Surgical management of airway obstructions during sleep.

Anatomical or physiological airway obstructions during sleep, of which the patient is unaware, cause daytime sleepiness at first, then signs of decreasing mental function, and eventually in some individuals, pulmonary and systemic hypertension. A few of these patients had been recognized before, the Pickwickian syndrome and in children with cardiac problems and large tonsils. The majority, however, present as sleep disorders. This paper describes our surgical experience with improving the airways of 19 children and adults with daytime somnolence.