0804 Sleep-disordered Breathing in Myelomeningocele and Chiari II Malformation: Our Experience at a Tertiary Care Center

Abstract Introduction Children with myelomeningocele (MMC) and Chiari Malformation type II (CMII) have some degree of sleep-disordered breathing (SDB), which may include central apnea, obstructive hypoventilation. Untreated SDB lead to growth failure, neurocognitive behavioral abnormalities, cor pulmonale, death. There is no standardized diagnostic management protocol be followed if suspected in a patient CMII MMC. Methods Variability physician practice patterns was assessed for patients MMC having at tertiary care center from January 2008 December 2018. Results 180 CM2 were identified. Pulmonology/Sleep providers consulted on 63 them. A sleep study ordered 73% these patients, snoring being the most common indication. Most had mean AHI 6 events/h. Recommendations after included supplemental oxygen (20%), non-invasive positive airway pressure initiation (9%), subspecialty referral 35% (otolaryngology neurosurgery), tracheostomy mechanical ventilation 10% patients. Conclusion In large center, there significant variability clinical children who SDB. Clinicians caring should consider PSG enhance early diagnosis could complement judgment this complex population. Support (if any)