TY - JOUR T1 - Respiratory arrest requiring resuscitation as a rare presentation of obstructive sleep apnoea and hypothyroidism JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-230163 VL - 12 IS - 8 SP - e230163 AU - Ka Yan Chiang AU - Tammy Sin Kwan Ma AU - Mary Sau Man Ip AU - Macy Mei Sze Lui Y1 - 2019/08/01 UR - http://casereports.bmj.com/content/12/8/e230163.abstract N2 - 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. ER -