Patterns and predictors of sleep disordered breathing in primary myopathies

• Published in: Thorax 2002-08, Vol.57 (8), p.724-728
• Main Authors: Ragette, R, Mellies, U, Schwake, C, Voit, T, Teschler, H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis; arterial carbon dioxide tension; arterial oxygen tension; Biological and medical sciences; Body mass index; Causes of; Comorbidity; Complications and side effects; daytime predictors; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Forced Expiratory Volume - physiology; Humans; Hypercapnia - etiology; Hypoventilation; Hypoventilation - etiology; inspiratory vital capacity; IVC; Male; maximal inspiratory muscle pressure; mean nocturnal oxyhaemoglobin saturation; mean transcutaneous carbon dioxide tension; measure of respiratory muscle effort; Medical sciences; Middle Aged; Muscle diseases; Muscle function; Muscular Diseases - complications; Muscular Diseases - physiopathology; Muscular dystrophy; Neurology; neuromuscular disease; Neuromuscular diseases; Neuromuscular Diseases - complications; Neuromuscular Diseases - physiopathology; Original; P0.1Pimax; Paco2; Pao2; Pimax; primary myopathies; Ptcco2; Respiration; Respiratory failure; Respiratory Muscles - physiology; Sao2; Sleep; Sleep Apnea Syndromes - etiology; Sleep Apnea Syndromes - physiopathology; sleep disordered breathing; Sleep disorders; Sleep, REM - physiology; Variables; Vital Capacity - physiology
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.57.8.724

Background: Sleep disordered breathing (SDB) is common in neuromuscular diseases but its relationship to respiratory function is poorly defined. A study was undertaken to identify distinct patterns of SDB, to clarify the relationships between SDB and lung and respiratory muscle function, and to identify daytime predictors for SDB at its onset, for SDB with continuous hypercapnic hypoventilation, and for diurnal respiratory failure. Methods: Upright and supine inspiratory vital capacity (IVC, % predicted), maximal inspiratory muscle pressure (Pimax), respiratory drive (P0.1), respiratory muscle effort (P0.1/Pimax), and arterial blood gas tensions were prospectively compared with polysomnography and capnometry (Ptcco2) in 42 patients with primary myopathies. Results: IVC correlated with respiratory muscle function and gas exchange by day and night. SDB evolved in three distinct patterns from REM hypopnoeas, to REM hypopnoeas with REM hypoventilation, to REM/non-REM (continuous) hypoventilation, and preceded diurnal respiratory failure. SDB correlated with IVC and Pimax which yielded highly predictive thresholds for SDB onset (IVC