PDF(Pubmed)
Abstract：
The timely introduction of non-invasive ventilation (NIV) is extremely relevant in the multidisciplinary management of patients affected by amyotrophic lateral sclerosis (ALS) and is based on the proper identification of red flags for early diaphragmatic exhaustion. Polygraphic sleep recording may provide insightful information on the ongoing respiratory impairment; in particular, atypical breathing patterns need to be recognized, as the application of current guidelines for sleep-related hypoxemia or sleep apnea may be insufficient for detecting early signs of diaphragmatic fatigue. We report the case of a 51-year-old man affected by ALS who was asymptomatic for breathing impairment, but whose nocturnal polysomnographic recording, despite not significant for obstructive sleep apnea nor for conventional hypoventilatory patterns, strongly suggested initial respiratory failure, as lately confirmed by the pulmonary follow-up. We discuss the advantages of including sleep recording in the clinical work-up of patients affected by ALS.
摘要：
及时引入无创通气（NIV）在肌萎缩侧索硬化症（ALS）患者的多学科管理中非常重要，并且基于正确识别早期膈肌衰竭的危险信号。测谎仪睡眠记录可以提供关于正在进行的呼吸损害的有见地的信息；特别是，需要识别非典型的呼吸模式，因为目前睡眠相关低氧血症或睡眠呼吸暂停指南的应用可能不足以检测膈肌疲劳的早期体征。我们报告了一例患有ALS的51岁男子，他因呼吸障碍无症状，但是他的夜间多导睡眠记录，尽管对阻塞性睡眠呼吸暂停和传统的低通气模式都不重要，强烈建议初次呼吸衰竭，最近肺随访证实。我们讨论了在受ALS影响的患者的临床检查中包括睡眠记录的优势。
