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Related Experiment Videos

Sleep and breathing in multiple system atrophy.

Alex Iranzo1

  • 1Alex Iranzo, MD Neurology Service, Hospital Clinic de Barcelona, C/Villarroel 170, Barcelona 08036, Spain. airanzo@clinic.ub.es.

Current Treatment Options in Neurology
|August 25, 2007
PubMed
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Multiple system atrophy (MSA) frequently causes sleep disorders, including REM sleep behavior disorder (RBD) and sleep-disordered breathing. Early identification of RBD and nocturnal stridor can signal MSA, with CPAP therapy effectively managing stridor.

Area of Science:

  • Neurology
  • Sleep Medicine
  • Pulmonology

Background:

  • Sleep disorders are prevalent in Multiple System Atrophy (MSA), presenting as fragmented sleep, daytime sleepiness, REM sleep behavior disorder (RBD), stridor, and sleep-disordered breathing.
  • RBD and nocturnal stridor are critical indicators of MSA, often preceding motor and autonomic symptoms by years.
  • RBD affects nearly all MSA patients, signifying extensive brain pathology affecting REM sleep regulation.

Purpose of the Study:

  • To detail the spectrum of sleep disorders in MSA.
  • To highlight the diagnostic significance of RBD and nocturnal stridor in MSA.
  • To discuss the pathophysiology and management of sleep-disordered breathing in MSA.

Main Methods:

  • Review of existing literature on sleep disorders in Multiple System Atrophy.

Related Experiment Videos

  • Analysis of clinical manifestations, diagnostic markers, and pathological correlates of sleep disturbances in MSA.
  • Evaluation of treatment outcomes for sleep disorders in MSA patients.

    • Main Results:

    • Sleep disorders, particularly RBD and sleep-disordered breathing (including central hypoventilation and obstructive sleep apnea with stridor), are hallmark features of MSA.
    • RBD is nearly universal (90-100%) in MSA and can precede other symptoms by years.
    • Nocturnal stridor, a potentially life-threatening condition caused by laryngeal dysfunction, is common and associated with respiratory failure.

    Conclusions:

    • Sleep disorders, especially RBD and stridor, are crucial diagnostic clues for Multiple System Atrophy.
    • Continuous positive airway pressure (CPAP) is an effective treatment for nocturnal stridor in MSA.
    • Tracheostomy may be necessary for persistent stridor unresponsive to CPAP or occurring during wakefulness.