Sleep-related breathing disorder and bradyarrhythmias, why to use continuous positive airway pressure (CPAP)...

In this report we describe the case of a 69-year-old woman, with a medical history of onset of asthenia, worsening of dyspnoea for mild efforts (class NYHA II) and events of nocturnal dyspnoea (without orthopnea or edema of lower limbs). The patient presents hypertension, dyslipedaemia and obesity (BMI 38 kg/m²) as cardiovascular risk factor. A previous 24-h Holter monitoring documents bradycardic events and sinusal pauses. The ergometric test and the echocardiogram do not show particulary pathological features. After a careful anamnesis about nocturnal events of dyspnoea and about daytime tiredness, and the Epworth questionnaire regarding the relationship between sleep-related breathing disorder and cardiovascular disease, we perform cardiorespiratory sleep study that shows a diagnosis of obstructive sleep apnea syndrome (OSAS). The patient begins therapy with continuous positive airway pressure (CPAP) during the night. It is shown a considerably decrease of bradycardic events during the night after a period of this treatment.