Nuredini Andi, Bottignole Dario, Stragliati Filippo, Anceschi Pietro, Romano Sonia, Pollara Irene, Abramo Anna, Rausa Francesco, Parrino Liborio, Zinno Lucia, Mutti Carlotta
Unit of Neurosciences, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, Parma, Italy.
Heliyon. 2024 May 31;10(11):e32250. doi: 10.1016/j.heliyon.2024.e32250. eCollection 2024 Jun 15.
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.
在肌萎缩侧索硬化症（ALS）患者的多学科管理中，及时引入无创通气（NIV）极为重要，其依据是正确识别早期膈肌疲劳的警示信号。多导睡眠记录可提供有关持续呼吸功能损害的有价值信息；特别是，需要识别非典型呼吸模式，因为应用当前关于睡眠相关低氧血症或睡眠呼吸暂停的指南可能不足以检测到膈肌疲劳的早期迹象。我们报告了一例51岁的ALS男性患者，他在呼吸功能损害方面无症状，但夜间多导睡眠记录尽管对阻塞性睡眠呼吸暂停和传统通气不足模式无显著意义，却强烈提示早期呼吸衰竭，这一点后来经肺部随访得到证实。我们讨论了将睡眠记录纳入ALS患者临床检查的优势。
