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Sudden Improvement in PAP Download Indices Without Treatment Change.

Journal of Clinical Sleep Medicine, Vol. 15, No. 5 May 15, 2019 A 77-year-old woman with a history of atrial fibrillation (AF) and congestive heart failure with a left ventricular ejection fraction (LVEF) of 20% and moderate obstructive sleep apnea (OSA) presented to the sleep clinic. She was being treated with auto-adjusting positive airway pressure (APAP) using a pressure range of 6 to 12 cmH2O for an apnea-hypopnea index (AHI) of 18 events/h with 4 central apneas. During an initial sleep clinic visit a large amount of periodic breathing was noted on the APAP download and the 90% pressure was 10 cmH2O. The pressure range was narrowed to 6 to 10 cmH2O. A PAP titration was considered but delayed as the patient was scheduled for an ablation procedure for treatment of AF. The SLEEP MEDICINE PEARLS