0849 Baclofen-induced severe central sleep apnea

Abstract Introduction Baclofen is a gamma-aminobutyric acid-B agonist that targets neurons in the spinal cord and brain. It has skeletal muscle-relaxant properties FDA approved to treat spasticity from injury (SCI), multiple sclerosis, or traumatic brain injury. Off label use includes treatment of alcohol disorder, hiccups, muscle spasms. A rare respiratory side effect baclofen apnea, with reports baclofen-induced central sleep apnea (CSA) pediatric patient four adults disorder. We describe case severe CSA veteran T7 paraplegia due chronic use. Report Cases: 42-year-old was referred medicine for unrefreshing sleep. He had remote history complicated by being treated oral (40 mg TID). Further evaluation obtained baseline polysomnography. total 146 hypopnea events were observed (5 obstructive apneas, 131 4 mixed apneas 6 hypopneas) an AHI 43.2 events/hour. Minimum oxygen saturation 85% 0.3 minutes spent <89%. Respiratory pattern suggestive crescendo decrescendo breathing but did not meet diagnostic criteria Cheyne-Stokes respiration (cycle length <40 seconds). Other causes investigated unrevealing. diagnosis made. Conclusion Spasticity common consequence SCI commonly managed baclofen. Apnea can significantly impact patients’ quality overall life. Our highlights how providers should have high suspicion sleep-disordered patients 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 Central Sleep 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 Associated With Chronic Therapy: Series. Chest. 2016;149(5):e127-e131. doi:10.1016/j.chest.2015.10.001