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The Study of Sleep Disordered Breathing at an Early Stage of Amyotrophic Lateral Sclerosis

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Tutor: DingWeiJiang
School: Nanchang University Medical College
Course: Neurology
Keywords: amyotrophic lateral sclerosis,polysomnography,sleep disorderedbreathing
CLC: R744
Type: Master's thesis
Year:  2013
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Objective:To investigate the sleep disordered breathing(SDB) manifestations,correlation factor and its clinical value at an early stage of amyotrophic lateralsclerosis (ALS).Methods:By polysomnography (PSG), we detected nocturnal sleep breathingbetween31ALS patients (study group) at an early stage and30healthy subjects(control group), compared the difference of related indicators between the twogroups, analyzed related factors of SDB on ALS patients at an early stage. Byregular follow-up the patients of the study group, we observed and compared theincidence of dyspnea in one year, analyzed the clinical value of SDB in diseaseprognosis on ALS patients at an early stage.Results:(1) Study group compared with the control group, total apneahypopnea index(AHI)、rapid eye movement AHI, non-rapid eye movement AHI,obstructive AHI have significant higher (P<0.01), nocturnal average pulse oxygensaturation(SpO2)and minimum SpO2have significant lower (P<0.001and P<0.05),central AHI and mixed AHI have no significant higher (P>0.05).(2) The study groupof SDB correlation factor analysis showed that:the patients’ body mass index andwhether bulbar involvement were negatively correlated with average SpO2(rs=-0.450,P<0.05and rs=-0.421,P<0.05), the amyotrophic lateral sclerosisfunctional rating scale revised (ALSFRS-R) were positive correlated with averageSpO2(rs=0.424,P<0.05), the patients’ age, the course of ALS, forced vital capacity(FVC) had no linear regression relationship with average SpO2(P>0.05), thepatients’ age, body mass index, the course of ALS, FVC, whether bulbarinvolvement, ALSFRS-R had no linear regression relationship with total AHI andminimum SpO2(P>0.05).(3) The follow-up study of ALS patients for one yeardisplayed that: total AHI≥5had significantly higher the incidence ofdyspnea(P<0.05), average SpO2≤96%had significantly higher the incidence ofdyspnea (P<0.05), minimum SpO2≤86%had significantly higher the incidence of dyspnea (P<0.05).Conclusion:The ALS patients at an early stage had shown significant SDB,bulbar involvement and the degree of illness might be the primary correlation factors.at an early stage of ALS patients, SDB had the value of early warning in respiratorymuscle paralysis, SDB which should be included in the routine evaluation of ALSpatients at an early clinical stage.
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