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Sleep-Disordered Breathing in Patients with Motor Neurone Disease: One Size Does Not Fit all
Vinod Aiyappan1,2, Peter Catcheside3, Nick Antic4,3
1Respiratory and Sleep Services, Southern Adelaide Local Health Network, Flinders Medical Centre, Bedford Park, South Australia, Australia, vinod.aiyappan@sa.gov.au.
Neuro-Degenerative Diseases
|March 18, 2021
Summary
Motor neurone disease (MND) patients show varied sleep-disordered breathing (SDB) patterns, often obstructive, not solely due to muscle weakness. These findings impact treatment strategies for MND patients with SDB.
Area of Science:
- Neurology
- Sleep Medicine
- Respiratory Medicine
Background:
- Sleep-disordered breathing (SDB) in motor neurone disease (MND) is typically linked to respiratory muscle weakness and hypoventilation.
- Observed SDB patterns in MND patients referred for non-invasive ventilation suggest factors beyond muscle weakness may be involved.
Purpose of the Study:
- To investigate the specific characteristics of sleep-disordered breathing (SDB) in patients diagnosed with motor neurone disease (MND).
Main Methods:
- Retrospective analysis of polysomnography (PSG) data, pulmonary function tests, and arterial blood gases in MND patients.
- Characterization of sleep apneas as obstructive or central, and hypopneas as obstructive versus central.
Main Results:
- 38% of MND patients (5/13) exhibited sleep hypoventilation.
- The median apnea/hypopnea index (AHI) was 44.4/h, with 92% having AHI >10/h, predominantly due to obstructive events.
- One patient (8%) also presented with frequent central apneas/hypopneas.
Conclusions:
- MND patients present a diverse range of SDB, including a notable prevalence of obstructive sleep apnea (OSA) despite normal BMI.
- Factors like tongue dystonia and upper airway collapsibility may contribute to OSA in MND.
- The varied SDB patterns have significant implications for optimizing ventilator settings and improving patient outcomes.
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