Rapid eye movement sleep alterations in myasthenia gravis

Papazian, Óscar

doi:10.1212/wnl.26.4.311

Cited by 58 publications

(26 citation statements)

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“…Sleep-disordered breathing is common in MG associated with peripheral respiratory muscle weakness, particularly diaphragmatic weakness. In common with other conditions, sleep-disordered breathing and nocturnal desaturation are most pronounced during REM sleep [16,18] and the majority of respiratory events are central. Older patients with a higher BMI, lower TLC and abnormal daytime arterial blood gases are most vulnerable [16].…”

Section: Myasthenia Gravismentioning

confidence: 99%

“…Older patients with a higher BMI, lower TLC and abnormal daytime arterial blood gases are most vulnerable [16]. Sleep-disordered breathing and nocturnal desaturation may improve following treatment with thymectomy [17] or prednisolone [18].…”

Section: Myasthenia Gravismentioning

confidence: 99%

“…Duchenne9s muscular dystrophy (DMD) [6][7][8][9][10], and myotonic dystrophy (MD) [11][12][13][14], myopathies (e.g. nemaline myopathy [15]), Guillian-Barré syndrome and myasthenia gravis [16][17][18]. Respiratory muscle weakness, apnoeas and hypopnoeas, and abnormalities of breathing pattern and ventilatory drive may all contribute to nocturnal desaturation and sleep disruption, even before daytime ventilatory failure ensues.…”

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confidence: 99%

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Sleep and breathing in neuromuscular disease

Bourke¹,

Gibson²

2002

Eur Respir J

151

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Respiratory muscle weakness in neuromuscular disease causes significant morbidity and mortality. The published data on respiratory muscle activity and breathing during sleep in normal subjects, the impact of respiratory muscle weakness on sleep and breathing and the relations to daytime respiratory function in neuromuscular disease are reviewed here. In normal subjects during sleep upper airway resistance increases, chemosensitivity is reduced and the wakefulness drive to breathe is lost, resulting in a fall in ventilation. During rapid eye movement (REM) sleep, ribcage and accessory breathing muscles are suppressed, particularly during bursts of eye movements, and breathing is more irregular, rapid and shallow, with a further fall in ventilation.In subjects with respiratory muscle weakness sleep is fragmented, with shorter total sleep time, frequent arousals, an increase in stage 1 sleep and a reduction in, or complete suppression of, REM sleep. Sleep-disordered breathing and nocturnal desaturation are common and most severe during REM sleep. Correlations between daytime respiratory function and nocturnal desaturation are moderate or weak, but daytime respiratory function has greater prognostic value than nocturnal measurements.Noninvasive ventilation improves sleep quality and breathing in subjects with respiratory muscle weakness. However, the optimal criteria for initiation of ventilation and its role in rapidly progressive neuromuscular diseases are unclear.

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Section: Myasthenia Gravismentioning

confidence: 99%

Section: Myasthenia Gravismentioning

confidence: 99%

mentioning

confidence: 99%

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Sleep and breathing in neuromuscular disease

Bourke¹,

Gibson²

2002

Eur Respir J

151

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“…Two groups have tried to use EEG sleep studies of the amount and timing of REM sleep to demonstrate central cholinergic abnormalities, but their results have apparently been discrepant. The first, by Papazian (1976), reported decreased and disturbed REM sleep. The second, by Mennuni et al (1983), found decreased REM latency.…”

Section: Myasthenia Gravismentioning

confidence: 99%

Rapid Eye Movement (REM) sleep: cholinergic mechanisms

Gillin¹,

Sitaram²

1984

Psychol. Med.

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EDITORIALRapid Eye Movement (REM) sleep: cholinergic mechanisms 1 Otto Loewe conceived of the experiment that led to the discovery of Vagusstoff or acetylcholine during a dream. As this review will attempt to show, it is likely that acetylcholine, acting as a neurotransmitter on a muscarinic synapse within the dorsal tegmentum of the pons, triggered the dream that resulted in its own discovery.Evidence for the involvement of acetylcholine with Rapid Eye Movement (REM) sleep comes both from human and animal studies. REM sleep is a complicated state, involving, on the psychological level, dreaming, and, on the physiological, activation of the EEG, bursts of rapid eye movements, atonia of the major antigravity muscles, monophasic waves in the pontine, geniculate and occipital areas (PGO spikes), hippocampal theta waves, variability of autonomic functioning, and increased firing rates of most central neurones (with notable exceptions, to be mentioned later). There is also a circadian propensity to REM sleep in man and many mammals. Acetylcholine may be involved in nearly all aspects of REM sleep. ANIMAL STUDIESSix different types of data from animal studies suggest that acetylcholine plays an important role in REM sleep.

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“…For instance, old studies reported increased incidence of epilepsy and electrophysiological changes in patients with MG 3,4 . Sleep disorders and memory impairment have also been described in MG, as the cholinergic system plays a major role in these functions 5,6 . However, the inappropriate methods of these previous studies precluded the establishment of any causal relationship between these findings and disruption of cholinergic neurotransmission 2 .…”

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confidence: 99%

Psychiatric disorders in myasthenia gravis

Ybarra

Kümmer²,

Frota³

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: To investigate the prevalence of psychiatric disorders in patients with myasthenia gravis (MG). Method: Forty-one patients with MG answered to a structured psychiatric interview (MINI-Plus). Results: Eleven (26.1%) patients were diagnosed with a depressive disorder and 19 (46.3%) were diagnosed with an anxiety disorder. Patients with dysthymia were older (p=0.029) and had longer disease duration (p=0.006). Patients with social phobia also had longer disease duration (p=0.039). Conclusion: Psychiatric disorders in MG are common, especially depressive and anxiety disorders.

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Rapid eye movement sleep alterations in myasthenia gravis

Cited by 58 publications

References 0 publications

Sleep and breathing in neuromuscular disease

Sleep and breathing in neuromuscular disease

Rapid Eye Movement (REM) sleep: cholinergic mechanisms

Psychiatric disorders in myasthenia gravis

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