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Volume 14 No. 03
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Case Reports

Persistent High Residual AHI After CPAP Use

Leay Kiaw Er, MD, MPH1,2; Shinn-Kuang Lin, MD2,3; Stephen Shei-Dei Yang, MD, PhD2,4; Chou-Chin Lan, MD, PhD2,5; Yao-Kuang Wu, MD2,5; Mei-Chen Yang, MD2,5
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, New Taipei City, Taiwan; 2School of Medicine, Tzu-Chi University, Hualien, Taiwan; 3Stroke Center and Department of Neurology, Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, New Taipei City, Taiwan; 4Department of Urology, Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, New Taipei City, Taiwan; 5Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, New Taipei City, Taiwan

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.

Citation:

Er LK, Lin SK, Yang SS, Lan CC, Wu YK, Yang MC. Persistent high residual AHI after CPAP use. J Clin Sleep Med. 2018;14(3):473–478.




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