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Erschienen in: Sleep and Breathing 4/2022

13.01.2022 | Sleep Breathing Physiology and Disorders • Original Article

Sleep-related hypoventilation and hypercapnia in multiple system atrophy detected by polysomnography with transcutaneous carbon dioxide monitoring

verfasst von: Atsuhiko Sugiyama, Jiro Terada, Yu Shionoya, Shigeki Hirano, Tatsuya Yamamoto, Yoshitaka Yamanaka, Nobuyuki Araki, Ken Koshikawa, Hajime Kasai, Shinobu Ikeda, Jiaqi Wang, Kyosuke Koide, Shoichi Ito, Satoshi Kuwabara

Erschienen in: Sleep and Breathing | Ausgabe 4/2022

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Abstract

Purpose

We aimed to evaluate sleep-related hypoventilation in multiple system atrophy (MSA) using polysomnography (PSG) with transcutaneous partial pressure of carbon dioxide (PtcCO2) monitoring.

Methods

This prospective study included 34 patients with MSA. Motor and autonomic function, neuropsychological tests, PSG with PtcCO2 monitoring, and pulmonary function tests were performed. Sleep-related hypoventilation disorder (SRHD) was defined according to the International Classification of Sleep Disorders, third edition.

Results

Nine (27%) of the 34 patients met the diagnostic criteria of SRHD. Twenty-nine (85%) patients had sleep-related breathing disorders based on an Apnea–Hypopnea Index of ≥ 5/h. The patients with MSA and SRHD had a higher arousal index (p = 0.017) and obstructive apnea index (p = 0.041) than those without SRHD. There was no difference in the daytime partial pressure of carbon dioxide in arterial blood or respiratory function between MSA patients with and without SRHD.

