Saturday, July 16, 2005

Old News Still Relevant

Link-skipping today, I encountered an article at BBC News about an unusual case report, or at least, a case report of an unusual presentation of a common illness:
Loud snoring link to hallucinations
BBC News
January 15, 1999

A sleep disorder that results in loud snoring could also combine with other factors to induce hallucinations, doctors say.

Doctors from Kings Mill Hospital in Nottinghamshire studied the case of a man who was admitted to hospital suffering confusion during the day and hallucinations at night.

Hospital staff originally thought the 65-year-old man, who also suffered bronchitis and was overweight, was suffering from dementia.

But he was referred to a specialist respiratory unit when his wife mentioned that he snored heavily, with periods of choking and breath-holding. [...]

The doctors say sleep apnoea combined with bronchitis could cause progressive carbon dioxide retention, leading to the man's symptoms.

They write: "Obstructive sleep apnoea is common, with prevalence estimates in the adult male population of about 1%.

"The main features of obstructive sleep apnoea are snoring and daytime sleepiness, but its presentation with neuropsychiatric symptoms is well recognised."
My only objection pertains to the last sentence. Patients with obstructive (or central) sleep apnea often do present with psychiatric symptoms, and this is well documented in the medical literature, but that is not the same as being well recognized.  Doctors quite often fail to recognize this presentation.  Patients who come in with main complaints of a psychiatric nature often are not subjected to sufficient medical evaluation.

Categories: medicine, sleep disorders
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