Coexistence of Sleep Apnea and Asthma Resulting in Severe Sleep Hypoxemia

ALTHOUGH significant hypoxemia may be present during status asthmaticus,¹ severe hypoxemia is unusual in chronic bronchial asthma.² We report the case of a patient with chronic bronchial asthma who had mild hypoxemia while awake, but the patient was unusual in that he had erythrocytosis. During sleep he had severe hypoxemia that was primarily due to obstructive apnea. A tracheostomy was required for effective treatment of the apnea and hypoxemia.

Report of a Case  A 66-year-old man from Detroit was referred to National Jewish Hospital and Research Center for evaluation and treatment of asthma. The patient had frequent episodes of intermittent dyspnea accompanied by wheezing for 2 1/2 years before admission. He had never been a cigarette smoker and produced minimal sputum. The patient reported more dyspnea during sleeping hours and awakening almost hourly. His spouse related a history of his loud snoring accompanied by fitful sleep, which had