Conclusion

Sleep-related hypoventilation may occur in patients with MSA even with a normal daytime partial pressure of carbon dioxide. This can be noninvasively detected by PSG with PtcCO2 monitoring. SRBD and sleep-related hypoventilation are common among patients with MSA, and clinicians should take this into consideration while evaluating and treating this population.
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Literatur
1.
Zurück zum Zitat Jecmenica-Lukic M, Poewe W, Tolosa E, Wenning GK (2012) Premotor signs and symptoms of multiple system atrophy. Lancet Neurol 11(4):361–368 CrossRefPubMed Jecmenica-Lukic M, Poewe W, Tolosa E, Wenning GK (2012) Premotor signs and symptoms of multiple system atrophy. Lancet Neurol 11(4):361–368 CrossRefPubMed
2.
Zurück zum Zitat Iranzo A (2007) Sleep and breathing in multiple system atrophy. Curr Treat Options 9(5):347–353 CrossRef Iranzo A (2007) Sleep and breathing in multiple system atrophy. Curr Treat Options 9(5):347–353 CrossRef
3.
Zurück zum Zitat Shimohata T, Aizawa N, Nakayama H, Taniguchi H, Ohshima Y, Okumura H et al (2016) Mechanism and prevention of sudden death in multiple system atrophy. Parkinsonism Relat Disord 30:1–6 CrossRefPubMed Shimohata T, Aizawa N, Nakayama H, Taniguchi H, Ohshima Y, Okumura H et al (2016) Mechanism and prevention of sudden death in multiple system atrophy. Parkinsonism Relat Disord 30:1–6 CrossRefPubMed
4.
Zurück zum Zitat Benarroch EE (2019) Control of the cardiovascular and respiratory systems during sleep. Auton Neurosci 218:54–63 CrossRefPubMed Benarroch EE (2019) Control of the cardiovascular and respiratory systems during sleep. Auton Neurosci 218:54–63 CrossRefPubMed
5.
Zurück zum Zitat Tsuda T, Onodera H, Okabe S, Kikuchi Y, Itoyama Y (2002) Impaired chemosensitivity to hypoxia is a marker of multiple system atrophy. Ann Neurol 52(3):367–371 CrossRefPubMed Tsuda T, Onodera H, Okabe S, Kikuchi Y, Itoyama Y (2002) Impaired chemosensitivity to hypoxia is a marker of multiple system atrophy. Ann Neurol 52(3):367–371 CrossRefPubMed
6.
Zurück zum Zitat Chokroverty S, Sharp JT, Barron KD (1978) Periodic respiration in erect posture in Shy-Drager syndrome. J Neurol Neurosurg Psychiatry 41(11):980–986 CrossRefPubMedPubMedCentral Chokroverty S, Sharp JT, Barron KD (1978) Periodic respiration in erect posture in Shy-Drager syndrome. J Neurol Neurosurg Psychiatry 41(11):980–986 CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Glass GA, Josephs KA, Ahlskog JE (2006) Respiratory insufficiency as the primary presenting symptom of multiple-system atrophy. Arch Neurol 63(7):978–981 CrossRefPubMed Glass GA, Josephs KA, Ahlskog JE (2006) Respiratory insufficiency as the primary presenting symptom of multiple-system atrophy. Arch Neurol 63(7):978–981 CrossRefPubMed
8.
Zurück zum Zitat Shimohata T, Nakayama H, Shinoda H, Tsukada H, Takahashi S, Gejo F et al (2006) Multiple system atrophy with progressive nocturnal hypoxemia: case report with polysomnography and continuous positive airway pressure treatment. Eur Neurol 56(4):258–260 CrossRefPubMed Shimohata T, Nakayama H, Shinoda H, Tsukada H, Takahashi S, Gejo F et al (2006) Multiple system atrophy with progressive nocturnal hypoxemia: case report with polysomnography and continuous positive airway pressure treatment. Eur Neurol 56(4):258–260 CrossRefPubMed
9.
Zurück zum Zitat Shimohata T, Shinoda H, Nakayama H, Ozawa T, Terajima K, Yoshizawa H et al (2007) Daytime hypoxemia, sleep-disordered breathing, and laryngopharyngeal findings in multiple system atrophy. Arch Neurol 64(6):856–861 CrossRefPubMed Shimohata T, Shinoda H, Nakayama H, Ozawa T, Terajima K, Yoshizawa H et al (2007) Daytime hypoxemia, sleep-disordered breathing, and laryngopharyngeal findings in multiple system atrophy. Arch Neurol 64(6):856–861 CrossRefPubMed
10.
Zurück zum Zitat McNicholas WT, Rutherford R, Grossman R, Moldofsky H, Zamel N, Phillipson EA (1983) Abnormal respiration pattern generation during sleep in patients with autonomic dysfunction. Am Rev Respir Dis 128(3):429–433 CrossRefPubMed McNicholas WT, Rutherford R, Grossman R, Moldofsky H, Zamel N, Phillipson EA (1983) Abnormal respiration pattern generation during sleep in patients with autonomic dysfunction. Am Rev Respir Dis 128(3):429–433 CrossRefPubMed
11.
