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NEUROLOGY 1990;40:677
© 1990 American Academy of Neurology

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

Frederick E. Munschauer, MD, Laurence Loh, MB, FFARCS, Roger Bannister, DM, FRCP and John Newsom-Davis DM, FRCP

State University of New York at Buffalo (Dr. Munschauer), Buffalo, NY, and The National Hospital for Nervous Disease (Drs. Loh, Bannister, and Newsom-Davis), Queen Square, London, UK.

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.

Address correspondence and reprint requests to Dr. Frederick E. Munschauer, University of New York at Buffalo, Department of Neurology, Buffalo General Hospital, 100 High Street, Buffalo, NY 14203.

Received February 16, 1988. Accepted for publication in final form September 25, 1989.




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