Diagnosis and management of Cheyne-Stokes respiration as a complication of dilated cardiomyopathy in a 10-year-old child.

Abstract

Central sleep apnea due to Cheyne-Stokes respiration (CSA-CSR) is frequently described in adults with cardiac failure, but few (<20) cases are reported in children. We report the case of a 10-year old boy with dilated cardiomyopathy and cardiac failure (left ventricular ejection fraction 36%), in whom recurrent, prolonged pauses in breathing during sleep were noted. A cardiorespiratory polygraphy (CRpoly) sleep study was performed, which demonstrated the presence of CSA-CSR. 373 central events were scored and central apnea-hypopnea index (cAHI) was 47.4. Overnight continuous positive airways pressure (CPAP) was commenced via a nasal mask. Both child and mother reported improved well-being on CPAP, and a repeat CRpoly on CPAP noted a fall in cAHI to 1.2. We believe this to be the first case describing successful treatment of CSA-CSR in a child using CPAP. The improvement in patient well-being highlights the importance of a sleep history and/or sleep studies in children with cardiac failure.