Resolution of syncope with treatment of sleep apnea

Sleep apnea is a common disorder associated with obesity and related health problems. Although treatment of sleep apnea may relieve some autonomic symptoms, it is currently unknown whether treatment of sleep apnea is specifically associated with the resolution of orthostatism and syncope. Herein we describe a 73-year-old man who had recurrent episodes of syncope. An extensive work-up, including cardiac and neurologic consultations, failed to identify the cause. An objective sleep evaluation led to the diagnosis of sleep apnea. Accordingly, the patient was treated with continuous positive airway pressure, which resolved the syncopal episodes. This case report generates a potentially important hypothesis that recurrent syncope may be effectively treated, in part, by correcting apnea. In patients with recurrent syncope of unknown etiology, a diagnosis of sleep apnea should be considered.