Sleep and breathing.

This paper reviews some of the recent advances in the sleep apnoea/hypopnoea syndrome. Sleep apnoea has recently been shown to be familial and in some of these patients this is due to retroposition of the maxilla and mandible. There is now good evidence that individuals with sleep apnoea have an increased risk of road accidents and increasing, although not yet 100% robust, evidence that they have an increased frequency of systemic hypertension. The last few years have seen a large number of randomised controlled trials of CPAP therapy which have shown clear evidence that CPAP improves symptoms, subjective sleepiness, objective sleepiness, cognitive function, IQ, mood, quality of life and driving ability. Evidence that CPAP influences cardiovascular and cerebrovascular outcomes is awaited.