title: Impact of nasal continuous positive airway pressure for congenital adrenal hyperplasia with obstructive sleep apnea and bruxism.
abstract: BACKGROUND
  Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders in humans. The most frequent CAH variant is 21-hydroxylase deficiency. Patients with 21-hydroxylase deficiency require long-term glucocorticoid replacement treatment. Although sleep disturbance is frequently observed under glucocorticoid replacement treatment, a case of obstructive sleep apnea(OSA) in patients with CAH has not been reported.
  
  
  METHODS
  A 43-year-old man with CAH who complained about sleep disturbance and sleep bruxism was diagnosed as obstructive sleep apnea (OSA) by polysomnography (PSG). Following the introduction of nasal continuous positive airway pressure (nCPAP), his sleep disturbance with symptoms also improved; in addition, he was able to reduce the dose of glucocorticoid replacement therapy without any adverse consequences on his sleep pattern.
  
  
  CONCLUSIONS
  Physicians who treat a patient with CAH should know the possibility in the existence of OSA in their patients. Because symptoms with OSA in CAH patient may increase the dosage of long-term glucocorticoid treatment for the patient, which may induce several adverse effects including body weight gain on the patient.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.forename: Takefumi
authors.initials: T
authors.lastname: Hitomi
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Handa
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Tuboi
authors.forename: Akio
authors.initials: A
authors.lastname: Niimi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000175:diagnosis / Q000628:therapy*; D000328:Adult; D015992:Body Mass Index; D002012:Bruxism / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure; D003907:Dexamethasone / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000187:drug effects; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone