TY - JOUR T1 - Does respiratory irregularity contribute to the pathogenesis of sleep-disordered breathing in multiple system atrophy? JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2243 AU - Satoshi Hokari AU - Hideaki Nakayama AU - Takayuki Matsuto AU - Takayoshi Shimohata AU - Toshinori Takada AU - Tetsutaro Ozawa AU - Masatoyo Nishizawa AU - Eiichi Suzuki AU - Ichiei Narita Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2243.abstract N2 - Background: Multiple system atrophy (MSA) is the neurodegenerative disease characterized by autonomic failure, parkinsonism, and cerebellar ataxia in various combinations, and has high frequency of sleep-disordered breathing (SDB), which caused by dysregulation of respiratory control.Aims: This study investigates whether respiratory irregularity is involved in the development of SDB with MSA.Methods: 22 MSA patients (9men, 60.0±6.2 years, BMI 23.1±5.0 kg/m2) were enrolled from January 2007 to June 2010. We performed polysomnography (PSG) and laryngoscopy under propofol sedation. Respiratory irregularity was assessed by approximate entropy (ApEn) of respiratory movement, which is a measure of system complexity (Pincus SM. Proc Natl Acad Sci USA 1991), evaluated from the three-minute data of respiratory movement before falling asleep in PSG (Burioka N, et al. Chest 2003). We chose the age-, sex-, and apnea-hypopnea index (AHI)-matched controls from ordinary obstructive sleep apnea (OSA) patients (BMI 27.6±4.5 kg/m2).Results: PSG demonstrated that all MSA patients fulfilled OSA criteria, and their AHI was 40.6±26 per hour. Laryngoscopy showed that 15 patients (68%) had vocal cord abductor paralysis (VCAP). In the MSA group, there was a significant correlation between AHI and ApEn of respiratory movement (r=0.63, p<0.01). However, AHI had no correlation with age, BMI, duration and severity of MSA, degree of VCAP, and any respiratory parameters. In the control group, their AHI significantly correlated with BMI (r=0.68, p<0.01), but not with ApEn.Conclusions: This study raises the possibility that respiratory irregularity influence the severity of SDB in MSA. ER -