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The Obstructive Sleep Apnoea/Hypopnoea Syndrome
  1. N. J. Douglas
  1. Department of Medicine, Edinburgh Royal Infirmary, UK; Email: njd{at}



In the last decade there has been a rapid increase in the number of patients diagnosed with the obstructive sleep apnoea/hypopnoea syndrome (OSAHS). Indeed, in many respiratory clinics OSAHS is now the most common diagnosis. Neurologists need to be familiar with the OSAHS because it may present rather like some primarily neurological conditions, and because patients with neurological and neuromuscular disorders can develop the OSAHS. Indeed, in the February 2002 issue of Practical Neurology, Sam Berkovic and Philip King urged neurologists to wake up to sleep medicine (Berkovic & King 2002).

The best definition of the OSAHS is at least five, some would say 15, breathing pauses (apnoeas) or hypopnoeas (near apnoeas), each lasting 10 s or more, per hour of sleep in association with sleepiness or at least two other major symptoms, including difficulty concentrating, unrefreshing nocturnal sleep or nocturia (Table 1). Numerous studies have shown that the

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