Should cardiologist routinely screen and evaluate patients for sleep disordered breathing?

Abstract

We report a case of a 61-year-old male patient who presented with reduced exercise capacity, dyspnea, lower limbs oedema, irregular heart rhythm, loud, irregular snoring, history of poorly controlled hypertension, nocturnal hypertension spikes, and morning headaches. Patient underwent ECG Holter monitoring and polygraphy, which revealed severe obstructive sleep apnea. In ECG Holter monitoring atrial fibrillation with pauses to 6.5 s were observed. Patient was referred for continuous positive airway pressure (CPAP) treatment. Three-months of CPAP therapy resulted in significant decrease in apnea-hypopnea index (31.6/h vs. 5.1/h) and better control of hypertension and heart failure. CPAP treatment allowed us to reduce patient's cardiovascular risk. Cardiologist should routinely screen and evaluate patients for sleep disordered breathing, especially when patients are obese, have hypertension and/or arrhythmias. Copyright © Polskie Towarzystwo Kardiologiczne.