Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 10 1 2025 09 08 23 28 Nazanin Esmaeili Autonomous Nervous System (ANS) Association, Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran. Arian Hasani Autonomous Nervous System (ANS) Association, Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran. Tayebeh Salehnezhad Department of Molecular Genetics, Ronash Medical Genetics Laboratory, Tehran, Iran. Hamed Amirifard Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2025 05 15 2025 05 19 We report a 37-year-old woman with recurrent episodes of excessive daytime sleepiness, bizarre behavior, social delays, and confusion lasting 3–5 days. Between episodes, she experienced only mild migraine-like headaches. Genetic testing identified an SCN1A mutation, which may cause central sleep apnea, basilar-type migraine, and a channelopathy-related encephalopathic state in her. This is the first report linking an SCN1A mutation with central sleep apnea. We recommend future cohort studies to clearly examine the association between SCN1A mutation and central sleep apnea. https://crcp.tums.ac.ir/index.php/crcp/article/view/1049 https://crcp.tums.ac.ir/index.php/crcp/article/download/1049/707