Sleep disordered breathing in Duchenne muscular dystrophy.

Symptoms of sleep disordered breathing (SDB) in younger boys with DMD are often poorly perceived and/or articulated by the patients or their families. As a result it is the watchful eye of the care-provider that determines the need for early polysomnographic (PSG) assessments. The use of polysomnography without capnometry should be considered completely inadequate when it comes to diagnosis and management of SDB in these patients. The stabilization of gas exchange with non-invasive ventilation may be achieved by the use of pressure or volume support ventilation. Serial PSG assessments are recommended to assure optimal management as the patients' clinical status evolves with disease progression and the emergence of additional morbidities such as cardiomyopathies, dysphagia, and chronic aspiration.