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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.52 no.4 São Paulo Dec. 1994

https://doi.org/10.1590/S0004-282X1994000400004 

Sleep polygraphic parameters in neuromuscular diseases

 

Parâmetros poligráficos do sono em doenças neuromusculares

 

 

Márcia Pradella

Sleep Laboratory and Pediatric Neurology Unit of the St Luc Training Hospital, Brussels, Belgium

 

 


SUMMARY

In a polysomnography study of 32 neuromuscular patients - 22 with a form of muscular dystrophy, 3 with a form of congenital myopathy, 4 with a form of spinal muscular atrophy, 1 with a recurrent form of polymyositis and 1 with osteogenesis imperfecta syndrome - of which 21 were nonambulatory, we observed sleep related respiratory disturbances represented by: drops in oxygen saturation (SaO2), cardiac arrythmia, sleep disruption, apneas, tachypnea, tachycardia and snoring. Nine out of the cohort of 32 patients presented with significant desaturations periods. These patients presented with an associated restrictive syndrome and thoracic deformities, some with tachypnea and/or SaO2 below 90% during wakefulness. In this group, snoring was observed in those patients with a form of muscular dystrophy while tachypnea was observed in patients who presented the highest desaturations levels. Sleep quantification revealed an increase of stage 1 sleep coupled with a decrease or even total absence of REM sleep. This is, we believe, a likely consequence of episodic desaturations that may accompany sleep hypoventilation which is potentialised during REM sleep stage.

Key words: polysomnography, neuromuscular diseases, sleep related respiratory disturbances.


RESUMO

Estudando 32 pacientes com doenças neuromusculares -22 com forma de distrofia muscular, 3 com forma de miopatia congênita, 4 com forma de atrofia muscular espinal, 1 com forma recorrente de polimiosite e 1 com síndrome de osteogenesis imperfecta - dos quais 21 estavam impossibilitados de deambulação, distúrbios respiratórios relacionados ao sono foram observados sob forma dessaturação da oxi-hemogloblina, arritmia cardíaca, taquipnéia, taquicardia e roncos. Nove desses 32 pacientes apresentaram períodos de dessaturação de oxi-hemoglobina maiores que 4% em relação aos níveis obtidos em vigília e repouso. Esse grupo de pacientes era caracterizado por apresentar síndrome respiratória restritiva associada a deformidade torácica (principalmente escoliose). Alguns apresentaram taquipnéia e/ou saturação da oxi-hemoglobina abaixo de 90% durante o repouso e em vigília. Neste grupo, roncos foram observados principalmente nos pacientes com forma de distrofia muscular, enquanto a taquipnéia foi observada sobretudo nos pacientes com os maiores níveis de dessaturação. A quantificação do sono mostrou aumento na porcentagem do estado 1 do sono associada a diminuição ou mesmo ausência do estado do sono paradoxal. Isso nos leva a crer em um provável mecanismo de proteção consequente à potencialização da hipoventilação observada durante o estado de sono paradoxal, em que os maiores níveis de dessaturação são observados.

Palavras-chave: polissonografia, doenças neuromusculares, distúrbios respiratórios relacionados ao sono.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

Acknowledgements - Our deepest appreciation goes to Prof. G Aubert, director of the Sleep laboratory, St Luc's training Hospital, Brussels, Belgium where the bulk of this research was carried out. Sincerest thanks to Prof. G Ferriére of the Pediatric Neurology Unit for academic and technical skills provided.

 

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Aceite: 5-maio-1994.

 

 

Dra. Marcia Pradella - Rua Antonio Rodrigues Passos 227, Jd. Cd Pirituba - 02941-040 São Paulo SP - Brasil.

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