History of the development of sleep medicine in the United States.

Sleep Medicine has only recently been recognized as a specialty of medicine. Its development is based on an increasing amount of knowledge concerning the physiology of sleep, circadian biology and the pathophysiology of sleep disorders. This review chronicles the major advances in sleep science over the past 70 years and the development of the primary organizations responsible for the emergence of Sleep Medicine as a specialty, sleep disorders as a public health concern and sleep science as an important area of research.

A practical method for describing patterns of tongue-base narrowing (modification of Fujita) in awake adult patients with obstructive sleep apnea.

Purpose: The purpose of the present study was to evaluate a clinically practical classification system for tongue-base narrowing and to assess intrarater and interrater reliability of the proposed system.

Patients And Methods: A population of 248 consecutive patients with polysomnographically proven upper airway obstructive pathology were evaluated (using the hypotonic method) for evidence of upper airway narrowing with the commonly available techniques of fiberoptic nasopharyngoscopy, clinical examination and lateral cephalometric analysis.

Results: Four basic patterns of tongue-base narrowing have been discerned to occur in awake adult patients with diagnosed obstructive upper airway pathology.