0981 Complex Sleep Apnea in a Patient with ROHHAD

Abstract Introduction Rapid onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare disorder associated sleep disordered breathing. Patients often have obstructive apnea (OSA) nocturnal hypoventilation (NH). We present case unique breathing pattern demonstrating both severe central demonstrated on two separate polysomnograms no evidence of significant NH. Report case(s) The patient now 8 year old girl who was initially diagnosed ROHHAD in October 2020 at age 5 years symptoms rapid weight gain, dysfunction (hyperprolactinemia), (recurrent fever, hypertension). Diagnostic polysomnography May OSA (oAHI 23.4/hr) as well (CAI 63.9/hr). SaO2 nadir 88% 15 minutes spent below 90%. There NH, however the CO2 greater than 50 mmHg for 9.5% total time. Subsequent titration study recommended BPAP ST 14/10 cmH20 back up rate (BUR) 12 bpm. had repeat split night 2022 7 years. During diagnostic portion, she persistent 39/hr) 21/hr). NH max TCO2 > 0.2% 18/10 BUR bpm led to resolution events. Conclusion remains disease which While there been reports CSA ROHHAD, none this severity. may be representation dysfunction, previous literature has described pauses patients while awake. did not either polysomnogram, one hallmarks disease, it that develop later course disease. Thus, important routinely screen their evolves. Support (if any)