a not uncommon sleep - disruption syndrome characterized by frequent episodes of apnea, or hypoapnea due to inspiratory occlusion of upper airway with snoring during sleep, and serious physiological consequences including excessive daytime sleepiness, intellectual deterioration, loss of libido, systemic hypertension, pulmonary hypertension and cardiac arrhythmias. Contributory causes include obesity, nasal obstruction, micro or macrognothia, acromegaly, hypothyroidism, vocal cord palsy and adenoidal or tonsillary hypertrophy. Diagnosis can be confirmed in a sleep laboratory by polysomnography. (Apneaic episodes less than 10 seconds and occurring infrequently (<30) at night are common in many normal young people).
Treatment
Painful crisis managed with rest, hydration and analgesics, and if very severe narcotics might be required. Folate supplementation is routine. Transfusion are to be given only for aplastic or hemolytic crisis and during the third trimester of pregnancy. Exchange transfusions are preferred for treatment of intractable crisis, priapism and stroke.
