Sleep apnea syndrome: central sleep apnea and pulmonary hypertension worsened during treatment with auto-CPAP, but improved by adaptive servo-ventilation.
In this 71-year-old man diagnosed as obstructive sleep apnea syndrome initially, the apnea-hypopnea index in polysomnography was 31.3/hour. He started auto-adjusted continuous positive airway pressure (auto-CPAP) treatment in July 2005 but developed congestive heart failure in December 2007. Pulmonary arterial pressure (PAP), estimated by echocardiography, was 71 mmHg. In January 2008, during simplified sleep examination with a breath-movement sensor under auto-CPAP, many central-type apneas were recognized. After replacing auto-CPAP with adaptive servo-ventilation (ASV), the apnea-hypopnea index was 5.3/hour and PAP became 36 mmHg after 3 months. It was thought that the increase of PAP was due to long-term inadequate use of auto-CPAP.
Ono
Hiroshi
H
Department of Internal Medicine, the Division of Respiratory Medicine, Infection Diseases, and Oncology, Nippon Medical School, Tokyo. h-ono@nms.ac.jp
Fujimoto
Hiroyuki
H
Kobayashi
Yoshinori
Y
Kudoh
Shoji
S
Gemma
Akihiko
A
D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000628:therapy*; D008297:Male; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000150:complications / Q000628:therapy*; D017211:Treatment Failure; D016896:Treatment Outcome; D012122:Ventilators, Mechanical