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- Title
Disordini respiratori durante il sonno nel paziente neuromuscolare.
- Authors
Antonaglia, Caterina; Salton, Francesco; Confalonieri, Marco
- Abstract
Respiratory sleep disorders occur frequently in neuromuscular disorders and can be considered as a predictive marker of respiratory involvement especially in patients with a rapidly progressive disease. Nocturnal cardiorespiratory monitoring or polysomnography play an important role in diagnosis and treatment management through a correct categorization and monitoring of sleep-related disorders. The main polysomnographic alterations in patients with neuromuscular diseases are diaphragmatic/pseudo-central events, obstructive apneas, central sleep apneas, nocturnal hypoventilation and Cheyne-Stokes periodic breathing. Current recommendations consider non-invasive ventilation (NIV) as a cornerstone of the respiratory treatment in patients with neuromuscular disorders. Non-invasive ventilation can improve both survival and quality of sleep; however it should be used with caution in the context of dilating cardiomyopathy or significant bulbar symptoms. Non-invasive ventilation may also cause sleep disordered breathing events including ineffective triggering, auto-triggering, central sleep apneas and glottic closure, which counterbalance its potential benefits increasing arousals, reducing therapeutic adherence and impairing sleep architecture. NIV setting appears to be more complicated than in others patients with primitive sleep apnea syndrome, thus it must be continuously monitored and adjusted to the progression of the disease.
- Publication
Rassegna di Patologia dell'Apparato Respiratorio, 2019, Vol 34, Issue 5/6, p160
- ISSN
0033-9563
- Publication type
Article