Abstract
Background: Patients waiting for and having received lung transplantation commonly demonstrate known risk factors for sleep disordered breathing (SDB) including central sleep apnea (CSA). However, little is known is about the prevalence or clinical implications of SDB in this patient population. Methods: We report a 61 year old man who underwent uncomplicated bilateral lung transplantation. Approximately 5 weeks post-transplant, the patient developed fatigue, somnolence, and mild intermittent confusion. Extensive cardiologic and neurologic evaluations were unrevealing regarding cause of symptoms. Diagnostic polysomnogram revealed severe central sleep apnea with a periodic respiratory pattern. Results: The patient was initiated on positive airway pressure therapy during sleep with an adaptive servoventilation device which successfully treated central sleep apnea and improved daytime symptoms. A repeat diagnostic polysomnogram performed 8 months post-transplant showed resolution of central sleep apnea. Conclusion: SDB including CSA is a poorly understood occurrence in the lung transplantation patient population that warrants clinical attention and further investigation.
Highlights
Patients waiting for and having received lung transplantation commonly demonstrate known risk factors for sleep disordered breathing (SDB) including central sleep apnea (CSA)
A 61 year old man underwent bilateral lung transplantation for respiratory failure due to severe chronic obstructive pulmonary disease (COPD).The surgical course was without significant complication and the patient was extubated without difficulty
The immediate post-operative period was significant for an isolated episode of atrial fibrillation with rapid ventricular response requiring cardioversion
Summary
We report a 61 year old man who underwent uncomplicated bilateral lung transplantation. 5 weeks post-transplant, the patient developed fatigue, somnolence, and mild intermittent confusion. Extensive cardiologic and neurologic evaluations were unrevealing regarding cause of symptoms. Diagnostic polysomnogram revealed severe central sleep apnea with a periodic respiratory pattern
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