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Obstructive sleep apnea: far beyond sleepiness
Sleep related-eating disorder (SRED) is a condition characterized by recurrent episodes of unconsciously eating during sleep, preferably by caloric foods, and sometimes inedible items. Weight gain and obesity are common adverse effects. Obstructive sleep apnea related headache (OSAH) is associated with the use of medications and comorbidities such as sleepwalking, restless legs syndrome, and OSA, and resolution with treatment. OSA-related headache is a type of problem that improves after controlling for respiratory events during sleep.
We aims to describe a patient with SRED and OSAH, besides other commons symptoms of OSA
We reported a patient with Sleep-Related Eating Disorder (SRED) and Obstructive Sleep Apnea related headache (OSAH), with significant improvement after appropriate treatment.
Case presentation: Male, 48 years old, complaining of snoring, mouth breathing, nocturia cough, and sleep sweating. Besides this, morning dry mouth, and excessive sleepiness (ES). Patient and caregiver reported unconscious food intake during sleep, with a weight gain of 40kg in 5 years. An attempt was made to ingest cosmetic and automotive wax. He has a normal daytime eating behavior. Also, he complained about moderate to severe awakening headache, with improvement after 10 minutes. Previous diagnosis of Bipolar Affective Disorder using quetiapine and carbolitium. On examination, BMI of 42.21 kg/m², Mallampati class 4, and macroglossia. Polysomnography showed a Respiratory Disturbance Index of 100.5 events/ hour, with significant desaturation. Polysomnography for continuous positive pressure titration (CPAP) determined a fixed pressure of 15 cmH₂O. After six months of regular CPAP use, he has reported a decrease in ES, an improvement in eating episodes during sleep, and other symptoms.
It is essential in the evaluation of OSA to consider other symptoms in addition to widespread respiratory complaints, as well as related entities such as SRED and OSA-related headache.
Obstructive Sleep Apnea; Sleep related eating disorder; Obstructive Sleep Apnea related headache
Relato de Caso
EMMANUELLE SILVA TAVARES Sobreira, CLARA MOTA RANDAL Pompeu, GABRIELA ANDRADE MEIRELES Bezerra, Jéssica Castro Vidal Sousa, Camila Rego Muniz, Patrícia Gomes Damasceno, Isabella Melo Matos, Alessandra Caland-Noronha, Camila Ferreira Leite, Manoel Alves Sobreira-Neto