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We studied respiration during sleep in 7 patients with multiple system atrophy and autonomic failure(MSA-AF)and 7 control subjects.Although mean respiratory rate,tidal volume,and inspiratory flow rate were statistically similar in both groups,the coefficients of variability in all were significantly greater in MSA-AF patients.Four of 5 nonstracheostomized 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. |
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