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Editorials |

Upper Airway Resistance Syndrome, Insomnia, and Functional Somatic Syndromes

Christian Guilleminault, MD, BiolD; Ritu Davé, MD
Author and Funding Information

Affiliations: Stanford, CA
 ,  Drs. Guilleminault and Davé are affiliated with the Stanford University Sleep Disorders Clinic.

Correspondence to: Christian Guilleminault, MD, BiolD, Stanford Sleep Clinic, Suite 3301, 401 Quarry Rd, Stanford, CA 94305; e-mail: cguil@stanford.edu



Chest. 2003;123(1):12-14. doi:10.1378/chest.123.1.12
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Snoring is probably the main reason that patients with sleep-disordered breathing (SDB) have been referred. Otolaryngologists often see these patients. Internists and pulmonary specialists have recognized an association between SDB and obesity. Historically, the first sleep and breathing studies were performed on very obese patients (“pickwickians”) who had developed multiple cardiovascular complications.1 The majority of these patients were men. The presence of nonobese male SDB patients was emphasized thereafter, and the term obstructive sleep apnea syndrome (OSAS) was coined. The associated cardiovascular risks and repetitive episodes of nocturnal hypoxemia attracted widespread medical attention. Decreases in daytime performance and professional competence, mostly due to sleepiness, led these patients to accept unattractive treatments such as permanent tracheostomy and nasal continuous positive airway pressure. Not all subjects with SDB had the above-mentioned profile. By 1972, the association between SDB and chronic insomnia was recognized.2 But further studies of SDB have revealed different clinical presentations.

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