title: Obstructive sleep apnea presenting as recurrent cardiopulmonary arrest.
abstract: A non-obese patient who was admitted initially with hypoglycemia had multiple episodes of cardiopulmonary arrests requiring resuscitations and a short period of mechanical ventilation. A subsequent sleep study confirmed the diagnosis of severe obstructive sleep apnea (OSA) and documented an episode of near-arrest with cerebral hypoxia during rapid eye movement sleep. We suggest that OSA coupled with impairment of arousal response and other apnea termination mechanisms had resulted in prolonged apnea, life-threatening hypoxemia, and cardiopulmonary arrest in this patient. We review the current understanding of the mechanisms of apnea termination in OSA and suggest that further studies are needed to investigate these mechanisms and their roles in sudden death during sleeping hours in patients with OSA.
authors.affiliation: Department of Medicine, Division of Respiratory, Critical Care and Sleep Medicine, National University Hospital, Singapore. KhooSM@nuh.com.sg
authors.forename: See Meng
authors.initials: SM
authors.lastname: Khoo
authors.forename: J J
authors.initials: JJ
authors.lastname: Mukherjee
authors.forename: Jason
authors.initials: J
authors.lastname: Phua
authors.forename: Dong Xia
authors.initials: DX
authors.lastname: Shi
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation; D045422:Continuous Positive Airway Pressure / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003937:Diagnosis, Differential; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology; D004562:Electrocardiography; D006323:Heart Arrest / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D002534:Hypoxia, Brain / Q000175:diagnosis / Q000209:etiology; D008297:Male; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology; D012008:Recurrence; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis* / Q000628:therapy