Stefania Redolfi1,2, Leo Grassion3,4, Isabelle Rivals1,5, Mario Chavez6, Nicolas Wattiez1, Isabelle Arnulf2, Jesus Gonzalez-Bermejo1,3, Thomas Similowski1,3. 1. UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM, Sorbonne Université, Paris, France. 2. Service de Pathologies du Sommeil, Département R3S, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France. 3. Service des Maladies Respiratoires, CHU de Haut-Lévêque, Pessac, France. 4. Service de Pneumologie, Médecine Intensive et Réanimation, Département R3S, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France. 5. Equipe de Statistique Appliquée-ESPCI Paris, PSL Research University, France; and. 6. CNRS-UMR 7225, Hôpital Pitié-Salpêtrière, Paris, France.
Abstract
Rationale: In patients with chronic obstructive pulmonary disease (COPD), increased activity of neck inspiratory muscles has been reported as a compensatory response to hyperinflation-related diaphragmatic dysfunction. The persistence of this activity during sleep could attenuate sleep-related hypoventilation and also negatively impact sleep and clinical outcomes. Objectives: To assess the persistence of neck-muscle activity during sleep in patients with COPD recovering from severe exacerbations (i.e., requiring hospitalization) and its impact on sleep quality and recurrence of exacerbations. Methods: Video polysomnography with neck-muscle EMG was performed in patients with COPD who were recovering from a severe exacerbation. The follow-up period lasted 6 months to record the next severe exacerbation.Measurements and Main Results: Twenty-nine patients were included in the study (median [25th-75th percentile] age, 71 [64-72] yr; 55% male; body mass index, 24 [21-29]; FEV1% predicted, 37 [29-45]; and BODE [body mass index, airflow obstruction, dyspnea, and exercise] index, 6 [5-7]). Twenty-six of these patients exhibited sleep-related neck-muscle activity, which was intermittent (limited to stage 3 sleep) in 17 and permanent throughout sleep in 9. α-Delta EEG activity during stage 3 sleep was observed in 87% of the patients. Compared with patients with no or intermittent neck-muscle activity, those with permanent neck-muscle activity showed more disrupted sleep, had experienced more exacerbations in the previous year, and suffered their next severe exacerbation earlier.Conclusions: Sleep-related neck-muscle activity occurs frequently in patients with COPD who are recovering from a severe exacerbation and seems to negatively affect sleep quality and prognosis; therefore, identification of this activity might improve COPD management after a severe exacerbation.
Rationale: In patients with chronic obstructive pulmonary disease (COPD), increased activity of neck inspiratory muscles has been reported as a compensatory response to hyperinflation-related diaphragmatic dysfunction. The persistence of this activity during sleep could attenuate sleep-related hypoventilation and also negatively impact sleep and clinical outcomes. Objectives: To assess the persistence of neck-muscle activity during sleep in patients with COPD recovering from severe exacerbations (i.e., requiring hospitalization) and its impact on sleep quality and recurrence of exacerbations. Methods: Video polysomnography with neck-muscle EMG was performed in patients with COPD who were recovering from a severe exacerbation. The follow-up period lasted 6 months to record the next severe exacerbation.Measurements and Main Results: Twenty-nine patients were included in the study (median [25th-75th percentile] age, 71 [64-72] yr; 55% male; body mass index, 24 [21-29]; FEV1% predicted, 37 [29-45]; and BODE [body mass index, airflow obstruction, dyspnea, and exercise] index, 6 [5-7]). Twenty-six of these patients exhibited sleep-related neck-muscle activity, which was intermittent (limited to stage 3 sleep) in 17 and permanent throughout sleep in 9. α-Delta EEG activity during stage 3 sleep was observed in 87% of the patients. Compared with patients with no or intermittent neck-muscle activity, those with permanent neck-muscle activity showed more disrupted sleep, had experienced more exacerbations in the previous year, and suffered their next severe exacerbation earlier.Conclusions: Sleep-related neck-muscle activity occurs frequently in patients with COPD who are recovering from a severe exacerbation and seems to negatively affect sleep quality and prognosis; therefore, identification of this activity might improve COPD management after a severe exacerbation.
Authors: Nicolle J Domnik; Devin B Phillips; Matthew D James; Grace A Ayoo; Sarah M Taylor; Robin E Scheeren; Amanda T Di Luch; Kathryn M Milne; Sandra G Vincent; Amany F Elbehairy; Sophie J Crinion; Helen S Driver; J Alberto Neder; Denis E O'Donnell Journal: Eur J Appl Physiol Date: 2022-01-16 Impact factor: 3.346
Authors: Andy I Ritchie; Jonathon R Baker; Trisha M Parekh; James P Allinson; Surya P Bhatt; Louise E Donnelly; Gavin C Donaldson Journal: Am J Respir Crit Care Med Date: 2021-07-01 Impact factor: 21.405
Authors: Jonathan P Wisor; Nils Henrik Holmedahl; Ingvild West Saxvig; Odd-Magne Fjeldstad; Eddie Weitzberg; Janne Grønli; Harald Kåre Engan Journal: Nat Sci Sleep Date: 2021-03-25
Authors: J McKenzie; P Nisha; S Cannon-Bailey; C Cain; M Kissel; J Stachel; C Proscyk; R Romano; B Hardy; P M A Calverley Journal: Respir Res Date: 2021-12-23