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Master Thesis

Étude polysomnographique des troubles respiratoires du sommeil dans l’atrophie multisystématisée : impact du syndrome d’apnées du sommeil dans l’évolution de la maladie

Abstract : Introduction: multiple system atrophy (MSA) is a rare and severe neurodegenerative disorder, without any treatment available to slow down the relentlessly progressing disease. Sleep respiratory disorders are frequently found in MSA patients, in particular sleep apnea syndrome (SAS). However, their impact on the prognosis of MSA remain a matter of debate. This study aimed at characterizing factors associated with SAS and at determining the impact of SAS on survival in MSA patients. Methods: this monocentric retrospective study was based on clinical, demographical and polysomnographic (PSG) data of patients followed at the French Reference Center for MSA in Bordeaux. PSG were not guided by patient’ complains. Activities of daily living, motor symptoms, overall disability, autonomic function and quality of life were examined annually with validated rating scales, i.e. UMSARS, COMPASS-31, MSA-QoL. For some patients, data of several PSG were available to study the progression of sleep apnea over time. Results: ninety-five patients were included, 58% had a SAS, as defined by an apnea/hypopnea index (AHI) superior or equal to 15 per hour of sleep. Patients with and without SAS had no differences in clinical and demographical data except tendencies for faster motor progression, higher proportion of cerebellar MSA phenotype, higher age of disease and body mass index in case of SAS. Micro-awakening and periodic respiration were higher in patients with SAS. In patients without SAS at baseline, AHI increased over time with 37.5 % of diagnosis of SAS. AHI was reduced by continuous positive airway pressure (CPAP) with 91% of residual AHI lower than 15/hour. An univariate analysis showed a trend toward reduced survival in MSA patients with SAS. However, SAS was not a predictive factor of survival in the final multivariate analysis. Conclusion: even if SAS was found in 58% of MSA patients, it had no effect on survival of MSA patients in the final multivariate analysis.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01845329
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Submitted on : Friday, July 20, 2018 - 12:18:59 PM
Last modification on : Wednesday, August 29, 2018 - 1:08:15 AM
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Anna Delamarre. Étude polysomnographique des troubles respiratoires du sommeil dans l’atrophie multisystématisée : impact du syndrome d’apnées du sommeil dans l’évolution de la maladie. Médecine humaine et pathologie. 2018. ⟨dumas-01845329⟩

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