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The Treatment of Sleep Apnea

Stuart D. Miller, MS
JAMA. 1986;256(3):348. doi:10.1001/jama.1986.03380030050017.
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To the Editor.—  The review by Dr Hall1 in the Feb 21 issue covered the pathophysiology of sleep apnea but neglected the revolution in treating this disorder. For a decade after the 1972 Rimini Symposium, a tracheostomy had been the best treatment available for severe sleep apnea; now, continuous positive airway pressure (CPAP) has replaced tracheostomy as the primary therapy for sleep apnea.Sullivan et al2 compared the two therapies in 1983. The difficulties of life with a tracheal stoma far outweigh the inconvenience of the CPAP compressor used at night. Dr Hall's references concerning CPAP are dated: CPAP machines and masks are now commercially available and have improved considerably compared with the earlier experimental technology.The current therapeutic procedure with suspected apneics is straightforward. An overnight polysomnogram confirms the diagnosis of sleep apnea in terms of severity and type (obstructive, central, or mixed). After a thorough history


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