Khalifa Abdelkarim, Spielmanns Marc
Sleep Medicine Center Zurich Oberland, GZO Wetzikon, 8620 Wetzikon, Switzerland.
Faculty of Health, Department for Pulmonary Medicine, University Witten Herdecke, 58455 Witten, Germany.
Reports (MDPI). 2023 Jul 18;6(3):32. doi: 10.3390/reports6030032.
Obstructive sleep apnea (OSA) is well known to often improve with non-supine positioning as opposed to supine positioning. Emerging research supports a role for sleep position management in patients with central sleep apnea (CSA) as well. We report a case of de novo complex sleep apnea syndrome (CompSAS) in a 78-year-old female, who presented after a car accident due to unclear syncope. Diagnostic polysomnography (PSG) showed moderate OSA. A CompSAS developed under automatic positive airway pressure (APAP), while 4 years of downloaded data showed good adherence. No significant benefit was reported under adaptive servo ventilation (ASV) and BiPAP-ST, while a reduction in CSA in the non-supine position was noticed. Oxygen and sleep positional therapy (SPT) were considered, resulting in a significant improvement in CSA and sleep quality. Further research on the prevalence of positional CSA is needed.
众所周知，与仰卧位相比，阻塞性睡眠呼吸暂停（OSA）通常在非仰卧位时会有所改善。新出现的研究也支持睡眠体位管理在中枢性睡眠呼吸暂停（CSA）患者中的作用。我们报告了一例78岁女性新发复杂性睡眠呼吸暂停综合征（CompSAS）的病例，该患者因不明原因晕厥在车祸后就诊。诊断性多导睡眠图（PSG）显示为中度OSA。在自动气道正压通气（APAP）治疗期间出现了CompSAS，而4年的下载数据显示依从性良好。在适应性伺服通气（ASV）和双水平气道正压通气-自主呼吸模式（BiPAP-ST）治疗下未报告显著益处，而在非仰卧位时CSA有所减少。考虑了吸氧和睡眠体位治疗（SPT），结果CSA和睡眠质量有显著改善。需要对体位性CSA的患病率进行进一步研究。
