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Hypoxemia during sleep in Duchenne muscular dystrophy

Smith, Philip E. M. ORCID: https://orcid.org/0000-0003-4250-2562, Calverley, Peter M. A. and Edwards, Richard H. T. 1988. Hypoxemia during sleep in Duchenne muscular dystrophy. American Review of Respiratory Disease 137 (4) , 884–888. 10.1164/ajrccm/137.4.884

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Abstract

Overnight polysomnography after acclimatization was performed on 14 patients with Duchenne muscular dystrophy (mean age, 18.3 yr; mean VC, 1.24 L). Despite their lack of sleep-related symptoms and normal daytime blood gas tensions, periods of hypopnea and/or apnea (H/A) were observed in all patients (mean frequency 9.6/h; range, 3.7 to 17.0; mean duration 23.1; range of means, 16 to 36 s). In 9 patients, between 0.5 and 12.3 oxygen desaturations of > 5% occurred per hour, with falls from a mean SaO2 baseline of 95.4 ± 0.6% (SEM) to a mean nadir of 74.2 ± 3.9% (range, 58 to 90). This desaturating group (n = 9) showed longer and more frequent H/A than did the 5 nondesaturators; the proportion of REM sleep occupied by H/A was 37.7 ± 3.8% in the desaturating group compared with only 15.1 ± 5.1% in the remainder (p < 0.01). The severity of sleep-disordered breathing could not be reliably predicted from daytime pulmonary function test results, and only maximal static expiratory pressure appeared significantly lower in the desaturating group. Hypopneas were associated with reduced chest wall movement in all subjects, and with chest wall paradox in one; continued submental “inspiratory” EMG activity throughout “central” apneas in 2 subjects suggested that these episodes were not truly central in origin. Sleep hypoxemia is imputed in the progression of several chronic respiratory diseases, and its prevention in Duchenne and related neuromuscular diseases may influence morbidity and mortality.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
ISSN: 0003-0805
Last Modified: 09 Nov 2022 10:18
URI: https://orca.cardiff.ac.uk/id/eprint/139027

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