Joseph Cummiskey

Alcohol and the Respiratory Tract

Possible mechanisms by which alcohol may adversely affect the respiratory system are considered. Alcohol ingestion impairs glottic reflexes, and alcoholics are predisposed to pneumonias and lung abscesses from aspiration of oropharyngeal bacteria. Alcohol intoxication also increases the frequency of sleep apnea and may result in respiratory failure from oversedation.

Respiratory control in the parents of sudden infant death syndrome victims. Ventilatory control in SIDS parents.

Summary: To determine if a familial abnormality in the control of breathing might explain the reasons for the sudden infant death syndrome (SIDS), three groups of parents were studied. The first (N = 8 sets of parents) had one infant die of SIDS (one SIDS) whereas the second (N = 6) had a SIDS victim plus a second child with a “near-miss‘’ occurrence (two SIDS). When compared to the third group (controls), these parents demonstrated no abnormality in the ventilatory response to hypoxia or hypercapnia. Similarly, they had normal respiratory frequency, tidal volume, inspiratory time, and arterial blood gas tensions. We conclude that a familial abnormality in breathing control measured during wakefulness is not the basis for SIDS.Speculation: Respiration during sleep may be abnormal in SIDS parents even though no alterations in the control of breathing were found during daytime studies.

The Effects of Flurazepam on Sleep Studies in Patients with Chronic Obstructive Pulmonary Disease

We studied five male nonobese patients (mean age, 61 years) who had moderate chronic obstructive pulmonary disease (COPD). Each patient underwent three successive nights of systematic monitoring of sleep variables. On nights 2 and 3, patients received placebo and flurazepam (30 mg). Patients were also given flurazepam (15 mg) for seven consecutive nights and underwent sleep monitoring on nights 1 and 7. Two patients exhibited oxygen desaturation during rapid-eye-movement (REM) sleep, both spontaneously and after administration of flurazepam. The three other patients had no nocturnal oxygen desaturation, either spontaneously or after ingestion of flurazepam. We concluded that sleep-induced respiratory abnormalities are not systematically worsened by flurazepam. Flurazepam (15 mg) had no effect on the sleep disturbances of our patients with COPD after seven nights of administration.