Chiari malformation and central sleep apnoea: successful therapy with adaptive pressure support servo-ventilation following surgical treatment.

Sleep apnoea is a common disorder with significant morbidity. It is categorised into obstructive and central sleep apnoea. There are a variety of conditions associated with central sleep apnoea ranging from cardiac failure to structural brain anomalies. We herein report a case of 57-year-old woman with Chiari malformation associated with significant sleep-disordered breathing. There was a family history of Chiari malformation. Although neurosurgical intervention had a significant impact on apnoea hypopnoea index (AHI) with a reduction from 81/h preoperatively to 22.1/h after the surgical treatment, it failed to cure the sleep disorder breathing completely and adaptive non-invasive servo-ventilation had a dramatic effect on symptoms and normalised the AHI. Although, central sleep apnoea is associated with a number of common disorders, this case illustrates that there may be an unusual cause. Moreover, adaptive pressure support servo-ventilation may provide a promising treatment option following surgical correction of Chiari malformation.