Physiologic events initiating REM sleep in patients with the postpolio syndrome

Siegel, Harrison R.; McCutchen, Charlotte B.; Dalakas, Marinos C.; Freeman, Amanda; Graham, Bonnie A.; Alling, David W.; Satô, Susumu

doi:10.1212/wnl.52.3.516

Cited by 28 publications

(8 citation statements)

References 13 publications

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“…Sleep disorders. These are frequently described [31,32] yet some studies have failed to observe a higher percentage of disorders indicative of sleep apnea in PPS patients versus controls [33].…”

Section: Respiratory Insufficiencymentioning

confidence: 99%

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Postpolio syndrome: a challenge to the health-care system

2005

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Section: Respiratory Insufficiencymentioning

confidence: 99%

“…In general, more aggressive ventilatory support systems are not called for [29]. In the event of sleep apnea, the standard treatment is required [31,32].…”

Section: Treatmentmentioning

confidence: 99%

Postpolio syndrome: a challenge to the health-care system

2005

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“…Muscle atrophy and muscle pain (myalgias) frequently accompany the new muscle weakness. New muscle weakness may also involve bulbar and respiratory muscles resulting in dysphagia [5], dysphonia [6•], respiratory failure [7], and sleep disorders [8,9]. Pain from joint instability is the main musculoskeletal problem (Table 1).…”

Section: Opinion Statementmentioning

confidence: 99%

Post-polio syndrome

Jubelt

2004

Curr Treat Options Neurol

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Post-polio syndrome (PPS) is the term used for the new late manifestations that occur in patients 30 to 40 years after the occurrence of acute poliomyelitis. PPS has been recognized for over 100 years, but is more common at the present time because of the large epidemics of poliomyelitis in the 1940s and 1950s. PPS is manifested by neurologic, musculoskeletal, and general manifestations. Neurologic manifestations include new weakness, muscle atrophy, dysphagia, dysphonia, and respiratory failure. Musculoskeletal manifestations include muscle pain, joint pain, spinal spondylosis and scoliosis, and secondary root and peripheral nerve compression. General manifestations include generalized fatigue and cold intolerance. New muscle weakness of a mild-to-moderate degree responds well to a nonfatiguing exercise program and pacing of activity with rest periods to avoid muscle overuse. Generalized fatigue may be treated with energy conservation and weight loss programs and lower extremity orthoses. Pharmacologic agents also may be helpful, but have not been beneficial in controlled trials. Bulbar muscle weakness includes dysphagia, dysphonia, sleep disorders, and chronic respiratory failure. Dysphagia may be improved with instruction on compensatory swallowing techniques. Dysphonia is treated with voice exercise therapy and voice amplification devices. Sleep disorders are treated similarly to sleep disorders in non-PPS patients. Respiratory failure may be treated with continuous positive airway pressure, bilevel positive airway pressure, and nasal ventilation, or tracheotomy and permanent ventilation if necessary. Musculoskeletal (muscle and joint) pain is treated with weight loss, pacing of activities, use of assistive devices, and prescribing anti-inflammatory medications and physical therapy techniques. Cardiopulmonary conditioning can be improved without muscle overuse with cycle or arm ergometer exercise or dynamic aquatic exercise.

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“…This inefficiency is assigned to more than 10 arousals per hour, seep-related disordered breathing, PLM, changes in the different sleep stages and muscle and/or joint pain. Polysomnographic examination demonstrated greater time spent in superficial sleep than in deeper stages 8 .This occurrence may be credited to the impairment induced by poliovirus on reticular formation, an area known to mediate initiation of REM sleep 8,9 . The latencies of tone reduction (MTR), sawtooth waves (STW), and REM seemed to be meaningfully higher in the bulbar involvement 9 .…”

Section: Sleep Disturbancesmentioning

confidence: 98%

“…Polysomnographic examination demonstrated greater time spent in superficial sleep than in deeper stages 8 .This occurrence may be credited to the impairment induced by poliovirus on reticular formation, an area known to mediate initiation of REM sleep 8,9 . The latencies of tone reduction (MTR), sawtooth waves (STW), and REM seemed to be meaningfully higher in the bulbar involvement 9 . In case of OSA, BiPAP, respiratory physical therapy, as well as, flu vaccines are among the resources indicated 6,8,10 .…”

Section: Sleep Disturbancesmentioning

confidence: 98%

Currents issues in cardiorespiratory care of patients with post-polio syndrome

Orsini

Lopes

Guimarães

et al. 2016

Arq. Neuro-Psiquiatr.

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Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs) in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

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Physiologic events initiating REM sleep in patients with the postpolio syndrome

Abstract: Prolongation of these latencies may be due to prolonged recruitment time for neurons in the pontine tegmentum, following damage from polio. This may be a sensitive marker of a brainstem lesion, and may also represent a type of sleep pathology not previously explored.

Cited by 28 publications

References 13 publications

Postpolio syndrome: a challenge to the health-care system

Postpolio syndrome: a challenge to the health-care system

Post-polio syndrome

Currents issues in cardiorespiratory care of patients with post-polio syndrome

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