Effects of clomipramine on excessive daytime sleepiness and respiratory disturbances in a case of Prader-Willi syndrome.

The association of Prader-Willi-syndrome with breathing disturbances such a s sleep apnea syndrome and/or hypoxemia during REM sleep, REM sleep abnorma lities and excessive daytime sleepiness is well known. We report the case o f an 11-year-old boy who presented with Prader-Willi syndrome, obesity (bod y mass index [BMI] = 45.6), severe obstructive sleep apnea syndrome and sig nificant daytime sleepiness on multiple sleep latency test. Behavioral diso rders did not allowed the use of continuous positive pressure in this patie nt. Therefore, clomipramine (20 nag per day) was administered Sleep examina tion over 8 months showed: slight weight loss (BMI = 44.4), persistence of severe obstructive sleep apnea syndrome, slight improvement in nocturnal hy poxemia, and disappearance of excessive daytime drowsiness with mean sleep latency of IS min 37 s (less than 2 min before treatment) and no diurnal RE M sleep periods. However, clomipramine had no effect on hyperphagia. (C) 19 98 Elsevier, Paris.