A 17-Year-Old Male With Exertional Dyspnea and Somnolence.

Abstract

A 17-year-old previously elite-level tennis player was referred with dyspnea, fatigue, and excessive sleepiness during prolonged matches. He would become somnolent between tennis sets to the point where he had several episodes of near collapse during play. He was not excessively sleepy during the day (Epworth Sleepiness Scale score 6) and did not report any non-exertional episodes of collapse or cataplexy. His medical history was notable for a significant road traffic accident at age 10, requiring endotracheal intubation and prolonged ventilation for 14 days. His recovery was complicated by subglottic stenosis that was later repaired with laryngotracheal reconstruction. At age 13, he underwent subglottic balloon dilatation as well as a left arytenoidectomy and division or interarytenoid scar band. The patient was referred to a specialized dyspnea service for further evaluation.