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[Clinical Picture] Continuous positive airway pressure device detects atrial fibrillation induced central sleep apnoea

A 64-year-old male physician with obstructive sleep apnoea presented for a scheduled outpatient follow-up appointment. He reported that the week before he had developed palpitations and shortness of breath, and was diagnosed with atrial fibrillation. Information downloaded from his continuous positive airway pressure (CPAP) device showed excellent adherence and a residual apnoea-hypopnoea index (AHI) of 2·8 events per h. Closer inspection of the information for the evening of the arrhythmia on Oct 3, 2017, showed a significant increase in the nightly residual AHI, a predominance of central sleep apnoea episodes, and a crescendo-decrescendo pattern of airflow consistent with classic Cheyne–Stokes respiration (figure).