Chewing gum: alternative therapy to oxygen intolerance

Rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome is a rare complex disorder associated with alterations in the endocrine system, autonomic nervous system, and respiratory system. Previously published case reports and studies have noted sleep-disordered breathing in patients with ROHHAD syndrome. Nocturnal respiratory manifestations, which if untreated early by respiratory support, may cause cardiorespiratory arrest and a life-threatening condition. More recently, it has been recognized that children with ROHHAD syndrome have central pauses during wakefulness associated with intermittent oxygen desaturations. We report novel findings of a child with ROHHAD syndrome displaying an irregular breathing pattern and significant central pauses associated with oxygen desaturations during wakefulness, whose respiratory status improved while chewing gum. This was used as an alternative to supplemental oxygen therapy.