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  • Title: [Sleep-disordered breathing in neuromuscular diseases].
    Author: Ragette R, Mellies U, Schwake C, Teschler H.
    Journal: Pneumologie; 2003 Dec; 57(12):729-33. PubMed ID: 14681744.
    Abstract:
    UNLABELLED: Sleep-disordered breathing is common in neuromuscular diseases but remains poorly defined in its relationship to daytime respiratory function. METHODS: We prospectively compared supine lung and respiratory muscle function with results of polysomnography/capnometry in 35 patients with progressive myopathies (age 32.5 +/- 15 years). RESULTS: 32/35 patients had restrictive ventilatory defect, 9/32 had hypercapnic respiratory failure by day (PaCO(2) 66.0 +/- 15.7 mm Hg). Supine inspiratory vital capacity (IVC(S)) correlated with maximal inspiratory muscle pressure (R = 0.75), respiratory muscle strain (P0.1/PImax, R = - 0.68), and daytime blood gases (p < 0.005 for all). SDB in the way of REM-sleep hypopneas, circumscribed hypoventilation episodes and sleep-stage independent continuous hypoventilation (PtcCO(2) > 50 mmHg > 50% of sleep time) was common at IVC(S)< 60% pred, and preceded daytime hypercapnia. IVC(S) correlated with nocturnal SaO(2) (R = 0.64), PtcCO(2) (R = - 0.87), percent light sleep (R = 0.67) and deep sleep (R = - 0.76). IVC(S) correlated only marginally with respiratory disturbance index (total sleep, R = - 0.45; REM-sleep, R = - 0.44). IVC(S) < 60% was 96% sensitive, 78% specific for presence of SDB. IVC(S) < 20 % was 89% sensitive, 96% specific for daytime hypercapnia. CONCLUSIONS: IVC(S) correlates with respiratory muscle function, daytime and nocturnal blood gases, and is highly predictive of SDB and daytime hypercapnia.
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