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Respiratory arrest requiring resuscitation as a rare presentation of obstructive sleep apnoea and hypothyroidism
  1. Ka Yan Chiang1,
  2. Tammy Sin Kwan Ma2,
  3. Mary Sau Man Ip1 and
  4. Macy Mei Sze Lui1
  1. 1 Department of Medicine, University of Hong Kong, Hong Kong
  2. 2 Adult Intensive Care Unit, University of Hong Kong, Hong Kong
  1. Correspondence to Dr Macy Mei Sze Lui, macymslui{at}


A 79-year-old man, who had significant cardiovascular morbidities, presented with out-of-hospital respiratory arrest. He regained breathing after brief cardiopulmonary resuscitation by his paramedic son. After meticulous investigations, acute cardiovascular events and metabolic causes were ruled out while features of obstructive sleep apnoea were elicited. The findings on in-laboratory polysomnography were compatible with severe obstructive sleep apnoea, with unusually prolonged apnoea duration of up to 2.7 min which most likely accounts for the presentation as ‘respiratory arrest’. Thyroid function test for investigation of his weight gain confirmed hypothyroidism. His symptoms improved gradually after positive airway pressure therapy with bi-level support and thyroxine replacement. On further evaluation, his hypothyroidism is believed to be a complication of long-term amiodarone exposure. The case highlights that the combination of obstructive sleep apnoea and hypothyroidism can lead to catastrophic manifestation and the unusually long apnoea could be a feature prompting further workup for possible hypothyroidism.

  • CPAP
  • thyroid disease
  • sleep disorders (respiratory medicine)

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  • Contributors All authors were involved in writing and editing the manuscript prior to submission, and approve the submitted version. K-YC, TSKM and MMSL reviewed the literature about the report subjects. MSMI and MMSL were directly involved in the care of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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