Sleep Med Psychophysiol.  2017 Dec;24(2):118-123. 10.14401/KASMED.2017.24.2.118.

A Case of Continuous Positive Airway Pressure Therapy in a Patient with Central Sleep Apnea and Heart Failure

• An JY
• Kim SB
• Kang HH

• KMID: 2404036
• DOI: http://doi.org/10.14401/KASMED.2017.24.2.118

Abstract

Central sleep apnea (CSA) is a highly prevalent comorbidity in patients with heart failure and may present in 25 to 40 percent of heart failure patients. Continuous positive airway pressure (CPAP) is the primary therapeutic option and effective in treatment of obstructive sleep apnea (OSA). In heart failure patients with CSA, several trials of CPAP showed a number of positive effects in heart failure treatment. A 58-year-old male visited the hospital because of dyspnea and he was diagnosed as heart failure with ischemic heart disease. He underwent coronary angiography and received percutaneous coronary intervention due to stenosis at the middle of left anterior descending coronary artery. However, dyspnea was not completely improved after treatment with percutaneous coronary intervention. The patient also experienced snoring and sleep apnea which worsened with symptom of dyspnea in the recent year. We suspected CSA and the patient underwent polysomnography to confirm whether sleep apnea was present. During the polysomnography, CSA with Cheyne-Stokes respiration (CSR) was observed and apnea-hypopnea index was 45.9/hr. The patient was treated with CPAP. After CPAP treatment, hypoxemia and CSA were resolved and dyspnea was improved with reducing NYHA class. We report a case successfully treated with clinical improvement by presuming CSA in a patient with heart failure.

Keyword

Central sleep apnea; Continuous positive airway pressure; Cheyne-Stokes respiration; Heart failure

MeSH Terms

Anoxia
Cheyne-Stokes Respiration
Comorbidity
Constriction, Pathologic
Continuous Positive Airway Pressure*
Coronary Angiography
Coronary Vessels
Dyspnea
Heart Failure*
Heart*
Humans
Male
Middle Aged
Myocardial Ischemia
Percutaneous Coronary Intervention
Polysomnography
Sleep Apnea Syndromes
Sleep Apnea, Central*
Sleep Apnea, Obstructive
Snoring