Risk for sleep apnea and excessive daytime sleepiness in patients with Myasthenia gravis

Abstract

Introduction: The Berlin questionnaire (BQ) has been used to help identify patients at risk for obstructive sleep apnea (OSA) in primary care. The BQ may be a useful adjunct in medicine and sleep research, but little applied in a population of patients with Myasthenia gravis (MG). The presence of sleep disorders in patients with MG may adversely affect the mechanics of breathing in wakefulness and sleep. Currently, few studies in the scientific literature show the presence of respiratory sleep disorders in patients with MG. Some studies have shown poor sleep quality, excessive daytime sleepiness (EDS) and the presence of sleep­disordered breathing, while others have not observed a positive correlation. Objective: To determine the sensitivity of BQ to sleep apnea/hypopnea index (IAH) obtained from overnight standard polysomnography (PSG) and verify the presence of EDS in MG patients. Methods: The Epworth Sleepiness Scale (ESS) and the BQ were applied. After completing the questionnaires, the patients were submitted to PSG. Results: Twenty­two patients (17 women) were evaluated. The mean age was 49.13 ± 11.53. BQ identified 60% of patients as being at high risk for OSA. PSG showed that 54.5% of patients had AHI above 5 and 36.3% AHI above 15. The ESS showed that 68% of the patients presented a score above 10. Conclusion: Our study showed a considerable increase in EDS and The BQ proved good sensitivity to identify patients at risk for OSA in a population of patients with MG.