High time we focus on sleep in amyotrophic lateral sclerosis!

Garima Shukla, Anupama GuptaNeurology India 2018 66(3):664-665
Source: Neurology India - Category: Neurology Authors: Source Type: research

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CONCLUSIONS: In ventilated ALS patients, autonomic activations may hardly have a role as surrogates of cortical arousals for assessment of sleep fragmentation and for respiratory scoring. Depression of ANS activity may be related to their poor performance. PMID: 30043387 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
ConclusionsIn ventilated ALS patients, autonomic activations may hardly have a role as surrogates of cortical arousals for assessment of sleep fragmentation and for respiratory scoring. Depression of ANS activity may be related to their poor performance.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Noninvasive ventilator support using bi-level positive airway pressure/continuous positive airway pressure (BiPAP/CPAP) is commonly utilized for chronic medical conditions like sleep apnea and neuromuscular disorders like amyotrophic lateral sclerosis (ALS) that lead to weakness of respiratory muscles. Generic masks come in standard sizes and are often perceived by patients as being uncomfortable, ill-fitting, and leaky. A significant number of patients are unable to tolerate the masks and eventually stop using their devices. The goal of this project is to develop custom-fit masks to increase comfort, decrease air leakage,...
Source: Journal of Medical Devices, Transactions of the ASME - Category: Medical Devices Source Type: research
Prahlad K Sethi, Nitin K SethiNeurology India 2018 66(3):666-666
Source: Neurology India - Category: Neurology Authors: Source Type: research
Conclusion: This is the first study from India providing insight into the presence of sleep disorders in ALS. About half of the patients of ALS had a poor sleep quality and two-thirds suffered from sleep disturbances.
Source: Neurology India - Category: Neurology Authors: Source Type: research
AbstractBackgroundOn initiation of long-term non-invasive ventilation (NIV), intermittent upper airway obstruction has rarely been described as possibly treatment-induced. Inspiratory pressure effects and the use of an oronasal interface may promote obstructive events in some patients with neuromuscular disease (NMD) and amyotrophic lateral sclerosis (ALS) in particular.MethodsWe evaluated clinical data from 212 patients in whom NIV was initiated using an oronasal mask. Treatment-induced upper airway obstruction (TAO) was defined as an AHI>  5/h along with a relative increase of the AHI in the first treatment nig...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Abstract BACKGROUND: On initiation of long-term non-invasive ventilation (NIV), intermittent upper airway obstruction has rarely been described as possibly treatment-induced. Inspiratory pressure effects and the use of an oronasal interface may promote obstructive events in some patients with neuromuscular disease (NMD) and amyotrophic lateral sclerosis (ALS) in particular. METHODS: We evaluated clinical data from 212 patients in whom NIV was initiated using an oronasal mask. Treatment-induced upper airway obstruction (TAO) was defined as an AHI> 5/h along with a relative increase of the AHI in the ...
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
Aim: To evaluate the diaphragm dysfunction in patients presenting with Amyotrophic Lateral Sclerosis (ALS)Methods: Demographics, spirometric measurements and arterial blood gasses of ALS patients reffered to our outpatient clinic were recorded. Diaphragm dysfunction was defined as having ≥20% difference in supine and prone FVC, paradoxical abdominal respiration or ≥3% difference in prone or supine SpO2. BIPAP usage, tracheostomy or PEG requirement and mortality rates evaluated.Results: Four hundred fifty one patients were evaluated for diaphragm dysfunction (F/M:198/253, age:58.7±12.3years). Basal FVC (n=318):...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Others Source Type: research
Discussion: The mouthpiece should alvays be considered for patient with neuromuscular disease that has to start NIV; it is useful to promote a positive approach and a rapid acceptance of the new condition; it should be considered for patients poorly tolerant to NIV or use NIV many hours a day sometimes alternatin with the nasal or fullface mask. In our experience MPV alone or combined with other interfaces improves the quality of patient's life and promotes greater adherence to NIV.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Noninvasive Ventilatory Support Source Type: research
Conclusions: The performance of PSG in ALS allows the evaluation of nocturnal respiratory failure parameters (CT90, AHI, ODI) and its behavior on sleep efficiency, which can serve as early criteria for initiating NIV and therefore help increase survival in these patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Noninvasive Ventilatory Support Source Type: research
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