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Introduction Central sleep apnoea (CSA) is rare in children, with limited existing data. This study describes the causes, clinical presentation and management of CSA at a single sleep centre.Methods All children who underwent Polygraphy (PG) over a 5-year period at the Sheffield Sleep House were retrospectively reviewed. Patients with a central apnoea index (CAI) ≥5 events per hour were included. Data was collected regarding their underlying causes, clinical presentation, PG results, and management. Those with predominantly obstructive sleep apnoea were excluded. Subgroup comparisons were made between those treated with respiratory support (in the form of oxygen therapy or non-invasive ventilation) and those managed without.Results 103 of 2289 patients had a CAI ≥5, with 83 having predominantly central events. 24 had no underlying cause identified. Achondroplasia was the most common identified comorbidity (N=8). The median(range) CAI, AHI, minimum SpO2 and duration of longest apnoea(seconds) were 7.05 (5.00-81.20), 9.65 (5.20- 108.00), 12.00(7.00-30.00) and 85.50 (50.00-97.00) respectively. Cranial imaging was performed in 46% of patients, with abnormalities in 32%. 25% of patients were treated conservatively with follow-up PG’s, 12% required no follow up. The most common intervention was respiratory support (42%), with 36% on home oxygen and 6% on non-invasive ventilation. Other treatments included neurosurgery, caffeine, growth hormone changes, reflux medications, and ENT referrals. Median CAI decreased by 3 events/hour (57.5%) between the 1st and last study in the 5-year period.Patients receiving respiratory support had a higher median CAI, AHI, longer apnoeas and a lower minimum SpO2. A greater proportion had abnormal imaging findings. (See table 1). All patients with Chiari malformation and Prader-Willi syndrome required respiratory support.Discussion CSA is an uncommon but clinically significant disorder in children. Respiratory support, particularly home oxygen and non-invasive ventilation, plays a key role in management.Abstract P52 Table 1Clinical differences between those treated with respiratory support and those treated without