1032 Mixed sleep apnea management in a pediatric patient with Arnold Chiari type 1 and septo-optic dysplasia leading to hypopituitarism

Abstract Introduction Mixed Sleep apnea and Central sleep are commonly noted in a patient with Arnold Chiari Malformation definitive treatment of is surgical decompression. Report case(s) The at the time diagnosis was 7 years old. She had already undergone tonsillectomy adenoidectomy age 4 years. Due to continued Sleep-disordered breathing, PSG done 2016 which showed predominantly mixed central events. MRI revealed 1 malformation cerebellar tonsils extending 6 mm below foramen magnum. also due septo-optic dysplasia hypopituitarism followed pediatric endocrinology on supplementation Desmopressin, Hydrocortisone, Levothyroxine, Somatropin. mother pregnancy substance abuser, incarcerated primary care assumed by patient’s legal guardian. guardian not interested surgery for as she feared long-term outcomes requested alternate options. underwent another split study started CPAP. did tolerate CPAP transitioned BiPAP. During her last clinic visit, compliance improved achieved therapeutic AHI. counseled effects GH untreated regularly Medicine Pediatric Endocrinology. after transitioning BiPAP has responded well apnea. Despite being supplementation, careful monitoring hormone levels Endocrinology symptom control Medicine, shown remarkable improvement. Conclusion secondary responds decompression improvement sleep-disordered breathing. In complicated medical history needing stress dose steroids, candidate surgery, intolerant CPAP, modality good Apnea. Support (if any)