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Sleep and neuromuscular disorders

Sleep and neuromuscular disorders 1 <h5>Introduction and overview</h5> Sleep disordered breathing (SDB) is very common in the setting of neuromuscular disorders. About 42% of patients with neuromuscular disorders have significant and symptomatic SDB (respiratory disturbance index or RDI of more than 15/h) [1] vs. 4% of men and 2% of women without any neuromuscular disorders [2] . Despite the high incidence of SDB in this population group only about 5% of patients with symptomatic SDB and neuromuscular disease are recognized and treated for respiratory problems and only 1.7% with specific recognition of SDB [1] . Respiratory dysfunction, due to neuromuscular disease, may become apparent or aggravated in the setting of the unique physiologic conditions that occur during sleep. Physiologic reduction of muscle tone in non-rapid eye movement (NREM) sleep, and frank loss of muscle tone in rapid eye movement (REM) sleep [3] in addition to increased upper airway resistance in REM [4] , with enhancement of the diaphragmatic drive and loss of activity in the intercostal muscles bring forth a unique series of circumstances in patients with neuromuscular illness. Sleep-related physiological changes interact with a compromised neuromuscular system to create conditions that result in different form of sleep-related hypoxemia and sleep fragmentation http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Sleep Medicine Elsevier
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