need if you consult with a sleep apnea expert…you owe it to yourself!

Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101717/ 

https://www.resmed.com/au/dam/documents/articles/clinical_newsletter/resmedica14.pdf

https://www.healthline.com/health/tracheostomy#procedure