1185 Cheyne-Stokes Respirations and Central Sleep Apnea in the Setting of Lacunar Infarct: A Case Report

Introduction Cheyne-Stokes respirations and central sleep apnea have been correlated to large areas of cerebral infarction and with smaller events such as transient ischemic attacks. Few studies and cases have analyzed and reported the association between Cheyne-Stokes respirations and lacunar infarct, an intermediary of the two extremes of cerebral events. Report of case(s) Mr. T is an 87 year old male who originally was referred to the University of Kentucky sleep medicine clinic due to symptoms of worsening daytime hypersomnia and snoring; he had never had a sleep study. His Epworth Sleepiness Scale score was 11. Patient underwent sleep study, which found severe obstructive sleep apnea with concern for Cheyne-Stokes respirations and central sleep apnea. Medications were reviewed, none of which were contributory. With patient’s history of transient ischemia attack and atrial fibrillation, work up included an echocardiogram, which showed an ejection fraction of 50-60%, CPAP titration study, which showed severe CSA, and an MRI brain, which showed evidence of old lacunar infarct. Ultimately, the patient had BIPAP S/T titration which ordered pressures of 21/13 and rate of 12. Currently patient’s pathologies are well controlled, as evidenced by his last sleep study and AHI of 1.8. He continues to have some issues with leak, for which he is trialing different masks. Conclusion Cheyne-Stokes respirations and central sleep apnea are present in patients with history of multiple types of cerebral events. With lacunar strokes constituting 25% of ischemic strokes, it is imperative to make the correlation between Cheyne-Stokes respirations, central sleep apnea, and lacunar infarct in patients with otherwise no clear etiology of those sleep pathologies. Support (if any)