Impact of nasal continuous positive airway pressure for congenital adrenal hyperplasia with obstructive sleep apnea and bruxism.

Satoshi Hamada, Kazuo Chin, Takefumi Hitomi, Toru Oga, Tomohiro Handa, Tomomasa Tuboi, Akio Niimi, Michiaki Mishima

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Sleep & breathing = Schlaf & Atmung 2012 Mar

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Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders in humans. The most frequent CAH variant is 21-hydroxylase deficiency. Patients with 21-hydroxylase deficiency require long-term glucocorticoid replacement treatment. Although sleep disturbance is frequently observed under glucocorticoid replacement treatment, a case of obstructive sleep apnea(OSA) in patients with CAH has not been reported. A 43-year-old man with CAH who complained about sleep disturbance and sleep bruxism was diagnosed as obstructive sleep apnea (OSA) by polysomnography (PSG). Following the introduction of nasal continuous positive airway pressure (nCPAP), his sleep disturbance with symptoms also improved; in addition, he was able to reduce the dose of glucocorticoid replacement therapy without any adverse consequences on his sleep pattern. Physicians who treat a patient with CAH should know the possibility in the existence of OSA in their patients. Because symptoms with OSA in CAH patient may increase the dosage of long-term glucocorticoid treatment for the patient, which may induce several adverse effects including body weight gain on the patient.

Citation

Satoshi Hamada, Kazuo Chin, Takefumi Hitomi, Toru Oga, Tomohiro Handa, Tomomasa Tuboi, Akio Niimi, Michiaki Mishima. Impact of nasal continuous positive airway pressure for congenital adrenal hyperplasia with obstructive sleep apnea and bruxism. Sleep & breathing = Schlaf & Atmung. 2012 Mar;16(1):11-5