History of Obstructive Sleep Apnea

In 1837 Charles Dickens undoubtedly described the first sleep apnea patient in “The Posthumous Papers of the Pickwick Club”. One of his characters (Joe) was described as follows, “ … and on the box sat a fat and red-faced boy, in a state of somnolency.”

In 1918 Sir William Osler coined the term “Pickwickian” to refer to obese, hypersomnolent patients. In 1956, Dr. Burwell and colleagues in describing several obese, hypersomnolent patients with respiratory and cardiac failure coined the term “Pickwickian Syndrome”

It wasn’t until 1965 that a French group of investigators, Dr. Gastault and colleagues made the important observation that “Pickwickian” patients had repetitive apnea events while asleep. Following this, Dr. Kuhlo and colleagues (1969) described a marked improvement in patients treated with tracheostomy. This established that a major reason why apneas occur is the collapse and closure of the upper airway breathing passage during sleep. In 1978 Dr. John Remmers and colleagues described the interaction between sleep, the breathing muscles of the chest, and the muscles of the upper airway which explained to a large degree why the upper airway collapses during sleep, leading to obstructive sleep apnea.

In 1981 Drs. Sullivan, Berthon-Jones, Issa and Eves from Australia published the first account of treating sleep apnea patients with continuous positive airway pressure (“CPAP”), thus initiating the most common and successful treatment, currently known, for this disorder. This landmark paper prompted a vast amount of research which has shed much light on why sleep apnea occurs, how common it is and what type of treatments are most successful.

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