Association between low sniff nasal-inspiratory pressure (SNIP) and sleep disordered breathing in amyotrophic lateral sclerosis: Preliminary results

Pierluigi Carratú, Anna Cassano, Felice Gadaleta, Mariangela Tedone, Salvatore Dongiovanni, Francesco Fanfulla, Onofrio Resta

Research output: Contribution to journalArticle

Abstract

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that rapidly involves the respiratory system, leading to persistent respiratory insufficiency. Neuromuscular respiratory weakness is also responsible for sleep disordered breathing (SDB), which occurs at an early stage of ALS. Maximal sniff nasal-inspiratory pressure (SNIP) is a sensitive test to early disclose respiratory muscle decline. The aim of this study was to evaluate the role of the SNIP test, compared to FVC, as a marker of SDB in ALS. We studied 31 (18 males) patients with ALS, who were divided into two groups according to the SNIP test value. Ten patients who showed a SNIP value higher than 60 cmH 2O were considered as group 1. Twenty-one patients exhibited a SNIP lower than 60 cmH 2O and were included in group 2. Both groups of patients were also investigated with nocturnal sleep study. A linear correlation between lower SNIP value and reduced nocturnal SaO 2 in patients with a SNIP value less than 60 cmH 2O (n = 21; r = 0.449; p = 0.04) was found. A negative correlation between SNIP and time spent in SaO 2 below 90% (TST90) (n = 21; r =-0.584; p = 0.0054), and between SNIP and oxyhaemoglobin desaturation index (ODI, events/hour) (n = 21; r =-0.458; p = 0.0368) was also established in all the patients of group 2, while, in this group, FVC did not correlate with any nocturnal parameter observed. A positive correlation between SNIP and PaO 2 at baseline of the entire population of patients (n = 31; r = 0.614; p <0.001) was also seen. In conclusion, the results of this preliminary study show that SNIP <60 cmH 2O might be considered an early predictor of SDB in ALS.

Original languageEnglish
Pages (from-to)458-463
Number of pages6
JournalAmyotrophic Lateral Sclerosis
Volume12
Issue number6
DOIs
Publication statusPublished - Nov 2011

Keywords

  • ALS
  • FVC
  • sleep disordered breathing
  • SNIP

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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