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Sleep and breathing in neuromuscular disease

Lookup NU author(s): Professor Stephen BourkeORCiD, Emeritus Professor John Gibson

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Abstract

Respiratory muscle weakness in neuromuscular disease causes significant morbidity and mortality. The published data on respiratory muscle activity and breathing during sleep in normal subjects, the impact of respiratory, muscle weakness on sleep and breathing and the relations to daytime respiratory function in neuromuscular disease are reviewed here, In normal subjects during sleep upper airway resistance increases, chemosensitivity is reduced and the wakefulness drive to breathe is lost, resulting in a fall in ventilation. During rapid eye movement (REM) sleep. ribcage and accessory breathing muscles are suppressed, particularly during bursts of eye movements, and breathing is more irregular, rapid and shallow, with a further fall in ventilation. In subjects with respiratory muscle weakness sleep is fragmented. with shorter total sleep time, frequent arousals, an increase in stage I sleep and a reduction in, or complete suppression of, REM sleep. Sleep-disordered breathing and nocturnal desaturation are common and most severe during REM sleep. Correlations between daytime respiratory function and nocturnal desaturation are moderate or weak, but daytime respiratory function has greater prognostic value than nocturnal measurements, Noninvasive ventilation improves sleep quality and breathing in subjects with respiratory muscle weakness. However, the optimal criteria for initiation of ventilation and its role in rapidly progressive neuromuscular diseases are unclear.


Publication metadata

Author(s): Bourke SC; Gibson GJ

Publication type: Review

Publication status: Published

Journal: European Respiratory Journal

Year: 2002

Volume: 19

Issue: 6

Pages: 1194-1201

ISSN (print): 0903-1936

ISSN (electronic): 1399-3003

URL: http://dx.doi.org/10.1183/09031936.02.01302001

DOI: 10.1183/09031936.02.01302001


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