Can postural changes in spirometry in children with Duchenne muscular dystrophy predict sleep hypoventilation?

C Pandit; B Kennedy; K Waters; H Young; K Jones; D A Fitzgerald

doi:10.1016/j.prrv.2023.08.002

Can postural changes in spirometry in children with Duchenne muscular dystrophy predict sleep hypoventilation?

Paediatr Respir Rev. 2024 Mar:49:9-13. doi: 10.1016/j.prrv.2023.08.002. Epub 2023 Aug 11.

Authors

C Pandit¹, B Kennedy², K Waters³, H Young⁴, K Jones⁴, D A Fitzgerald³

Affiliations

¹ Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address: chetan.pandit@health.nsw.gov.au.
² Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.
³ Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
⁴ Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Neurogenetics Service, The Children's Hospital at Westmead, Sydney, NSW, Australia.

PMID: 37696714
DOI: 10.1016/j.prrv.2023.08.002

Abstract

Aim: To explore the relationship between postural changes in lung function and polysomnography (PSG) in children with Duchenne muscular dystrophy (DMD).

Methods: In this prospective cross-sectional study, children with DMD performed spirometry in sitting and supine positions. A control group of age and gender matched healthy children also underwent postural lung function testing. PSG was performed within six months of spirometry.

Results: Seventeen children with DMD, aged 12.3 ± 3 years performed sitting spirometry. 14 (84%) performed acceptable spirometry in the supine position. Mean FEV₁_sit and FVC_sit were 77% (SD ± 22) and 74% (SD ± 20.4) respectively, with mean% ΔFVC₍_sit-sup₎ 9% (SD ± 11) (range 2% to 20%), and was significantly greater than healthy controls 4% (n = 30, SD ± 3, P < 0.001). PSG data on the 14 DMD children with acceptable supine spirometry showed total AHI 6.9 ± 5.9/hour (0.3 to 29), obstructive AHI 5.2 ± 4.0/hour (0.2 to 10), and REM AHI 14.1 ± -5.3/hour (0.1 to 34.7). ΔFVC(sit-sup) had poor correlation with hypoventilation on polysomnography.

Conclusion: Children with DMD and mild restrictive lung disease showed greater postural changes in spirometry than healthy controls but lower supine spirometry was not predictive of sleep hypoventilation.

Keywords: Duchenne muscular dystrophy; Polysomnography; Supine spirometry.

Publication types

Review

MeSH terms

Child
Cross-Sectional Studies
Humans
Hypoventilation
Muscular Dystrophy, Duchenne* / complications
Prospective Studies
Sleep
Spirometry