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Breathing pattern awake and asleep in myotonic dystrophy
C C Ververs1, F G Van der Meché, A F Verbraak
1Department of Pulmonary Diseases, University Hospital, Rotterdam-Dijkzigt, Netherlands.
Respiration; International Review of Thoracic Diseases
|January 1, 1996
Summary
Patients with myotonic dystrophy exhibit breathing irregularities. This study found no link between daytime and nighttime breathing issues, suggesting distinct underlying mechanisms possibly involving the brainstem.
Area of Science:
- Pulmonary Medicine
- Neurology
- Sleep Medicine
Background:
- Myotonic dystrophy is associated with significant breathing pattern abnormalities during both wakefulness and sleep.
- Understanding the relationship between these daytime and nighttime respiratory irregularities is crucial for patient management.
Purpose of the Study:
- To investigate the interrelationship between breathing pattern variability during wakefulness and periodic breathing during sleep in myotonic dystrophy patients.
- To explore potential correlations with pulmonary function, ventilatory response to carbon dioxide, and maximal respiratory pressures.
Main Methods:
- Assessed breathing pattern variables (tidal volume, respiratory cycle time) in 11 myotonic dystrophy patients and controls while awake and asleep.
- Measured pulmonary function indices, ventilatory CO2 response, and maximal mouth pressures.
- Analyzed correlations between awake and asleep breathing parameters, age, and ventilatory CO2 response.
Main Results:
- Patients showed significantly greater variability in tidal volume and respiratory cycle time when awake compared to controls.
- Periodic breathing was observed in up to 100% of light sleep time but absent in deep sleep, with a strong age correlation (r = 0.73, p = 0.01).
- No significant relationship was found between awake and asleep breathing disturbances; a trend for increased awake tidal volume variability was noted with decreased CO2 response (p = 0.1).
Conclusions:
- Distinct mechanisms likely underlie daytime and nocturnal breathing irregularities in myotonic dystrophy.
- Impaired brainstem integrative functions are hypothesized as a potential cause for these respiratory abnormalities.