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Severe Central Sleep Apnea Associated With Chronic Baclofen Therapy: A Case Series

Pierre-Yves Olivier, MD; Marie Joyeux-Faure, PharmD, PhD; Thibaut Gentina, MD; Sandrine H. Launois, MD, PhD; Marie Pia d’Ortho, MD, PhD; Jean-Louis Pépin, MD, PhD; Frédéric Gagnadoux, MD, PhD
Author and Funding Information

Drs Pépin and Gagnadoux contributed equally to this publication.

CORRESPONDENCE TO: Frédéric Gagnadoux, MD, PhD, Université d'Angers, CHU Angers, Département de Pneumologie, 4 rue Larrey, 49033 Angers Cedex, France


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(5):e127-e131. doi:10.1016/j.chest.2015.10.001
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Baclofen, a gamma-aminobutyric acid-B agonist with muscle-relaxant properties, is widely used in patients with severe spasticity. In animals, baclofen has been shown to decrease respiratory drive. In humans, however, use of baclofen at the standard dose did not significantly impair sleep-disordered breathing in a susceptible population of snorers. Recently, there has been increasing interest in the role of baclofen for the treatment of alcohol dependence. We describe severe central sleep apnea (CSA) in four patients with none of the conditions commonly associated with CSA who were receiving chronic baclofen therapy for alcohol withdrawal. In one patient, baclofen withdrawal was associated with a complete resolution of CSA. Three patients were treated by adaptive servo-ventilation while continuing their treatment with baclofen. Given the increasing number of patients receiving baclofen for alcohol withdrawal treatment, physicians should be aware that these patients might be affected by severe CSA. Future studies are required to determine the mechanisms, prevalence, and treatment modalities of sleep-disordered breathing associated with baclofen usage.

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