0864 Severe Central Sleep Apnea

Abstract Introduction Central sleep apnea (CSA) is a rare form of disordered breathing with repeated apneic episodes absence associated respiratory effort. CSA due to medication well described in literature opiate therapy. Baclofen which gamma-aminobutyric acid-B agonist muscle relaxant properties has been implicated CSA. We present case likely chronic baclofen use. Patient underwent polysomnogram (PSG) while on therapy revealed severe central apnea. was weaned off completely and subsequent PSG performed resolution the Methods 28 year old male cerebral palsy neurogenic bladder who presented for evaluation snoring, insomnia non-refreshing sleep. Overnight further his related complaints therapy, Trial positive airway pressure treatment supplemental oxygen were attempted during but had be terminated intolerance. Echocardiography magnetic resonance imaging brain rule out congestive heart failure Chiari malformation respectively, no underlying pathology explaining this patient thought repeat revealing Results 1st diagnostic - Baclofen: 139 apneas, 6 obstructive 3 mixed apnea, 38 hypopneas. This study showed The apnea-hypopnea index (AHI) 51.5, REM 21.8 supine 51.5. 39.5. Respiratory events moderate desaturations. mean saturation 92.8%, minimum 81%. spent 2.9 minutes an equal or less than 88% entire study. CPAP titration aborted, having difficulty tolerating CPAP. Supplemental briefly added at 0.5 LPM, also discontinued complaining burning sensation nose. Head bed elevated several levels (20 degrees, 30 degrees 45 degrees) did not attenuate events. 2nd Diagnostic – Sleep efficiency reduced 59.4%. onset latency 7.5 minutes. 163 100% total time position Moderate snoring. 4.2, 36.5 4.2. mainly noted using 93.9%, 83%. 1.2 Labs Workup after first Echo MRI brain, Therefore, baclofen. Conclusion male, concurrent past medical history palsy, bladder. Presented, initially medicine clinic insomnia, Wheelchair bound. Has spasticity, Underwent initial study, snoring insomnia. doses. His Oxygen nadir echo, explain list concern driving force behind As result, stopped. Repeat overall AHI greatly improved from In closing side effect profile leading case, recommend alternative place Support (If Any) 1. Ghanavatian S, Derian A. Baclofen. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 15, 2021.2. Locatelli F, Formica Galbiati et al. Polysomnographic Analysis Pediatric Case Baclofen-Induced Apnea. J Clin Med. 2019;15(2):351-354. Published 2019 Feb 15. doi:10.5664/jcsm.76443. Olivier PY, Joyeux-Faure M, Gentina T, Severe Apnea Associated With Chronic Therapy: A Series. Chest. 2016;149(5):e127-e131. doi:10.1016/j.chest.2015.10.001