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Awaiting moderation 17831 Article |
Knowing about snoring: a short history KNOWING ABOUT SNORING: A SHORT HISTORY
The comparatively recent "discovery" of the sleep apnoea syndromes and the heightened community awareness of problematic snoring has given rise to the misconception that it is an entirely new phenomenon, an affliction of the modern era like repetitive strain injury (RSI) suffered by computer keyboard operators. In fact snoring has been with us for centuries, but only recently has the technology been available to investigate the sleeping patient in a way that will not result in sleep disruption.
Unfortunately we will never know whether pre-historic man was a snorer but, with some exercise of the imagination, it is not difficult to picture our cave dwelling ancestors sharing this attribute with modern man. Snoring has been observed in animal species other than man, the most notorious being the easily recognizable brachycephalic or short nosed breeds of dogs such as the bulldogs, pugs and Pekingese; admirable dogs in many respects but with an unfortunate predisposition to respiratory problems. Laboured breathing after exercise, frequent infections and snoring all result from a distorted airway, particularly the elongation of the soft palate, a part of the airway which plays a crucial role in the development of snoring in both man and beast.
Some of the greatest writers and poets are responsible for the earliest references to snoring. Homer, the ancient Greek poet, believed to have lived around 800 B.C. wrote in his epic work, The Odyssey: "Then nodding with the fumes of wine, Dropt his huge head, and snoring lay supine." 'The great writers obviously knew something about the relationship between alcohol, sedatives and snoring, as William Shakespeare was to write in Macbeth (1605): "The surfeited Groomes doe mock their charge with snores. I have drugg'd their Possets." Again from Shakespeare, and with a touch of artistic license in The Tempest: "Thou do'st snore distinctly, There's meaning in thy snores." Perhaps the most celebrated snorer appears in the pages of Charles Dickens' novel, The Pickwick Papers (1837) as the fat boy Joe who was forever nodding off to sleep. Dickens' portrayal of young Joe made an impression on the medical world, as the Pickwickian Syndrome became synonymous with obese and excessively sleepy patients which probably represented an early recognition of the sleep apnoea syndromes.
Snoring has not only provided subject material for poets, playwrights and novelists for centuries, but has without doubt been keenly observed by the medical profession for at least the same period of time. The very first volume of the British Medical Journal (1889) published a letter on the subject of snoring which, although somewhat dated by the quaint prose of the nineteenth century, recognized the effects of nasal obstruction and alcohol, and alluded to the sleep disturbance associated with severe snoring.
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