Zurück zum Zitat American Academy of Sleep Medicine, (2014) The international classification of sleep disorders. 3 rd Edition (ICSD-3). American Academy of Sleep Medicine, (2014) The international classification of sleep disorders. 3 rd Edition (ICSD-3).
12.
Zurück zum Zitat Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ et al (2008) Second consensus statement on the diagnosis of multiple system atrophy. Neurology 71(9):670–676 CrossRefPubMedPubMedCentral Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ et al (2008) Second consensus statement on the diagnosis of multiple system atrophy. Neurology 71(9):670–676 CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Takenoshita S, Terada S, Yoshida H, Yamaguchi M, Yabe M, Imai N et al (2019) Validation of Addenbrooke’s cognitive examination III for detecting mild cognitive impairment and dementia in Japan. BMC Geriatr 19(1):123 CrossRefPubMedPubMedCentral Takenoshita S, Terada S, Yoshida H, Yamaguchi M, Yabe M, Imai N et al (2019) Validation of Addenbrooke’s cognitive examination III for detecting mild cognitive impairment and dementia in Japan. BMC Geriatr 19(1):123 CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Wilson BA, Alderman N, Burgess PW, Emslie H, Evans JJ (1996) Behavioural assessment of the Dysexecutive Syndrome, Thames Valley Test Company, Bury St. Edmunds, UK. Wilson BA, Alderman N, Burgess PW, Emslie H, Evans JJ (1996) Behavioural assessment of the Dysexecutive Syndrome, Thames Valley Test Company, Bury St. Edmunds, UK.
16.
Zurück zum Zitat Sugiyama A, Yokota H, Yamanaka Y, Mukai H, Yamamoto T, Hirano S et al (2020) Vertical pons hyperintensity and hot cross bun sign in cerebellar-type multiple system atrophy and spinocerebellar ataxia type 3. BMC Neurol 20(1):157 CrossRefPubMedPubMedCentral Sugiyama A, Yokota H, Yamanaka Y, Mukai H, Yamamoto T, Hirano S et al (2020) Vertical pons hyperintensity and hot cross bun sign in cerebellar-type multiple system atrophy and spinocerebellar ataxia type 3. BMC Neurol 20(1):157 CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Iijima M, Osawa M, Momose M, Kobayakawa T, Saito S, Iwata M, Uchiyama S (2010) Cardiac sympathetic degeneration correlates with olfactory function in Parkinson’s disease. Mov Disord 25(9):1143–1149 CrossRefPubMed Iijima M, Osawa M, Momose M, Kobayakawa T, Saito S, Iwata M, Uchiyama S (2010) Cardiac sympathetic degeneration correlates with olfactory function in Parkinson’s disease. Mov Disord 25(9):1143–1149 CrossRefPubMed
18.
Zurück zum Zitat Johns MW (1994) Sleepiness in different situations measured by the Epworth Sleepiness Scale. Sleep 17(8):703–710 CrossRefPubMed Johns MW (1994) Sleepiness in different situations measured by the Epworth Sleepiness Scale. Sleep 17(8):703–710 CrossRefPubMed
19.
Zurück zum Zitat Miyamoto T, Miyamoto M, Iwanami M, Kobayashi M, Nakamura M, Inoue Y et al (2009) The REM sleep behavior disorder screening questionnaire: validation study of a Japanese version. Sleep Med 10(10):1151–1154 CrossRefPubMed Miyamoto T, Miyamoto M, Iwanami M, Kobayashi M, Nakamura M, Inoue Y et al (2009) The REM sleep behavior disorder screening questionnaire: validation study of a Japanese version. Sleep Med 10(10):1151–1154 CrossRefPubMed
20.
Zurück zum Zitat Celli BR, MacNee W, ATS, ERS Task Force, (2004) Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 23(6):932–946 CrossRefPubMed Celli BR, MacNee W, ATS, ERS Task Force, (2004) Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 23(6):932–946 CrossRefPubMed
21.
Zurück zum Zitat Guideline of respiratory function tests—spirometry, flow-volume curve, diffusion capacity of the lung (2004) Nihon Kokyuki Gakkai Zasshi J Jpn Respir Soc Suppl:1–56. Guideline of respiratory function tests—spirometry, flow-volume curve, diffusion capacity of the lung (2004) Nihon Kokyuki Gakkai Zasshi J Jpn Respir Soc Suppl:1–56.
22.
Zurück zum Zitat Jin K, Okabe S, Chida K, Abe N, Kimpara T, Ohnuma A et al (2007) Tracheostomy can fatally exacerbate sleep-disordered breathing in multiple system atrophy. Neurology 68(19):1618–1621 CrossRefPubMed Jin K, Okabe S, Chida K, Abe N, Kimpara T, Ohnuma A et al (2007) Tracheostomy can fatally exacerbate sleep-disordered breathing in multiple system atrophy. Neurology 68(19):1618–1621 CrossRefPubMed
23.
