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08-07-2023 | Amyotrophic Lateral Sclerosis | Neurology • Original Article

Detection of episodic nocturnal hypercapnia in patients with neurodegenerative disorders

Authors: Hiroyuki Naito, Takamichi Sugimoto, Kazuki Kimoto, Takafumi Abe, Narumi Ohno, Mayumi Giga, Tomoyuki Kono, Hiroki Ueno, Eiichi Nomura, Hirofumi Maruyama

Published in: Sleep and Breathing | Issue 1/2024

Abstract

Purpose

Episodic nocturnal hypercapnia (eNH) in transcutaneous carbon dioxide pressure (PtcCO₂) corresponding to rapid eye movement sleep hypoventilation is a useful biomarker for detecting nocturnal hypoventilation. However, the relationship between eNH and neurodegenerative diseases with sleep-related breathing disorders (SRBDs) is unknown. The aim of this study was to evaluate the relationship between eNH and nocturnal hypoventilation in neurodegenerative diseases.

Methods

Patients with neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), multiple system atrophy (MSA), Parkinson’s disease, progressive supranuclear palsy, corticobasal syndrome, and idiopathic normal pressure hydrocephalus, were enrolled and received overnight PtcCO₂ monitoring. The patients were divided into groups for eNH and sleep-associated hypoventilation (SH) prevalence analysis: A (ALS), B (MSA), and C (others).

Results

Among 110 patients, twenty-three (21%) and 10 (9%) of the patients met eNH and SH criteria, respectively. eNH and SH were significantly more frequent in groups A and B than in C. The prevalence of SH in the patients with eNH was 39% whereas most of patients with SH (90%) presented with eNH. Among patients with daytime carbon dioxide pressure in arterial blood ≤ 45 mmHg, eNH frequency was 13%, whereas none of the patients met SH criteria. The frequency of noninvasive positive pressure ventilation after PtcCO₂ monitoring was significantly higher in those with than without eNH.

Conclusions

eNH is common in patients with MSA and ALS who present with SRBD. eNH with overnight PtcCO₂ monitoring is a useful biomarker to detect hypoventilation among neurodegenerative diseases with different SRBD mechanisms.

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Title: Detection of episodic nocturnal hypercapnia in patients with neurodegenerative disorders
Authors: Hiroyuki Naito
Takamichi Sugimoto
Kazuki Kimoto
Takafumi Abe
Narumi Ohno
Mayumi Giga
Tomoyuki Kono
Hiroki Ueno
Eiichi Nomura
Hirofumi Maruyama
Publication date: 08-07-2023
Publisher: Springer International Publishing
Keywords: Amyotrophic Lateral Sclerosis
Sleep-Related Breathing Disorder
Progressive Supranuclear Palsy
Published in: Sleep and Breathing / Issue 1/2024
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-023-02876-3

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