Improvement in sleep apnea associated with closure of a patent foramen ovale

Recent reports have documented an association between patent foramen ovale and obstructive sleep apnea. We report on a 51-year-old man with obstructive sleep apnea and recent stroke who was enrolled in a clinic trial evaluating the efficacy of closure of patent foramen ovale following ischemic stroke. He was randomly assigned to device closure. There was subjective dramatic improvement in sleep-apnea symptoms and objective improvement in polysomnographic testing after device implantation. Aside from a drop in apneas and hypopneas from 181 and 8 on the first polysomnogram to 19 and 0 on the second, there was no significant weight loss nor were there other significant changes in sleep parameters or medications. He stopped using continuous positive airway pressure 2 months after implantation and has had no recurrent sleep complaints during 18 months of follow-up. Further studies evaluating the relationship among patent foramen ovale, sleep apnea, and device implantation are warranted.