Zurück zum Zitat Deguchi K, Ikeda K, Goto R, Tsukaguchi M, Urai Y, Kurokohchi K et al (2010) The close relationship between life-threatening breathing disorders and urine storage dysfunction in multiple system atrophy. J Neurol 257(8):1287–1292 CrossRefPubMed Deguchi K, Ikeda K, Goto R, Tsukaguchi M, Urai Y, Kurokohchi K et al (2010) The close relationship between life-threatening breathing disorders and urine storage dysfunction in multiple system atrophy. J Neurol 257(8):1287–1292 CrossRefPubMed
24.
Zurück zum Zitat Muntean ML, Sixel-Döring F, Trenkwalder C (2013) No difference in sleep and RBD between different types of patients with multiple system atrophy: a pilot video-polysomnographical study. Sleep Disord 2013:258390. Muntean ML, Sixel-Döring F, Trenkwalder C (2013) No difference in sleep and RBD between different types of patients with multiple system atrophy: a pilot video-polysomnographical study. Sleep Disord 2013:258390.
25.
Zurück zum Zitat Guo XY, Cao B, Lei F, Huang L, Chen K, Song W et al (2013) Clinical and polysomnographic features of patients with multiple system atrophy in Southwest China. Sleep Breath 17(4):1301–1307 CrossRefPubMed Guo XY, Cao B, Lei F, Huang L, Chen K, Song W et al (2013) Clinical and polysomnographic features of patients with multiple system atrophy in Southwest China. Sleep Breath 17(4):1301–1307 CrossRefPubMed
26.
Zurück zum Zitat Cao B, Wei QQ, Ou R, Zhao B, Hu T, Chen Y et al (2018) Impact of sleep-related breathing disorder on motor and non-motor symptoms in multiple system atrophy. Sleep Breath 22(4):981–987 CrossRefPubMed Cao B, Wei QQ, Ou R, Zhao B, Hu T, Chen Y et al (2018) Impact of sleep-related breathing disorder on motor and non-motor symptoms in multiple system atrophy. Sleep Breath 22(4):981–987 CrossRefPubMed
27.
Zurück zum Zitat Parreira S, Antunes F, Coelho M, Bentes C, Peralta R (2021) Sighs during sleep in multiple system atrophy. Sleep Med 78:75–80 CrossRefPubMed Parreira S, Antunes F, Coelho M, Bentes C, Peralta R (2021) Sighs during sleep in multiple system atrophy. Sleep Med 78:75–80 CrossRefPubMed
28.
Zurück zum Zitat Wang Y, Shao WB, Gao L, Lu J, Gu H, Sun LH, et al (2014) Abnormal pulmonary function and respiratory muscle strength findings in Chinese patients with Parkinson’s disease and multiple system atrophy-comparison with normal elderly. PLoS ONE 9(12):e116123. Wang Y, Shao WB, Gao L, Lu J, Gu H, Sun LH, et al (2014) Abnormal pulmonary function and respiratory muscle strength findings in Chinese patients with Parkinson’s disease and multiple system atrophy-comparison with normal elderly. PLoS ONE 9(12):e116123.
29.
Zurück zum Zitat Richerson GB (2004) Serotonergic neurons as carbon dioxide sensors that maintain pH homeostasis. Nat Rev Neurosci 5(6):449–461 CrossRefPubMed Richerson GB (2004) Serotonergic neurons as carbon dioxide sensors that maintain pH homeostasis. Nat Rev Neurosci 5(6):449–461 CrossRefPubMed
30.
Zurück zum Zitat Benarroch EEE (2007) Brainstem respiratory control: substrates of respiratory failure of multiple system atrophy. Mov Disord 22(2):155–161 CrossRefPubMed Benarroch EEE (2007) Brainstem respiratory control: substrates of respiratory failure of multiple system atrophy. Mov Disord 22(2):155–161 CrossRefPubMed
31.
Zurück zum Zitat Tada M, Kakita A, Toyoshima Y, Onodera O, Ozawa T, Morita T et al (2009) Depletion of medullary serotonergic neurons in patients with multiple system atrophy who succumbed to sudden death. Brain 132(Pt 7):1810–1819 CrossRefPubMed Tada M, Kakita A, Toyoshima Y, Onodera O, Ozawa T, Morita T et al (2009) Depletion of medullary serotonergic neurons in patients with multiple system atrophy who succumbed to sudden death. Brain 132(Pt 7):1810–1819 CrossRefPubMed
32.
Zurück zum Zitat Benarroch EE, Schmeichel AM, Low PA, Parisi JE (2007) Depletion of putative chemosensitivity respiratory neurons in the ventral medullary surface in multiple system atrophy. Brain 130(Pt 2):469–475 CrossRefPubMed Benarroch EE, Schmeichel AM, Low PA, Parisi JE (2007) Depletion of putative chemosensitivity respiratory neurons in the ventral medullary surface in multiple system atrophy. Brain 130(Pt 2):469–475 CrossRefPubMed
33.
Zurück zum Zitat Benarroch EE, Schmeichel AM, Low PA, Parisi JE (2003) Depletion of ventromedullary NK-1 receptor-immunoreactive neurons in multiple system atrophy. Brain 126(Pt 10):2183–2190 CrossRefPubMed Benarroch EE, Schmeichel AM, Low PA, Parisi JE (2003) Depletion of ventromedullary NK-1 receptor-immunoreactive neurons in multiple system atrophy. Brain 126(Pt 10):2183–2190 CrossRefPubMed
