Idiopathic Central Sleep Apnea: A Case Report
Background and Objective: Central sleep apnea (CSA) is defined as cessation of breathing in the absence of ventilatory drive for at least 10 seconds. Idiopathic central sleep apnea (ICSA) is a rare disorder with unclear etiology, and diagnosis is made upon exclusion of other causes. Many of the patients with ICSA do not receive appropriate treatment.
Case Report: Here, we report a 38-year-old man with history of daily hypersomnolence and decreased concentration since two years before referring to our center. After comprehensive medical approach for CSA, he was diagnosed as ICSA. The patient did not respond and did not tolerate continuous positive airway pressure (CPAP). Zolpidem was prescribed for the patient, and he had dramatic improvement of symptoms.
Conclusion: ICSA is a rare sleep breathing disorder presenting with CSA, and may be misdiagnosed with other causes of CSA in the cases of non-appropriate medical evaluation. However, there is no definite treatment.
2. Bixler EO, Vgontzas AN, Ten Have T, et al. Ef-fects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 1998; 157: 144-8.
3. Bixler EO, Vgontzas AN, Lin HM, et al. Preva-lence of sleep-disordered breathing in women: Effects of gender. Am J Respir Crit Care Med 2001; 163: 608-13.
4. Xie A, Wong B, Phillipson EA, et al. Interaction of hyperventilation and arousal in the pathogenesis of idiopathic central sleep apnea. Am J Respir Crit Care Med 1994; 150: 489-95.
5. Bradley TD, McNicholas WT, Rutherford R, et al. Clinical and physiologic heterogeneity of the central sleep apnea syndrome. Am Rev Respir Dis 1986; 134: 217-21.
6. Quera-Salva MA, McCann C, Boudet J, et al. Effects of zolpidem on sleep architecture, night time ventilation, daytime vigilance and performance in heavy snorers. Br J Clin Pharmacol 1994; 37: 539-43.
7. Zucconi M, Ferri R. B. Assessment of sleep disorders and diagnostic. In: Bassetti C, Dogas Z, Peigneux P, Editors. Sleep medicine textbook. Regens-burg, Germany: European Sleep Research Society; 2014. p. 98-9.
8. Berry RB, Brooks R, Gamaldo CE, et al. The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifica-tions. Darien, IL: American Academy of Sleep Medi-cine; 2014.
9. Ryan CM, Bradley TD. Central sleep apnea. In: Broaddus VC, Mason RC, Ernst JD, Editors. Murray & Nadel's textbook of respiratory medicine e-book. Phila-delphia, PA: Elsevier Health Sciences; 2015. p. 1569-82.
10. Malhotra A, Owens RL. What is central sleep apnea? Respir Care 2010; 55: 1168-78.
11. Walker JM, Farney RJ, Rhondeau SM, et al. Chronic opioid use is a risk factor for the development of central sleep apnea and ataxic breathing. J Clin Sleep Med 2007; 3: 455-61.
12. Szollosi I, Jones M, Morrell MJ, et al. Effect of CO2 inhalation on central sleep apnea and arousals from sleep. Respiration 2004; 71: 493-8.
13. Eckert DJ, Jordan AS, Merchia P, et al. Central sleep apnea: Pathophysiology and treatment. Chest 2007; 131: 595-607.
14. Quadri S, Drake C, Hudgel DW. Improvement of idiopathic central sleep apnea with zolpidem. J Clin Sleep Med 2009; 5: 122-9.