Multiple System Atrophy with Progressive Nocturnal Hypoxemia: Case Report with Polysomnography and Continuous Positive Airway Pressure Treatment

A 6 1-year-old woman, with no past his-tory of cardiopulmonary diseases, devel-oped a gait disturbance at age 57 and uri-nary incontinence and orthostatic hypo-tension at age 58, all of which steadily worsened. At age 59, she presented with nocturnal stridor and daytime sleepiness. At age 60, she was admitted to our hospital for the evaluation of the cause of her noc-turnal stridor. Her height and weight were 146.5 cm and 54.5 kg, respectively (body mass index 25.4). A chest X-ray revealed normal findings, but arterial blood gas ex-amination in room air showed a mild hy-poxemia (PaO