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Words matter: a proposed nosologic lexicon for sleep breathing.

HUMANS EXPRESS CONCEPTS IN WORDS. THUS, ADVANCES IN SCIENCE REQUIRE PARALLEL ADVANCES IN LANGUAGE. WHEN SCIENTIFIC ADVANCEMENT is rapid, however, language may struggle to keep up. Today, 40 years after the "discovery" of obstructive sleep apnea (OSA), the language related to disorders of sleep breathing lags the accumulated knowledge of those disorders. As a result, sleep medicine as a field may suffer because of shortcomings in its language, just when interest in sleep is expanding beyond its usual subspecialty confines. The nosologic lexicon related to sleep breathing is particularly problematic. A lexicon is "the special vocabulary of a person, a branch of knowledge, a profession, etc."2 It is distinct from “nosology,” which refers to the classification of disease,3 often in a taxonomy. The “nosologic lexicon,” therefore, is the set of terms describing disease entities. Below, I illustrate the complexity, idiosyncrasy, and inconsistency of sleep breathing's current nosologic lexicon. A new lexicon, without these problems, is then proposed.