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Sleep-related obstructive and nonobstructive apneas and neurologic disorders
C Guilleminault1, R Stoohs, M A Quera-Salva
1Stanford Sleep Research Center, Palo Alto, CA 94304.
Neurology
|July 1, 1992
Summary
Neurologic lesions can cause breathing problems that worsen during sleep, often presenting as insomnia or daytime sleepiness. Investigating these sleep-related breathing disorders is crucial for diagnosis and treatment.
Area of Science:
- Neurology
- Sleep Medicine
- Respiratory Medicine
Background:
- Neurologic lesions frequently cause breathing problems that exacerbate during sleep.
- Sleep-related breathing complaints like insomnia or somnolence can be early signs of conditions such as myopathy or myotonic dystrophy.
Purpose of the Study:
- To emphasize the importance of investigating sleep-related breathing disorders caused by neurologic impairments.
- To differentiate these conditions from obstructive sleep apnea and upper airway resistance syndrome.
Main Methods:
- Systematic investigation of breathing patterns during sleep in patients with suspected neurologic lesions.
- Analysis of lesion locations affecting the respiratory control loop, from sensory receptors to respiratory muscles.
Main Results:
- Neurologic lesions often lead to decreased inspiratory efforts (diaphragmatic apnea/hypopnea) during sleep.
- These events are distinct from obstructive sleep apnea and upper airway resistance syndrome, which involve upper airway abnormalities.
Conclusions:
- Nasal ventilation methods (CPAP, IPAP, volume ventilation) are effective treatments for sleep-disordered breathing secondary to neurologic conditions.
- These methods offer an alternative to tracheostomy and diaphragmatic pacing, with better long-term compliance than drug treatments for obstructive sleep apnea.