Obstructive sleep apnea in heart transplant patients. A report of five cases

Clinically significant obstructive sleep apnea syndrome (OSAS) was diagnosed in five patients who had undergone heart transplantation and they represent 2.5 percent of our transplantation series. To determine if these individuals had unique clinical features that would have suggested the presence of OSAS, we reviewed their case histories. Although four of five patients had symptoms of OSAS prior to transplant, none was suspected of having the diagnosis before their surgery. Excessive daytime sleepiness and loud snoring were noted in all patients, and there were no unusual clinical features that characterized these individuals. Our data indicate that the occurrence of OSAS in heart transplant recipients approximates the prevalence in the general population. Because OSAS may adversely affect cardiac function, we recommend that heart transplantation candidates be screened for a history suggestive of OSAS, and that polysomnography be performed if it is present.