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There is currently no cure for ROHHAD. Rather, treatment consists of

early identification, meticulous monitoring, and symptomatic manage-

ment of the various symptoms as they develop. Comprehensive initial

evaluations should determine the nature and severity of hypoventilation,

HD, and ANS dysregulation, and appropriate interventions should be

implemented. Obesity is very difficult to control, but in consultation with

a nutritionist and endocrinologist, the trajectory of advancing weight

gain can be diminished with moderate exercise and calorie restriction,

leading to improved body mass index (BMI) with advancing age. Specific

signs of HD and ANS dysregulation should be evaluated by a pediatric

endocrinologist and expert in pediatric autonomic medicine, respectively,

and treated as necessary. Such treatments or management strategies may

include hormone replacement; regimented fluid intake; ophthalmologic

assessment and treatment; longitudinal monitoring of peripheral, core,

and ambient temperature; and management of constipation with stool

softeners. Disordered water balance to prevent dehydration should be

addressed, as well as regulation of heart rate, since bradycardia is seen

in some patients (usually with decreased core temperature).

Neural crest tumors should be assessed and resected by a pediatric

surgeon together with a pediatric oncologist, because the sheer size of