Resolution of central sleep apnea following upper airway surgery: A case report

Abstract

Introduction: Central sleep apnea (CSA) and obstructive sleep apnea (OSA) are characterized by recurrent pauses in breathing secondary to decreased central respiratory drive and upper airway obstruction, respectively. Oropharyngeal surgery is not a treatment option for CSA but may be considered in select patients with OSA.

Case presentation: A 37-year-old female presented with an Apnea Hypopnea Index (AHI) of 122/hour that included a Central Apnea Index (CAI) of 74/hour, and chronic tonsillitis with tonsillar hypertrophy and a baseline BMI of 36 kg/m². Complete resolution of CSA and marked improvement in sleep were noted following tonsillectomy combined with expansion pharyngoplasty.

Conclusions: Although there can be significant overlap between OSA and CSA, resolution of CSA following soft tissue oropharyngeal surgery in an adult has not been previously reported. For this patient an unusual underlying pathophysiology, possibly post-arousal in nature, may explain the unanticipated outcome.

Keywords: CSA; Case report; Expansion pharyngoplasty; OSA; Semaglutide; Tonsillectomy.