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Cerebral anoxic attacks in sleep apnea syndrome
F Cirignotta1, M Zucconi, S Mondini
1Institute of Neurology, University of Bologna, Italy.
Sleep
|October 1, 1989
Summary
Severe obstructive sleep apnea (OSAS) caused prolonged apneas during REM sleep, leading to cerebral anoxic attacks. This case highlights a potential cause of sudden death or coma during sleep.
Area of Science:
- Neurology
- Sleep Medicine
- Pulmonology
Background:
- Obstructive sleep apnea (OSAS) is a common sleep disorder characterized by repeated upper airway collapse during sleep.
- Rapid eye movement (REM) sleep is a stage of sleep associated with vivid dreaming and muscle atonia.
Observation:
- A 52-year-old man with OSAS experienced cerebral anoxic attacks exclusively during REM sleep.
- Polysomnography revealed severe hypoxia due to exceptionally prolonged apneas, lasting up to 220 seconds.
- Electroencephalogram (EEG) and clinical data distinguished these attacks from epileptic seizures.
Findings:
- The prolonged apnea duration suggests a potential impairment in the mechanism that normally terminates apneas.
- The underlying cause of this apnea termination impairment remains unknown in this patient.
Implications:
- This case report suggests a novel pathogenetic mechanism for sleep-related sudden death or coma, distinct from cardiac arrhythmias.
- Understanding apnea termination mechanisms is crucial for managing severe OSAS and preventing potentially fatal outcomes during sleep.