Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, New Taipei City, Taiwan.
School of Medicine, Tzu-Chi University, Hualien, Taiwan.
J Clin Sleep Med. 2018 Mar 15;14(3):473-478. doi: 10.5664/jcsm.7004.
Treatment-emergent central sleep apnea has recently been noted after various treatment modalities for obstructive sleep apnea. It often remits spontaneously or can be treated with continuous positive airway pressure. However, we encountered a pediatric patient with obstructive sleep apnea who presented with severe complications, including growth failure, attention-deficit hyperactivity disorder, poor school performance, daytime sleepiness, and urinary difficulty that required permanent cystostomy. His obstructive sleep apnea resolved after adenotonsillectomy. However, treatment-emergent central sleep apnea developed after adenotonsillectomy and was further aggravated after continuous positive airway pressure and bilevel positive airway pressure without a backup respiratory rate use. After bilevel positive airway pressure with a backup respiratory rate treatment for 3 months initially, all his symptoms improved, except growth failure. Later, after adaptive servoventilation was used for 10 months, the patient's growth began to improve.
治疗后出现的中枢性睡眠呼吸暂停症最近在各种阻塞性睡眠呼吸暂停症治疗方法后被注意到。它通常会自发缓解，也可以用持续气道正压通气治疗。然而，我们遇到了一位患有阻塞性睡眠呼吸暂停症的儿科患者，他出现了严重的并发症，包括生长发育迟缓、注意力缺陷多动障碍、学习成绩差、白天嗜睡和需要永久性膀胱造口术的排尿困难。他的阻塞性睡眠呼吸暂停症在腺样体扁桃体切除术后得到了缓解。然而，在腺样体扁桃体切除术后出现了治疗后出现的中枢性睡眠呼吸暂停症，并且在没有后备呼吸频率使用的情况下，持续气道正压通气和双水平气道正压通气进一步加重。最初使用双水平气道正压通气并带有后备呼吸频率治疗 3 个月后，除了生长发育迟缓外，所有症状均得到改善。后来，使用适应性伺服通气治疗 10 个月后，患者的生长开始改善。
