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Treatment of central sleep apnea (CSA) is complex, and multiple options are tried with variable outcomes. This case describes a 13-year-old boy with obesity and mixed apnea (apnea-hypopnea index 67.4/hour) who developed hypercapnic respiratory failure requiring prolonged mechanical ventilation. Following acetazolamide therapy, he was successfully weaned; at two months he reported no further apnea and an improved quality of life. Acetazolamide use for central/mixed apnea in children is rare and warrants further study.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/acetazolamide-assisted-weaning-from-mechanical-ventilation-in-a-child-with-mixed-sleep-apnea-a-case-report/432392/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/acetazolamide-assisted-weaning-from-mechanical-ventilation-in-a-child-with-mixed-sleep-apnea-a-case-report/432392.png","ImageObject",300,407,{"name":92,"@type":93},"Elsa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What condition did the child have in this case report?","Question",{"text":112,"@type":113},"The 13-year-old had obesity with mixed sleep apnea, with an apnea-hypopnea index of 67.4/hour and both central and obstructive components.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why was acetazolamide considered in the management?",{"text":117,"@type":113},"Acetazolamide is a carbonic anhydrase inhibitor known to induce metabolic acidosis and stimulate the respiratory drive, potentially helping with weaning from mechanical ventilation in central apnea.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the outcome after acetazolamide therapy?",{"text":121,"@type":113},"The patient was successfully weaned from prolonged mechanical ventilation after acetazolamide treatment and, after discharge, had no apnea and was doing well with improved quality of life at two months.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},432392,1790787864,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},137455077381,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Review began 11/24/2025  \nReview ended 11/30/2025  \nPublished 12/05/2025  \n© Copyright 2025  \nTripathy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98508  \nOpen Access Case Report  \nAcetazolamide-Assisted Weaning From Mechanical Ventilation in a Child With Mixed Sleep Apnea: A Case Report  \nSaroj Kumar Tripathy 1 , Sarbari Sarkar 1, Medhagopal R. G. 1 , Pradosh Kumar Sarangi 2, Archana Malik 3 , Sarthak Das 1  \n1. Pediatrics, All India Institute of Medical Sciences, Deoghar, Deoghar, IND 2. Radiodiagnosis, All India Institute of Medical Sciences, Deoghar, Deoghar, IND 3. Pulmonary Medicine, All India Institute of Medical Sciences, Deoghar, Deoghar, IND  \nCorresponding author: Sarthak Das, [sarthak.ped@aiimsdeoghar.edu.in](sarthak.ped@aiimsdeoghar.edu.in)  \nAbstract  \nAn elevated central apnea-hypopnea index is typically considered indicative of abnormal breathing in children. Treatment of central sleep apnea (CSA) is complex, and multiple treatment options are tried with variable outcomes. Acetazolamide, a carbonic anhydrase inhibitor, is known to induce metabolic acidosisand can stimulate the respiratory drive. We report a 13-year-old boy who was having obesity and mixed apnea with an apnea-hypopnea index of 67.4/hour, who was hospitalized with hypercapnic respiratory failure. He was successfully weaned from prolonged mechanical ventilation following acetazolamide therapy. Post-discharge, he has had no apnea and continues to do well, with an improved quality of life at two months of follow-up. Acetazolamide use for central apnea/mixed apnea in children is very rare and not well established. Our case highlights the potential use of acetazolamide as an adjunct therapy in children with CSA, which needs further exploration.  \nCategories: Pediatrics  \nKeywords: acetazolamide, adolescent, case report, mixed sleep apnea, obesity  \nIntroduction  \nThe American Academy of Sleep Medicine defines central sleep apnea (CSA) as the cessation of airflow, accompanied by absent chest wall and/or abdominal movements, lasting longer than 20 seconds or more than two baseline respiratory cycles, if associated with arousal, awakening, or oxygen desaturation of at least 3%[1] . A central apnea-hypopnea index (CAHI) of five events per hour or more is considered pathological in children [2] . Several therapeutic options have been considered for the treatment of CSA, including  \nsupplemental oxygen therapy, bilevel positive airway pressure therapy, and methylxanthines.  \nAcetazolamide, a carbonic anhydrase inhibitor, is known to induce metabolic acidosis and can stimulate the respiratory drive. Weaning from mechanical ventilation in children with central apnea is complex and  \ngradual, with frequent failures and guarded results. Here, we report a case of a 13-year-old boy with  \ndifficulty weaning from mechanical ventilation who had a positive outcome following treatment with  \nacetazolamide.  \nCase Presentation  \nA 13-year-old male patient was admitted with complaints of frequent sleepiness during the day, poor sleep at night, and frequent awakenings at night for two years. The episodes were frequent and increasing over the last two months. On examination, the child was obese (BMI 23 .8) and had stable vital signs: pulse rate (PR) 90/min, respiratory rate (RR) 15/min, blood pressure (BP) 94/60 mm Hg, and SpO294% on room air. Systemic examination was unremarkable. The patient underwent polysomnography, which showed an apneahypopnea index (AHI) of 67.4/hour, with a central apnea index of 3 .4 and an obstructive apnea index of 2.6, and the lowest SpO2 of 67% . Although the child had a short neck with obesity, any significant local cause of obstruction needing surgical intervention was ruled out after multispecialty consulta","cbCaioDxs5PIPof5","https://ap.wps.com/l/cbCaioDxs5PIPof5","pdf",112309,"English","# Abstract\n# Introduction\n# Case Presentation\n# Treatment and Outcome","[{\"question\":\"What condition did the child have in this case report?\",\"answer\":\"The 13-year-old had obesity with mixed sleep apnea, with an apnea-hypopnea index of 67.4/hour and both central and obstructive components.\"},{\"question\":\"Why was acetazolamide considered in the management?\",\"answer\":\"Acetazolamide is a carbonic anhydrase inhibitor known to induce metabolic acidosis and stimulate the respiratory drive, potentially helping with weaning from mechanical ventilation in central apnea.\"},{\"question\":\"What was the outcome after acetazolamide therapy?\",\"answer\":\"The patient was successfully weaned from prolonged mechanical ventilation after acetazolamide treatment and, after discharge, had no apnea and was doing well with improved quality of life at two months.\"}]","Acetazolamide-Assisted Weaning From Mechanical Ventilation in a Child With Mixed Sleep Apnea - A Case Report | PDF",1790659427]