Pulmonary edema as a presenting feature of sleep apnea syndrome

Patients with sleep apnea syndrome may present with many types of cardiopulmonary abnormalities. Acute pulmonary edema, however, either as a part, or as the presenting feature, of the sleep apnea syndrome has not been reported to our knowledge. A 20-year-old obese woman with no history of cardiopulmonary disease presented twice to the emergency room because of sudden onset of shortness of breath. Each time her chest roentgenogram showed bilateral pulmonary edema. On nocturnal polysomnographic recording, the patient had obstructive apneic episodes; the longest apneic episode lasted 132 seconds. Complete resolution to her symptoms occurred following tracheostomy.