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Resumo

The present case is particularly challenging in this patient's polycythemia, which occurred without concomitant respiratory diseases and with nocturnal oxygen desaturation secondary to obstructive sleep apnea (OSA). A male patient with mild OSA (Apnea-Hypopnea Index (AHI) and = 14.8/h and minimum oxygen saturation of 82%), poor nasal function, and polycythemia secondary to OSA (initial hemoglobin (Hb), 18 g/dL; hematocrit (HCT), > 50%) underwent treatment with a continuous positive airway pressure machine (CPAP), resulting in complete resolution of respiratory events. The patient reported discomfort with CPAP, which led to drug-induced sleep endoscopy with a simultaneous polygraphy sleep test. We performed interstitial reduction of the inferior turbinates using radiofrequency and physiotherapy to improve CPAP adaptation. This surgery improved CPAP compliance without any discomfort. Within a two-month follow-up, we observed a decrease of Hb = 16.4 g/dL and HCT = 48%, being both currently stable. Multidisciplinary and complete patient diagnosis allows for an individualized and assertive approach to OSA.