Adaptive servo‐ventilation for the treatment of intrathecal baclofen‐induced central sleep apnea: A case report

Abstract

Abstract Baclofen is a common muscle relaxant agent used in a number of neurological disorders acting at central level and potentially causing adverse respiratory events, still largely unknown at therapeutic doses. We present the case of a young woman with spastic tetraparesis secondary to perinatal asphyxia treated with a standard dose of intrathecal baclofen who developed nocturnal symptoms, somnolence and memory loss during the day. Nocturnal cardio‐respiratory sleep monitoring showed a high number of central sleep apneas (CSA). The patient was adapted and treated with a positive air pressure device, Adaptative Servo‐Ventilator, specific designed to treat CSA particularly in patients with heart failure. The treatment was well tolerated and within few days CSA was reversed. The patient reported a feeling of restful sleep and disappearance of morning tiredness. The efficacy of the treatment was verified with nocturnal cardio‐respiratory monitoring after 2 months and complete resolution of all symptoms was also confirmed.

Keywords

• baclofen
• central sleep apnea
• CPAP
• servo‐ventilation
• sleep‐disordered breathing
• spastic tetraparesis