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Yıl:2014; Cilt: 1; Sayı: 1>> Özet
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Türk Uyku Tıbbı Dergisi; 2014;1(1):33-35
Obstrüktif Uyku Apne Sendromlu Bir Hastada Polisomnografi Tetkiki Esnasında Solunum Arrestine Bağlı Exitus
G Benbir, M Nalbantoğlu, D Karadeniz
İstanbul Üniversitesi, İstanbul
Obstrüktif Uyku Apne sendromu (OUAS) komplikasyonları arasında hayati önem taşıyan hipertansiyon, inme, iskemik kalp hastalığı ve kardiyak ritim bozukluğu gibi hastalıklar yer almaktadır. Kırk yaşında kadın hasta, şeker hastalığı, hipertansiyon, hipofiz mikroadenomu ve Cushing sendromu tanıları ile Endokrinoloji servisinde yatmakta iken, gece uykusunda nefes durmalarının gözlenmesi üzerine uyku bozuklukları birimimize yönlendirildi. Hastanın son 10 yıldır horlama, terleme, sabah yorgun uyanma ve gündüz aşırı uykululuk şikayetleri olduğu öğrenildi. Polisomnografi tetkikinde solunum kayıtlarında NREM uyku evresinde sürekli, saatte 60 sıklığında tekrarlayan obstrüktif tipte hipopneler kaydedildi. Hastanın REM uyku evresine girmesi ile birlikte 100 saniye süreli santral apne ve bunu takiben bradikardi ve kardiyak arrest gelişmiş, hasta tüm müdahalelere karşın kurtarılamamıştır. Burada, hayati riskleri olan ancak etkin tedavisi (invaziv olmayan mekanik ventilasyon) ile tüm komplikasyonları ortadan kaldırılabilen önemli bir nörolojik hastalık olan obstrüktif uyku apne sendromuna tüm branştaki hekimlerin dikkatinin çekilmesi hedeflemiştir. Özellikle hipertansiyon, obezite ve kalp hastalıkları gibi eşlik eden komorbiditelerin varlığında dikkatlice sorgulanmalı ve ivedilikle tedavi edilmelidir. Sunulan olguda olduğu gibi tanı ve tedavideki gecikmeler, ölümcül sonuçlar doğuracaktır.
Exitus Secondary to Respiratory Arrest in a Patient with Obstructive Sleep ApneaDuring Polysomnographic Investigation
Obstructive sleep apnea syndrome (OSAS) has severe, life-threatening complications such as hypertension, stoke, ischemic heart disease or rhythm problems. A 40-year old woman was referred to our sleep laboratory due to witnessed apnea during her hospitalization in endocrinology yard because of hypertension, hipophyseal microadenoma and Cushing syndrome. Her past medical history revealed that she had snoring, sweating at night, tiredness in morning and excessive daytime sleepiness for the last 10 years. In polysomnography investigation, we observed continuous obstructive hypopneas during NREM sleep stage with an index of 60 (times per an hour). As she started to have REM sleep stage, she had a central apnea lasting for 100 seconds, followed by bradicardia and cardiac arrest; the patient was lost in spite of urgent intervention. Here we aimed to attract attention of physicians from all disciplines to OSAS, which is a neurological life-threatening condition but all complications could be removed by non-invasive mechanical ventilation therapy. Especially in the presence of hypertension, obesity and cardiac disorders, OSAS should be questioned in detailed and be treated immediately. Otherwise, delay in diagnosis and treatment would result in lethal consequences, as in the patient reported here.

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