New Insights into Sleep and Respiratory Impairment in ALS Patients

Research presented at the 2023 American Academy of Neurology (AAN) annual meeting, held from April 22-27, provided new insights into sleep and respiratory impairments in individuals with amyotrophic lateral sclerosis (ALS) from diagnosis through 6 months. These findings confirm earlier studies that show that respiratory impairment is a significant prognostic factor in ALS and suggests that early recognition of sleep and respiratory impairments along intervention may be important tools in ALS management.  

This study from researchers at the University of Torin, Italy, enrolled 37 newly diagnosed patients with ALS and 37 healthy controls between August 2021 and January 2022. At baseline and at 6 months, all participants underwent neurologic examination, polysomnography (PSG), and spirometry; had arterial blood gasses (ABG) measured; and filled out sleep and respiratory questionnaires.

At baseline, researchers observed an excess of periodic limb movement in those with ALS vs the control group (P=.01). An additional finding from the study was a direct correlation between ALS disease progression and both apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) (r=0.546 and r=0.442; P<.05). Over the course of the study, a significant worsening of PSG parameters (P<.05) was observed in patients with ALS compared with controls. Of the patients who were prescribed nocturnal noninvasive ventilation (NIV) (10 out of 37), all showed significant improvement in PSG measurements.