Implicit in the physicians decision to treat is recognizing impairment or impending impairment of the patients well-being and the expectation of improving longevity and/or quality of life. Until recently, the only treatment for occlusive sleep apnea was tracheostomy. This procedure, while definitively alleviating occlusive apnea and excessive daytime sleepiness, often has significant medical and psychological morbidity. Therefore, other therapeutic alternatives, including protriptyline, continuous positive airway pressure via nasal mask (n-CPAP) and uvulopalatopharyngoplasty (UPPP), have been tried. Unlike tracheostomy, these therapies frequently provide only partial reductions in occlusive apnea and nocturnal hemoglobin oxygen desaturation. Without question, the abolition of malignant cardiac dysrhythmias and disabling daytime sleepiness represent therapeutic success. Less obvious is how to determine the level of benefit derived from varying degrees of amelioration of […]

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