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Characteristics of obstructive sleep apnea in myasthenia gravis patients: a single center study

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Abstract

Background

Recent studies have shown a high prevalence of obstructive sleep apnea in myasthenia gravis compared to the normal population. The aim of this study was to elucidate clinical and polysomnographic differences between clinically stable Korean MG patients with and without OSA.

Methods

A total of 18 consecutively stable MG patients were included in this prospective study. We compared MG patients with OSA (n = 7) and without OSA (n = 11) with respect to the baseline characteristics and overnight polysomnography (PSG) parameters. Demographic parameters, prescribed medication status, thymectomy status, myasthenia gravis foundation of America score, and antibody status were obtained from their medical records. We performed the Korean version of Pittsburg sleep quality index to assess the subjective quality of sleep. Statistical analyses were performed using SPSS version 18.0 with Wilcoxon rank sum test, chi-square test, Fisher’s exact test, and Spearman correlation test.

Results

Among the clinical parameters, MG patients with OSA showed a higher proportion of male sex (p = 0.016) and increased body mass index (p = 0.033). The PSG showed an 11-fold higher supine apnea-hyponea index (AHI) in MG patients with OSA. AHI was further analyzed with supine and non-supine position. MG patients with OSA had a higher supine AHI (19.5 ± 15.8) compared to those without OSA (1.9 ± 1.2, P = 0.008). Most of MG patients with OSA (85.7%) showed more than two times higher supine AHI than non-supine AHI.

Conclusions

This study showed that the occurrence of OSA in patients with MG is associated with male sex and obesity, which is in accordance with the normal population. Moreover, PSG data showed a high prevalence of supine dominant OSA in MG patients with OSA.

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Funding

This work was supported by the Biomedical Research Institute grant, Kyungpook National University Hospital (2016).

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Authors and Affiliations

  1. Department of Otorhinolayngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea

    Sung Jae Heo & Jung-Soo Kim

  2. Department of Neurology, Kyungpook National University Chilgok Hospital, Daegu, South Korea

    Jin-Sun Jun, Ho-Won Lee & Jin-Sung Park

  3. Department of Rehabilitation, Daegu Fatima Hospital, Daegu, South Korea

    Donghwi Park

  4. Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea

    Ho-Won Lee & Jin-Sung Park

Authors
  1. Sung Jae Heo
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  2. Jin-Sun Jun
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  4. Ho-Won Lee
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  5. Jung-Soo Kim
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Correspondence to Jin-Sung Park.

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Heo, S.J., Jun, JS., Park, D. et al. Characteristics of obstructive sleep apnea in myasthenia gravis patients: a single center study. Neurol Sci 40, 719–724 (2019). https://doi.org/10.1007/s10072-019-3706-1

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  • DOI: https://doi.org/10.1007/s10072-019-3706-1

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