Abnormal respiration and sudden death during sleep in multiple system atrophy with autonomie failure

Abstract
We studied respiration during sleep in 7 patients with multiple system atrophy and autonomie failure (MSA-AF) and 7 control subjects. Although mean respiratory rate, tidal volume, and inspiratory Sow rate were statistically similar in both groups, the coefficients of variability in all were significantly greater in MSA-AF patients. Four of 5 non-tracheostomized had evidence of upper airway obstruction without significant oxygen desaturation. Three of these 5 patients died suddenly during sleep. MSA-AF is associated with upper airway dysfunction and disordered central respirations which can be life threatening. Evidence of even mild obstruction during sleep should warrant tracheostomy.

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