0750 Efficacy of Baclofen in Management of Central Hypersomnias: A 5-Year Retrospective Single-Center Analysis of Clinical and Patient-Reported Outcomes

Abstract Introduction Central hypersomnias, narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH) are chronic disorders marked by excessive daytime sleepiness and fragmented sleep. Beyond oxybates, pharmacologic options to enhance sleep quality are limited. Baclofen, a GABA-B receptor agonist, has been found to enhance sleep consolidation and slow-wave sleep, which is often disrupted in patients with central hypersomnia. Data on efficacy of this off-label treatment remain limited. Methods Electronic health records from 12/05/2020 through 12/05/2025 were reviewed for patients with NT1, NT2, or IH and who were prescribed baclofen in a single center in Texas. Extracted variables included demographics, diagnosis, nightly dose, continuation of therapy, concomitant use of oxybates, and patient-reported benefit. Results Forty-five patients on baclofen therapy were identified: NT1 (n=18), NT2 (n=24), and IH (n=3). Of these, 38 (85%) were female and 7 (15%) were male. The cohort’s mean age was 37.9 years and mean BMI was 27.4 kg/m². Baclofen doses ranged from 5 to 30 mg nightly, with the most common range 10 to 20 mg. Twenty-seven patients (60%) did a trial of oxybate prior to initiation of baclofen and were not on oxybate when starting baclofen. Thirteen (48%) of those continued on baclofen. Eight other patients (17%) did trial of baclofen with oxybates nightly and currently 7 (87.5%) continued on both. Of the 45 patients, 34 had data available about subjective improvement. Eighteen patients (53%) reported subjective improvement in sleep continuity: 4 NT1 (22%), 13 NT2 (54%), 1 IH (33%). A total of 15/45 (33%) of patients discontinued baclofen due to either an absence of benefit (7) or other reasons (8). Seven patients without follow-up remain under active evaluation. Conclusion In this five-year retrospective analysis of 45 patients with central hypersomnias, baclofen was associated with subjective improvement in sleep quality. Though a small sample size, these findings support further evaluation of baclofen as a potentially effective agent in patients with central hypersomnias. Support (if any) N/A