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Case 40 - “So tired I take naps in the morning”

from Part VIII - Neuromuscular disorders and sleep

Published online by Cambridge University Press:  10 November 2010

By
Antonio Culebras
Edited by
Antonio Culebras
Antonio Culebras
Affiliation:
Upstate Medical University, New York
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Summary

This chapter discusses the case of a 37-year-old man referred to the sleep center for evaluation of excessive daytime fatigue and sleepiness that had been present for several years. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. The polysomnography (PSG) evaluation showed abnormal results with an apnea-hypopnea index (AHI) of 77 events per hour of sleep. The diagnosis was obstructive sleep apnea (OSA) of severe intensity and Charcot-Marie-Tooth disease (CMT). The most common complaint is excessive daytime sleepiness (EDS) resulting from repeated arousals and sleep fragmentation caused by sleep-disordered breathing, hypoventilation, nocturnal hypoxemia or a combination of all three. Patients with CMT have a high prevalence of obstructive sleep apnea syndrome (OSAS). Phrenic nerve paralysis has also been reported in patients with CMT complicated with diabetes mellitus.

Keywords

differential diagnosisdrowsinessEEGNREM-sleep-arousal parasomniasovernight video-polysomnographyneurological examinationnocturnal frontal lobe epilepsyREM-sleep behavior disorder
Type
Chapter
Information
Case Studies in Sleep Neurology
Common and Uncommon Presentations
 , pp. 281 - 286
Publisher: Cambridge University Press
Print publication year: 2010

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