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Ventilation and breathing pattern during sleep in Duchenne muscular dystrophy

Smith, P. E. M. ORCID:, Edwards, R. H. T. and Calverley, Peter M. A. 1989. Ventilation and breathing pattern during sleep in Duchenne muscular dystrophy. Chest 96 (6) , pp. 1346-1351. 10.1378/chest.96.6.1346

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Ventilatory data, including timing and partitioning of ventilation, were obtained from six subjects with advanced Duchenne muscular dystrophy, aged 16 to 22 years, during polysomnography on two consecutive nights; the subjects were randomized to breathing air or oxygen. Five of the six patients developed oxygen desaturation exceeding 5 percent during rapid eye movement (REM) sleep while breathing air. Minute ventilation on air (the mean of at least six consecutive minutes) was 6.9±0.7 (SEM) L min −1 but fell, owing to decreases in both tidal volume and frequency, to 4.9±0.3 L min −1 (p<0.05) in slow wave sleep and to 4.5±0.6 L min −1 (p<0.05) in REM sleep. Similar falls were seen on oxygen. The variability of all ventilatory data was significantly greater in REM than non-REM (NREM) sleep. The mean abdominal contribution to breathing was lower than predicted for wakefulness and all sleep stages, and two subjects showed paradoxical abdominal movement in NREM sleep; a correlation (p<0.05) existed between the NREM abdominal (diaphragmatic) contribution and the extent of oxygen desaturation subsequently seen in REM. We conclude that although awake minute ventilation is normal in Duchenne muscular dystrophy, hypoventilation occurs in all sleep stages, and those with diaphragmatic dysfunction are especially vulnerable to oxygen desaturation during REM sleep.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Elsevier
ISSN: 0012-3692
Last Modified: 09 Nov 2022 10:19

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