Nothing new under the moon. Historical accounts of sleep apnea syndrome.

A systematic review of the 19th-century literature related to sleep disorders revealed that patients with obstructive sleep apnea were vividly described in the second half of the century. Also, there were documented observations on the linkage between airway obstructions and noisy snoring, nocturnal insomnia, and excessive somnolence. The coining of the term "pickwickian" to describe an obese somnolent patient was made in 1889 during a clinical presentation of a patient with sleep apnea. Respiratory failure in sleep because of "failure of the chest and diaphragmatic movements" was defined as a specific sleep disorder by Silas Weir Mitchell in 1890. The two main reasons for overlooking the sleep apnea syndrome for so long have been misdiagnosis of patients with sleep apnea as having narcolepsy and skepticism regarding the validity of excessive somnolence as a clinical sign.