Polysomnography: Some Difficult Questions

Excerpt

Syndromes associated with hypersomnia and sleep apnea are well established (1). Breathing may cease during light sleep and rapid-eye-movement sleep because of upper airway obstruction, central cessation of respiratory drive, or a combination of both. Oxygen desaturation may follow either cessation or diminution of breathing and can lead to pulmonary hypertension, cardiac arrhythmias, cor pulmonale, and sudden death (2, 3). Patients with these disorders are usually fat, very sleepy, and extremely loud snorers; they may have congestive heart failure and frank disorders of respiratory control (pickwickian syndrome) (4). Treatment for this condition in its most severe form usually consists of