A Pediatric Patient with Severe Obstructive Sleep Apnea and Comorbid Depression and Substance Abuse

Table 1

Patient presentation before and after initiation of BiPAP for OSA.

	Before BiPAP use	After BiPAP use
Overnight oxygen saturation	63.5%–88%	>90%
Presenting symptoms	Depressed mood with active suicidal ideation, anxiety, fatigue, diffuse body aches, significant sleep disturbances	Mildly depressed mood, no active suicidal ideations, acute marijuana withdrawal, no sleep complaints
Active substance use	Marijuana, nicotine vapor, intranasal cocaine, psychedelics, daily alcohol use	Marijuana, occasional alcohol use
Medication regimen at admission	Aripiprazole 10 mg, fluoxetine 40 mg, bupropion 150 mg (all discontinued by patient prior to admission)	Active : bupropion 150 mg
Medication regimen at discharge	Lithium 450 mg	Bupropion 150 mg, risperidone 1 mg, gabapentin 100 mg twice daily