International Journal of Emergency Mental Health and Human Resilience
Open Access

Case Report

Sleep apnea in Chiari I malformation

Maher Abouda^1*, Ferdaous Yangui², Senda Turki², Mehdi Charfi²

¹University of Tunis El-Manar, Faculty of Medicine of Tunis, Respiratory and Sleep Medicine, FMT Bab Saadoun, TN 1004, Tunis, Tunisia

²University of Tunis El-Manar, Faculty of Medicine of Tunis, Interior Security Forces Teaching Hospital. FMT Bab Saadoun, TN 1004, Tunis, Tunisia

Corresponding Author:

Maher Abouda
University of Tunis El-Manar, Faculty of Medicine of Tunis
Respiratory and Sleep Medicine, FMT Bab Saadoun, TN 1004,Tunis, Tunisia
E-mail: maherabouda@yahoo.fr

A 36-year-old non-obese woman consulted her physician for recent excessive daytime sleepiness (EDS) with Epworth sleepiness scale (ESS) at 13/24, morning headache and heavy snoring. Polysomnography revealed moderate mixed sleep apnea syndrome with an Apnoea–Hypopnoea Index (AHI) of 23/h (Figure 1). Despite adequate continuous positive airway pressure (CPAP) therapy, the patient reported an aggravation of EDS and headache. A second polysomnography with CPAP, conclude to moderate complex sleep apnea syndrome by revealing the persistence of numerous central sleep apnea (AHI of 21/h) but no evidence of obstructive events. The patient reported a sensation of unrefreshing sleep and EDS (ESS at 17/24) with no symptoms suggesting cardiac failure, periodic limb movement disorder or narcolepsy. Physical examination, including neurologic and cardiac examinations, was normal. Routine blood tests, arterial blood gas analysis and echocardiography were performed and showed no significant abnormalities.

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