The History of Sleep Surgery.

Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%. The only other surgical procedure for OSA was permanent tracheostomy, but patients suffered from social stigma from the visible stoma with skin flaps and complications such as tracheal granulomas and tracheitis. UPPP was introduced in the USA as an alternative to permanent tracheostomy by Fujita in 1981. Since then, multiple surgical approaches and combinations of approaches have surfaced, with variable success rates.

Snoring in the ancient world.

Published in Sudhoffs Archiv für Geschichte der Medizin und Naturwissenschaften, 1941.

Sleep medicine before and after Dickens.

Sleep disordered breathing has come to public awareness in the last 10 to 15 years. However, the roots of medical knowledge about sleep disordered breathing reach back several hundred years farther. Greek and Roman publications reported heavy snoring and breathing pauses as diseases that impaired social life. In our day, popular comic strip figures like "Obelix" remind us that the mysterious noise of heavy snoring has been nerve-racking to people since ancient times.

[History of the treatment of snoring]. / Historique du traitement du ronflement.

The history of snoring can be divided into three major periods. First, there was a prehistoric phase during which everything was ignored and in which there was no interest in knowing anything. We call this "le repos du guerrier'. Sleep was regarded mainly as a phase of recovery, and there was no question of related problems. A second period began about the beginning of this century: they still did not know anything, but it was felt that something needed to be done. Multiple types of therapy were attempted. This was a time in which research extended in all directions. Modern times began in the middle of this century with the first serious work of medical scientists who discovered and defined the sleep apnea syndrome, the UPPP, the CPAP, etc.