Obstructive sleep apnea is a potentially life-threatening condition seen in millions of men and women. This condition is typically characterized by loud snoring, cessation of air flow during sleep and daytime sleepiness. The following is a case study of a patient suspected of having this disorder.

John was 45 years old when he severely injured his knee playing softball at the company picnic. Recovery from surgery took longer than expected. It appeared that John's days of playing sports were over. With the loss of his daily exercise routine came gradual weight gain. By age 50, John's weight had increased by 50 pounds and his collar size had expanded to 18. He weighed 230 pounds and most of his clothes no longer fit. Additionally, John's snoring had gotten so loud that Mary, his wife, could no longer sleep in the same room as him. She was unable to get the sleep she needed to feel refreshed.

Mary's frustration and concern grew when she and John shared a room while vacationing in Mexico. She lay awake witnessing John as he slept: He snored, gasped, choked and stopped breathing briefly. While this recurrent pattern of abnormal breathing seemed to improve when John turned to his side, it remained intolerable to Mary.

When they returned home, Mary insisted that John seek medical help. At first, he resisted. Soon after, however, he totaled the couple's new car. He had drifted off to sleep while driving home from work and had crashed into a tree. No one was hurt, but John was shaken enough to make a doctor's appointment.

John immediately visited Dr. Gordon, his primary care physician. Dr. Gordon arranged for John and Mary to see a sleep specialist at an accredited sleep center. John agreed not to drive until his physicians indicated that he could do so safely.

The next day, John reviewed his medical history with a sleep specialist at the local university. Mary added details of her nightly observations. The specialist determined that John should undergo a sleep study, also known as a polysomnogram. The specialist reiterated the need for John to avoid driving until he'd been effectively treated for his sleep problems. The specialist also discussed the role of weight gain in the development of sleep apnea. He explained that increased fat was deposited throughout John's body, including in the back of his throat. Just a few extra millimeters of fat could narrow John's breathing passage and contribute to obstruction to airflow when his muscles relaxed during sleep.

That evening, John and Mary had a long discussion about their visit with the sleep specialist. John pledged to change his eating habits and focus on weight loss. He was looking forward to his night in the sleep center for his polysomnogram -- and Mary was looking forward to it even more.

In my next article, I will discuss John's sleep study.