34.
Zurück zum Zitat Virkki A, Polo O, Gyllenberg M, Aittokallio T (2007) Can Carotid body perfusion act as a respiratory controller? J Theor Biol 249(4):737–748 CrossRefPubMed Virkki A, Polo O, Gyllenberg M, Aittokallio T (2007) Can Carotid body perfusion act as a respiratory controller? J Theor Biol 249(4):737–748 CrossRefPubMed
35.
Zurück zum Zitat Healey CJ, Fedullo AJ, Swinburne AJ, Wahl GW (1987) Comparisons of noninvasive measurements of carbon dioxide tension during withdrawal from mechanical ventilation. Crit Care Med 15(8):764–768 CrossRefPubMed Healey CJ, Fedullo AJ, Swinburne AJ, Wahl GW (1987) Comparisons of noninvasive measurements of carbon dioxide tension during withdrawal from mechanical ventilation. Crit Care Med 15(8):764–768 CrossRefPubMed
36.
Zurück zum Zitat Clark JS, Votteri B, Ariagno RL, Cheung P, Eichhorn JH, Fallat RJ et al (1992) Noninvasive assessment of blood gases. Am Rev Respir Dis 145(1):220–232 CrossRefPubMed Clark JS, Votteri B, Ariagno RL, Cheung P, Eichhorn JH, Fallat RJ et al (1992) Noninvasive assessment of blood gases. Am Rev Respir Dis 145(1):220–232 CrossRefPubMed
37.
Zurück zum Zitat Iranzo A, Santamaria J, Tolosa E (2000) Continuous positive air pressure eliminates nocturnal stridor in multiple system atrophy. Lancet 356(9238):1329–1330 CrossRefPubMed Iranzo A, Santamaria J, Tolosa E (2000) Continuous positive air pressure eliminates nocturnal stridor in multiple system atrophy. Lancet 356(9238):1329–1330 CrossRefPubMed
38.
Zurück zum Zitat Ghorayeb I, Yekhlef F, Bioulac B, Tison F (2005) Continuous positive airway pressure for sleep-related breathing disorders in multiple system atrophy: long-term acceptance. Sleep Med 6(4):359–362 CrossRefPubMed Ghorayeb I, Yekhlef F, Bioulac B, Tison F (2005) Continuous positive airway pressure for sleep-related breathing disorders in multiple system atrophy: long-term acceptance. Sleep Med 6(4):359–362 CrossRefPubMed
39.
Zurück zum Zitat Piper AJ, Sullivan CE (1994) Effects of short-term NIPPV in the treatment of patients with severe obstructive sleep apnea and hypercapnia. Chest 105(2):434–440 CrossRefPubMed Piper AJ, Sullivan CE (1994) Effects of short-term NIPPV in the treatment of patients with severe obstructive sleep apnea and hypercapnia. Chest 105(2):434–440 CrossRefPubMed
40.
Zurück zum Zitat Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D et al (2006) Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 29(3):375–380 CrossRefPubMed Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D et al (2006) Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 29(3):375–380 CrossRefPubMed
41.
Zurück zum Zitat Windisch W, Geiseler J, Simon K, Walterspacher S, Dreher M; on behalf of the Guideline Commission (2018) German National Guideline for treating chronic respiratory failure with invasive and non-invasive ventilation – revised edition 2017: part 2. Respiration 96(1):171–203. Windisch W, Geiseler J, Simon K, Walterspacher S, Dreher M; on behalf of the Guideline Commission (2018) German National Guideline for treating chronic respiratory failure with invasive and non-invasive ventilation – revised edition 2017: part 2. Respiration 96(1):171–203.
42.
43.
Zurück zum Zitat Eberhard P, Gisiger PA, Gardaz JP, Spahn DR (2002) Combining transcutaneous blood gas measurement and pulse oximetry. Anesthe Analg 94(1 Suppl):S76-80 Eberhard P, Gisiger PA, Gardaz JP, Spahn DR (2002) Combining transcutaneous blood gas measurement and pulse oximetry. Anesthe Analg 94(1 Suppl):S76-80
44.
Zurück zum Zitat Tobias JD (2009) Transcutaneous carbon dioxide monitoring in infants and children. Pediatr Anesth 19(5):434–444 CrossRef Tobias JD (2009) Transcutaneous carbon dioxide monitoring in infants and children. Pediatr Anesth 19(5):434–444 CrossRef
Metadaten
Titel
Sleep-related hypoventilation and hypercapnia in multiple system atrophy detected by polysomnography with transcutaneous carbon dioxide monitoring
verfasst von
Atsuhiko Sugiyama
Jiro Terada
Yu Shionoya
Shigeki Hirano
Tatsuya Yamamoto
Yoshitaka Yamanaka
Nobuyuki Araki
Ken Koshikawa
Hajime Kasai
Shinobu Ikeda
Jiaqi Wang
Kyosuke Koide
Shoichi Ito
Satoshi Kuwabara
Publikationsdatum
13.01.2022
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-022-02568-4

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