in patients with neuromuscular disease and I would add that close monitoring of respiratory function and sleep evaluation should be the standard of care in people who have suffered physical injury to their bodies, especially in people with behaviour and sleep problems.. Respiratory involvement is hard to detect unless minute volume is continually assessed during appointments with any health professional. Abnormal respiratory rate is an important clue to neuromuscular problems due to any causes, congenital or acquired.

Pulm Med. 2019; 2019: 2734054. Published online 2019 Dec 26. doi: 10.1155/2019/2734054

Respiratory Involvement in Patients with Neuromuscular Diseases: A Narrative Review

Athanasios Voulgaris, 1 , 2 Maria Antoniadou, 1 , 3 Michalis Agrafiotis, 1 , 3 and  Paschalis Steiropoulos 1 , 2Author informationArticle notesCopyright and License informationDisclaimer1MSc Program in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece2Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece3Department of Pneumonology, General Hospital “G. Papanikolaou”, Thessaloniki, GreeceCorresponding author.Paschalis Steiropoulos: moc.oohay@soluoporietsAcademic Editor: Roberto Walter Dal Negro

Abstract

Respiratory muscle weakness is a major cause of morbidity and mortality in patients with neuromuscular diseases (NMDs). Respiratory involvement in NMDs can manifest broadly, ranging from milder insufficiency that may affect only sleep initially to severe insufficiency that can be life threatening. Patients with neuromuscular diseases exhibit very often sleep-disordered breathing, which is frequently overlooked until symptoms become more severe leading to irreversible respiratory failure necessitating noninvasive ventilation (NIV) or even tracheostomy. Close monitoring of respiratory function and sleep evaluation is currently the standard of care. Early recognition of sleep disturbances and initiation of NIV can improve the quality of life and prolong survival. This review discusses the respiratory impairment during sleep in patients with NMDs, the diagnostic tools available for early recognition of sleep-disordered breathing and the therapeutic options available for overall respiratory management of patients with NMDs.