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European Respiratory Society, European Respiratory Journal, 2(41), p. 368-375

DOI: 10.1183/09031936.00202211

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Atypical patterns in portable monitoring for sleep apnoea: Features of nocturnal epilepsy?

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Cardiorespiratory atypical patterns can be found in routine clinical use of portable monitoring for diagnosis of sleep disordered breathing (SDB).Over 1000 consecutive portable recordings, were analysed to study the potential ictal nature of stereotyped cardio-respiratory and motor patterns.Snoring, airflow, thoracic effort, pulse rate, body position, oxygen saturation and activity of the anterior tibialis muscles were quantified. Recordings showing stereotyped polygraphic patterns recurring throughout the night, but without the features of sleep apnoea (Apnoea Hypopnoea Index <5), were selected for investigation. Once included in the study, patients underwent an attended nocturnal video-polysomnography.A total of 15 recordings showing repeated polygraphic patterns characterized by a sequence of microphone activation, respiratory activity atypical for sleep and wakefulness, heart rate acceleration, limb movements, followed by body position change, were selected for investigation. Once included in the study, patients underwent an attended nocturnal video-polysomnography that showed frontal epileptic discharges triggering periodic electroencephalographic arousals, autonomic activation and stereotyped motor patterns. A diagnosis of Nocturnal Frontal Lobe Epilepsy (NFLE) was established for all patients.NFLE should be taken into consideration in patients with stereotyped and recurrent behavioural features during portable monitoring carried out for diagnosis of SDB.