수면정신생리

수면정신생리 (14권1호 49-53)

A Case of Mitochondrial Myopathy Showing Severe Hypoxemia during REM Sleep

렘수면중 심한 저산소혈증을 보인 사립체근병증 1례

Kim, Ju-Sang;Kim, Sung-Kyung;Lee, Sang-Haak;Ahn, Joong-Hyun;Kim, Chi-Hong;Moon, Hwa-Sik;

Department of Internal Medicine, The Catholic University of Korea College of Medicine;Department of Internal Medicine, The Catholic University of Korea College of Medicine;Department of Internal Medicine, The Catholic University of Korea College of Medicine;Department of Internal Medicine, The Catholic University of Korea College of Medicine;Department of Internal Medicine, The Catholic University of Korea College of Medicine;Department of Internal Medicine, The Catholic University of Korea College of Medicine;

Abstract

Mitochondrial myopathy is characterized by variable clinical manifestations from mild limb weakness to fatal respiratory failure and central nervous system sequela. But it is a rare event that sleep disordered breathing become a clue of diagnosis for mitochondrial myopathy. We report a case of a 21 year-old man who was diagnosed as mitochondrial myopathy during the investigation for the possible cause of chronic hypoventilation syndrome. Before being admitted to our hospital, he was suspected as having sleep apnea syndrome in another hospital. We re-evaluated the history, physical examination, laboratoy findings and polysomnography in detail. Severe hypoxemia was noted during REM sleep on nocturnal polysomnography and the diagnosis of mitochondrial myopathy was made by muscle biopsy in rectus abdominis muscle. We treated him with bilevel positive airway pressure therapy during sleep and it could reverse the hypoxemia during REM sleep. He could be discharged with improved condition and is being well with the use of this ventilatory assistance.

Keywords

Mitochondrial myopathy;REM sleep;Hypoventilation;Hypoxemia;