BENEFICIAL EFFECT OF OXYGEN IN PRIMARY ALVEOLAR HYPOVENTILATION WITH CENTRAL SLEEP-APNEA

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Abstract
A 58-yr-old man with primary alveolar hypoventilation, central sleep apnea, and secondary polycythemia failed to improve when treated with respiratory stimulant medications, including oxtriphylline, acetazolamide and medroxyprogesterone. After institution of treatment with low-flow nocturnal O2, there was a marked decreased in the number and duration of sleep apneas and an increase in the level of ventilation during sleep. These changes were sustained during 5 mo. of nocturnal O2 therapy. The improvement produced by O2 may have been due to the fact that the patient had no demonstrable ventilatory response to hypoxia during wakefulness and may have developed hypoxic brainstem depression during sleep. O2 therapy during sleep may be beneficial in patients with primary alveolar hypoventilation and central sleep apnea who demonstrate no ventilatory response to hypoxia during wakefulness.

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