OSA pt’s drop their O2 sats at night; can cause brain damage; apoptosis of brain cells. Mouse equivalents. In the 1980’s when everybody quit smoking, it seemed like pulmonologists were going to starve. Pulmonary residents started doing fellowships in ICU-critical care medicine. Then in mid 1990’s they started doing fellowships in “sleep medicine.” I thought, “What a joke. I could learn whatever I wanted to about sleep just by reading for one weekend. Why sell yourself into indentured servitude for one year to study such a mickey mouse topic.” But I was wrong. Pulmonology has a new tidal wave of patients, a veritable tsunami: fat people with sleep apnea.
Most sleep apnea is thought be obstructive (although I’m not completely convinced of that, because their airways don’t look so bad on MRI and CT). Patients with sleep apnea are on the highway to dementia. CPAP is helpful for treatment and can be adjusted with BiPAP. The smart move is to lose weight by becoming a low fat, low sodium, whole food, organic only, vegan, but most people are willing to do that; but most people don’t age well.
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