Sleep-related respiratory disturbances in patients with Duchenne muscular dystrophy.
Sleep-related respiratory disturbances (SRD) in patients with muscle diseases may have significant clinical implications, because the patients frequently die at night. The aims of the study were to :1) assess the presence and severity of sleep-related respiratory disturbances in patients with Duchenne muscular distrophy (DMD); and 2) investigate the relationship of sleep-related respiratory disturbances to daytime symptoms and pulmonary function. We studied six clinically stable patients with Duchenne muscular dystrophy, mean age (+/- SD) 18 +/- 2 yrs. Vital capacity was 27 +/- 19% of predicted and daytime arterial oxygen tension (PaO2) was 10.9 +/- 1 kPa (range 8.9-12.4 kPa). The presence of daytime somnolence, insomnia, headache, nightmares and/or snoring was recorded. Four patients (67%) showed symptoms that suggest sleep-related respiratory disturbances. At night, the apnoea-hypopnoea index (AHI) was 11 +/- 6. The patients with more symptoms during the daytime had the highest AHI scores. Most of the apnoeas (85%) were central, particularly during rapid eye movement (REM) sleep. Sleep architecture was well-preserved. Arterial desaturation (> 5% below baseline) occurred during 25 +/- 23% of total time. AHI correlated with daytime PaO2, and AHI in REM sleep correlated with age. A stepwise multivariate analysis showed that PaO2 and, to some extent, the degree of airflow obstruction were significantly correlated with AHI. We conclude that sleep-related respiratory disturbance are frequently present in patients with Duchenne muscular dystrophy. Therefore, physicians should look for symptoms related to sleep-related respiratory disturbances in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Servei Pneumología, Hospital Univ. Son Dureta, Palma de Mallorca, Spain.
F
F
Barbé
M A
MA
Quera-Salva
C
C
McCann
P
P
Gajdos
J C
JC
Raphael
J
J
de Lattre
A G
AG
Agustí
D000293:Adolescent; D000328:Adult; D002648:Child; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D009136:Muscular Dystrophies / Q000150:complications*; D017286:Polysomnography; D011659:Pulmonary Gas Exchange; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D014797:Vital Capacity