Brahms' Lullaby Revisited -- Did the Composer Have Obstructive Sleep Apnea?

Mitchell L. Margolis, MD, FCCP, From the Pulmonary Section, Philadelphia VA Medical Center and Hospital of the University of Pennsylvania, University & Woodland Ave, Philadelphia, PA.

Disclosures

CHEST. 2000;118(1) 

In This Article

Introduction

Historians are divided as to whether Johannes Brahms (1833-1897), whose music is among the most beloved and masterful in history, actually made the above remark on taking his leave from a party.[1,2] But there is little doubt that he could have. Brahms was possessed of a crusty personality, and even long, close friendships with Clara Schumann and the violin virtuoso Josef Joachim were frequently punctuated by bursts of rancor and thoughtlessness. Brahms' personality was probably influenced by humiliating childhood experiences playing the piano in Hamburg bordellos to augment the meager family income, although considerable debate persists as to the exact nature of these episodes.[3,4,5] Also, the overwhelming expectations thrust on him by no less than Robert Schumann and Hans von Bulow (the leading music critic of the day) as the successor to Bach and especially Beethoven contributed an additional huge psychic burden. Indeed, it is a measure of his genius that Brahms was able to meet and even exceed these daunting predictions. The reader is referred to Jan Swafford's fine biography 3 of the composer for a more complete understanding of Brahms' personality and life.

From a medical standpoint, Brahms' life seems rather straightforward. A lithe and handsome man in his young years (Fig 1), Brahms seems to have known few illnesses throughout his life; even at age 57, on the occasion of a rare flu-like sickness, he "seemed to have no idea what a fever was."[3] Finally, in 1896, he developed progressive jaundice and weight loss. This terminal illness, analyzed in depth by Neumayr,4 was probably carcinoma of the pancreas.

Brahms in his thirties. Repeated with permission from Swafford.[3]

However, a more careful reading of the Brahms canon suggests that he may have suffered from obstructive sleep apnea (OSA), a condition unknown to the physicians of his day. In this article, I summarize evidence in support of this hypothesis.

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