Objective: The purpose of this case report is to describe the chiropractic management of an infant with the clinical presentation of central sleep apnea.
Clinical Features: A five-month old male with a history of respiratory distress following sleeping intervals which began at 10 weeks of age. The diagnosis of central sleep apnea was given at approximately 3 months of age based on the readings of an apnea monitor. The patient was managed with 50 mg QD caffeine citrate and 15 mg Prevacid. After five months of chiropractic care, the patient's parents noted the bradycardia alarm sounded every night at the same time. The neurologist, working under the suspicion of a mitochondrial disorder, planned to schedule a muscle biopsy and genetic testing. After discussion with the pharmacist, the mother hypothesized that the bradycardia events were due to caffeine. As the baby matured, his metabolism was utilizing the caffeine more rapidly, causing the drop in heart rate. Once the child was weaned off the caffeine citrate, but still on the Prevacid, the bradycardia events subsided. The apnea events did not resolve, but diminished and rarely set off the alarm.
Intervention and Outcome: Chiropractic treatment plan consisted of gentle upper cervical adjustments and craniosacral therapy administered 12 times over a 6-month period. The results demonstrated a decrease of complete elimination of the total amount of apneic and bradycardic events recorded on the monitor. This case report is designed to explore whether chiropractic care might benefit an infant with idiopathic central sleep apnea and demonstrates a multidisciplinary approach to care which may prevent errors in diagnosis and treatment as a patient heals.
Conclusion: This case report suggests that chiropractic care including craniosacral therapy may provide a complement to traditional treatment options. It is difficult to objectively assess the contribution of chiropractic care based on the number of interventions performed that prepared the child for healing to the point of no longer needing a caffeine citrate prescription. But this case suggests that further study into the benefits of chiropractic care on sleep apnea disorders is warranted.
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