Yasuyoshi Ohshima1, Hideaki Nakayama2, Naho Matsuyama3, Satoshi Hokari3, Takuro Sakagami3, Tomoe Sato4, Toshiyuki Koya3, Tetsuya Takahashi4, Toshiaki Kikuchi3, Masatoyo Nishizawa4, Takayoshi Shimohata4. 1. Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. Electronic address: ohshima@med.niigata-u.ac.jp. 2. Department of Respiratory Medicine, Tokyo Medical University, Tokyo, Japan. 3. Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. 4. Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan.
Abstract
OBJECTIVE/ BACKGROUND: Multiple system atrophy (MSA) frequently results in the development of sleep-disordered breathing (SDB). Few reports have described the natural course of this phenomenon. The aim of the present study was to determine the natural course of SDB and prognostic factors associated with such conditions in MSA. PATIENTS/ METHODS: Twenty-four consecutive patients were recruited with probable MSA, who had not been treated with continuous positive airway pressure (CPAP) and had undergone overnight polysomnography (PSG) more than once following the development of snoring or stridor. Based on changes in the apnea-hypopnea index (AHI) over the course of the disease, patients were divided into two groups (AHI-maintained and AHI-deteriorated) and the clinical findings were compared. RESULTS: Mean duration between the first and last PSG was 2.4 ± 1.5 years, and patients underwent PSG assessment an average of 2.5 ± 0.6 times during this period. During this interval, AHI increased from 19.4 ± 22.8/hour to 34.4 ± 30.1/hour (p = 0.006), although spontaneous improvement was observed in 29% of patients. Following the first PSG, all patients were diagnosed with obstructive sleep apnea; however, the SDB type changed from obstructive sleep apnea to central sleep apnea in 3 of the 24 (13%) patients during the period between the first and last PSG. CONCLUSIONS: Although SDB associated with MSA exacerbates with disease progression, spontaneous improvement in AHI may occur in some patients. Earlier development of snoring or stridor may predict rapid progression of SDB in MSA.
OBJECTIVE/ BACKGROUND:Multiple system atrophy (MSA) frequently results in the development of sleep-disordered breathing (SDB). Few reports have described the natural course of this phenomenon. The aim of the present study was to determine the natural course of SDB and prognostic factors associated with such conditions in MSA. PATIENTS/ METHODS: Twenty-four consecutive patients were recruited with probable MSA, who had not been treated with continuous positive airway pressure (CPAP) and had undergone overnight polysomnography (PSG) more than once following the development of snoring or stridor. Based on changes in the apnea-hypopnea index (AHI) over the course of the disease, patients were divided into two groups (AHI-maintained and AHI-deteriorated) and the clinical findings were compared. RESULTS: Mean duration between the first and last PSG was 2.4 ± 1.5 years, and patients underwent PSG assessment an average of 2.5 ± 0.6 times during this period. During this interval, AHI increased from 19.4 ± 22.8/hour to 34.4 ± 30.1/hour (p = 0.006), although spontaneous improvement was observed in 29% of patients. Following the first PSG, all patients were diagnosed with obstructive sleep apnea; however, the SDB type changed from obstructive sleep apnea to central sleep apnea in 3 of the 24 (13%) patients during the period between the first and last PSG. CONCLUSIONS: Although SDB associated with MSA exacerbates with disease progression, spontaneous improvement in AHI may occur in some patients. Earlier development of snoring or stridor may predict rapid progression of SDB in MSA.
Authors: Carmen Rodríguez-Blázquez; Maria João Forjaz; Monica M Kurtis; Roberta Balestrino; Pablo Martinez-Martin Journal: Front Neurol Date: 2018-06-07 Impact factor: 4.003