Abstract
We report a case of central sleep apnea syndrome (CSAS) presenting a Cheyne-Stokes like respiration that was normalized following a cardiac surgery. A 58-year-old male patient with insomnia, 156cm in height, and 60kg in weight was diagnosed as having severe nocturnal bradycardia by means of a 24hour EKG recording. Polysomnography performed prior to surgery revealed CSAS as well as bradycardia with concomitant hypoxia. After mitral commissurotomy and aortic valvuloplasty, the examinations showed improvements of CSAS, bradycardia and concomitant hypoxic episode. It suggested that CSAS of the present case was cured by the surgical intervention to the cardiac pathology. After improvement of cardiac performance, the patient might regain the compensatory property for nocturnal circulatory depression associated with the sleep apnea and the concomitant hypoxia. As a consequence, the instability of the respiratory center might be prevented. The clinical implication of this report might be that pre-existing cardio-respiratory diseases could worsen cardio-respiratory depres-sion induced by sleep apnea and concomitant hypoxia, and vice versa.
