Nocturnal Pulse Event Frequency Is Reduced in Multiple System Atrophy
Corresponding Author
Stuart J. McCarter MD
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Address correspondence to Dr McCarter, Department of Neurology and Center for Sleep Medicine, Mayo Clinic College of Medicine, 200 First St SW Rochester MN 55905. E-mail: [email protected]
Search for more papers by this authorElizabeth A. Coon MD
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Search for more papers by this authorEduardo E. Benarroch MD
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Search for more papers by this authorMichael H. Silber MB, ChB
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Search for more papers by this authorErik K. St. Louis MD, MS
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Department of Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Department of Neurology, Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
Department of Clinical and Transational Neurology, Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
Search for more papers by this authorCorresponding Author
Stuart J. McCarter MD
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Address correspondence to Dr McCarter, Department of Neurology and Center for Sleep Medicine, Mayo Clinic College of Medicine, 200 First St SW Rochester MN 55905. E-mail: [email protected]
Search for more papers by this authorElizabeth A. Coon MD
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Search for more papers by this authorEduardo E. Benarroch MD
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Search for more papers by this authorMichael H. Silber MB, ChB
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Search for more papers by this authorErik K. St. Louis MD, MS
Department of Neurology, Mayo Clinic College of Medicine and Science Rochester, Rochester, MN, USA
Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Department of Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Department of Neurology, Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
Department of Clinical and Transational Neurology, Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
Search for more papers by this authorAbstract
Risk of sudden death in multiple system atrophy (MSA) is greatest during sleep with unknown mechanisms. We compared nocturnal pulse event frequency in 46 MSA patients and age-/sex-matched controls undergoing overnight pulse oximetry. Nocturnal oxyhemoglobin desaturation indices and pulse event indices (PEIs) were recorded, and relationships between pulse oximetry variables and survival were analyzed. MSA patients had lower PEI (3.1 ± 5.3 vs. 12.8 ± 10.8, p < 0.001) despite greater hypoxic burden and similar frequency of respiratory events. Nocturnal pulse events were not associated with severity of daytime autonomic failure. Two MSA patients had suspected sudden death, both with severely reduced PEI. MSA patients have fewer nocturnal pulse events compared with controls, despite similar respiratory event frequency, suggesting abnormal cardiac responses to sleep-disordered breathing. Whether this contributes to sudden death in MSA requires further study. ANN NEUROL 2023;93:205–212
Potential Conflicts of Interest
Nothing to report.
Open Research
Data Availability
All relevant data have been shared and published in this article.
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