Effects of alterations in pulmonary function and sleep variables on survival in patients with amyotrophic lateral sclerosis

P. C. Gay, P. R. Westbrook, J. R. Daube, William J Litchy, Anthony John Windebank, R. Iverson

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

Breathing abnormalities and nocturnal hypoventilation occur in patients with amyotrophic lateral sclerosis (ALS). A prospective study was undertaken to determine the relationship of pulmonary function test abnormalities with quality of sleep and survival in 21 patients with ALS. Results of spirometry including determination of maximal respiratory pressures and arterial blood gases were compared with several formal polysomnographic variables and then also with 18-month survival. The patients had mild to moderate pulmonary function deficits, but the quality of sleep was best related to age (mean age, 58.5 years). The results of pulmonary function tests and arterial blood gas measurements did not correlate well with the presence of nocturnal breathing events or survival time, but the maximal inspiratory pressure was 86% sensitive for predicting the presence of a nocturnal oxygen saturation nadir of 80% or less and 100% sensitive for predicting 18-month survival. Although obstructive breathing events occurred, the primary explanation for the decline in nocturnal oxygen saturation was hypoventilation. We conclude that routine pulmonary function tests may be useful for screening for reductions in nocturnal oxygen saturation and also may have prognostic value. Further studies may determine whether treatment of nocturnal hypoventilation will have an effect on survival in patients with ALS who have breathing impairment.

Original languageEnglish (US)
Pages (from-to)686-694
Number of pages9
JournalMayo Clinic Proceedings
Volume66
Issue number7
StatePublished - 1991

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Amyotrophic Lateral Sclerosis
Sleep
Hypoventilation
Respiratory Function Tests
Respiration
Lung
Survival
Oxygen
Gases
Spirometry
Prospective Studies
Maximal Respiratory Pressures

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of alterations in pulmonary function and sleep variables on survival in patients with amyotrophic lateral sclerosis. / Gay, P. C.; Westbrook, P. R.; Daube, J. R.; Litchy, William J; Windebank, Anthony John; Iverson, R.

In: Mayo Clinic Proceedings, Vol. 66, No. 7, 1991, p. 686-694.

Research output: Contribution to journalArticle

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