The effect of sleep in patients with neuromuscular and chest wall disorders
- Robert C Basner, MD
Robert C Basner, MD
- Professor of Medicine
- Columbia University Medical Center
- Section Editors
- Jeremy M Shefner, MD, PhD
Jeremy M Shefner, MD, PhD
- Section Editor — Neuromuscular Disease
- Professor and Chair of Neurology, Barrow Neurological Institute
- Professor of Neurology, University of Arizona, Phoenix
- Clinical Professor of Neurology, Creighton University
- M Safwan Badr, MD
M Safwan Badr, MD
- Section Editor — Sleep Related Breathing Disorders
- Professor and Chief, Pulmonary Critical Care and Sleep Medicine
- Wayne State University School of Medicine
Physiologic alterations during normal sleep are clinically insignificant in most adults, but can induce hypoventilation and hypoxemia in patients with neuromuscular and chest wall disorders, who characteristically have challenged ventilation when awake due to one or more of the following: perturbed lung and chest wall mechanics, respiratory muscle weakness, chemoreceptor sensitivity abnormality, and blunted central neural output ("drive to breathe"). In this topic review, the following issues are discussed:
●Normal sleep-related physiologic alterations that affect ventilation, with special attention given to their impact on patients with neuromuscular or chest wall disorders. (See 'Ventilation' below.)
●Sleep-related alterations in blood gases, with special attention on the differences between healthy adults and patients with neuromuscular or chest wall disorders. (See 'Blood gases' below.)
●The major points of this topic review. (See 'Summary and recommendations' below.)
Evaluation and treatment of sleep-disordered breathing in patients with neuromuscular or chest wall disorders are reviewed separately. (See "Evaluation of sleep-disordered breathing in patients with neuromuscular and chest wall disease" and "Types of noninvasive nocturnal ventilatory support in neuromuscular and chest wall disease".)
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