null
Sleep Apnoea and CPAP: A History

Posted by Blooms The Chemist on 20 Jul 2020

Sleep Apnoea and CPAP: A History


Knowledge of sleep apnoea can be traced back to ancient times; records of symptoms such as heavy snoring date back more than 2000 years.

Sleep apnoea is a sleep disorder that affects breathing during sleep. The disorder includes pauses in breathing, as well as snoring and other symptoms. Today, modern technology and the development of CPAP machines allows for the effective treatment of sleep apnoea.

However, this has not always been the case. Evidence of sleep apnoea can be seen since ancient times, as can the development of various perceptions and approaches to the disorder.

Sleep Apnoea Throughout History


Throughout history, there are various examples of literature indicating the knowledge of some form of sleep apnoea. Various writings describe the disorder as a character trait, without an understanding of it as a disease.

Ondines curse

For example, Ondine’s curse is a rare form of sleep apnoea. The name references a German myth in which an unfaithful husband is cursed by his wife, so that he would stop breathing should he ever fall asleep. This story has continued to live throughout literature and art in adaptations such as ‘The Little Mermaid’.

Pickwickian syndrome

Another example of sleep apnoea history is in Charles Dickens’ novel, ‘The Pickwick Papers’. The novel includes a description of an overweight character, whose description reflects an adult with symptoms of sleep apnoea (in this example, snoring and falling asleep standing up). William Osler referenced the novel in his coining of the term ‘Pickwickian Syndrome’. This term refers to a breathing disorder that is similar to sleep apnoea, affecting people diagnosed with obesity.

Sleep apnoea in medical literature

When it comes to medical literature and a more in depth understanding of sleep apnoea, the late 19th century saw the introduction of the aforementioned term ‘Pickwickian Syndrome’. Research around this topic focused on obesity rather than disordered breathing; this began to change in the 1960’s, as research indicated that other factors should be taken into account. Since then, significant progress has been made towards understanding sleep apnoea, allowing for the development of modern CPAP technology.

The Development of Sleep Apnoea Treatment


Tracheotomy

Before the introduction of continuous positive airway pressure (CPAP) technology, the only solution to sleep apnoea was an invasive surgical procedure called a tracheotomy. This procedure consists of making an incision on the neck, allowing for an opening that can be used as an airway. The tracheotomy is closed off throughout the day, but opened at night in order to bypass the collapsed upper airway that is experienced by those with severe sleep apnoea.

The tracheotomy has a long history, with the procedure first being depicted on Egyptian artefacts as far back as 3600 BC. There is evidence of occasional tracheotomy research from this point onwards, with legitimate recognition of the procedure as a solution to airway obstruction occurring in the 19th century.

The tracheotomy procedure was performed only on severe cases of sleep apnoea. Whilst it is helpful in treating the sleep disorder, it is an invasive surgical procedure with various complications and risks. Those with a tracheotomy cannot swim or have a bath, and they experience significant risk of infection, as the air flow is not warmed or moistened.

Continuous positive airway pressure

The continuous positive airway pressure (CPAP) machine was invented in the 1980’s, by Australian physician Colin Sullivan. With the goal of discovering a non invasive treatment to sleep apnoea, Sullivan’s research led to his first testing of the idea of using positive airway pressure to treat sleep apnoea in June 1980. One of Sullivan’s initial creations consisted of pool tubing, a paint compressor with the motors reversed, and a mask that was glued to the face.

Since the first commercial CPAP machine was made available in 1985, significant developments have been made. These include the self-sealing mask in 1990, the introduction of Bi-Level air pressure CPAP, nasal CPAP masks, and countless other advancements.

Sleep Apnoea and CPAP Today


The continued development and research of CPAP technology, as well as a greater understanding of sleep apnoea, has resulted in the modern, effective machines that are available today. Many of these machines include advanced connectivity options, intelligent detection, and other comfort and ease of use features.

In addition to modern comfort and functional features within CPAP machines, usage trends have also changed. For example, in the early 2000’s, research indicated significant health risks that may come with sleep apnoea; for example, cardiovascular disease/heart attack risk and brain deterioration. We now also know about the benefits of weight loss in relation to sleep apnoea. As a result, CPAP therapy is also recommended for those with less severe sleep apnoea.