[Multiple System Atrophy and Sleep-Related Breathing Disorders]

Multiple system atrophy (MSA) is a sporadic, progressive neurodegenerative disease that affects multiple systems, including the Parkinsonian and cerebellar systems. It is commonly associated with obstructive and central sleep apnea, sleep-related hypoventilation, and stridor, which may evolve with changes in the disease phenotype and severity. These respiratory complications are considered potential causes of sudden death, making the critical importance of their evaluation and management in patients with MSA. However, no established treatment has been developed, and therapeutic approaches, such as continuous positive airway pressure (CPAP) or tracheostomy, have been attempted on a case-by-case basis.